Role Of Nurses In Caring For Health Of Prisoners

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A major study by the University of the West of England commissioned by the Department of Health Policy Research Programme, has highlighted the role of nurses in caring for the health of prisoners and the need for consistency in service delivery.

Responsibility for health care in prisons has been transferred from the Home Office to the NHS and is now mostly commissioned and provided by local NHS Primary Care Trusts (PCTs). There has been a gradual handover of health care services from the Prison Service to the NHS with most of the health care services in prisons being delivered by PCTs.

There are currently around 80,000 prisoners held in 142 institutions in England and Wales. The aim of the research was to build up a clear picture of the way in which health services are delivered in prisons and to focus on any specific areas in which further support is needed for the nurses who currently deliver a large part of the service and any changes that are needed under the new arrangements.

The research was carried out by the late Gill Hek*; Louise Condon and Francesca Harris (Research Nurses, UWE) who were seconded from local PCTs to undertake the research; Jane Powell, Moira Plant and Sally Price (all from UWE); and Terry Kemple a local research GP. The researchers visited twelve prisons in England and carried out interviews with 80 nurses and other health staff as well as interviewing a sample of 111 prisoners. Prisoners were questioned about their experience of health care in prison compared to the health care they had experienced outside. They were also asked about any specific health issues such as asthma or diabetes.

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Jane Powell on behalf of the research team says," Many of the nurses recognise the limitations of the service in the past, but are now more aware of the potential of their role to make a difference to prisoners. They can see that health promotion and education are areas in which they will be able to make a significant contribution to the health needs of prisoners".

"Amongst the prison population smoking rates are high, as well as past use of illegal drugs, hazardous drinking, and there is an increased risk of hepatitis, STDs, HIV and communicable diseases amongst prisoners. In addition prisoners are more likely to have mental health problems than the rest of the population and previous research has shown that imprisonment tends to make mental health problems worse."

"Improving the health of prisoners may also help to reduce re-offending and reduce the spread of diseases and social problems such as drug abuse back into society when prisoners leave prison. Health promotion is key in this process. Prisoners need to be encouraged and supported in managing their own health within the constraints of the prison regime, and become more self aware of their own health needs."

"From the perspective of the prisoners, the findings indicate the importance of having their health needs assessed and managed whilst in prison. For the nurses, there are issues about identifying and meeting the needs of prisoners, conflict between the prison regimes and care, and the development of the nursing workforce to meet the needs of prisoners in the modern NHS."

Nurses are at the front line of health care in prisons, and Francesca Harris from the research team has taken the lead in producing a good practice guide which went out to 142 prisons in England and Wales and will help the service to be delivered in a consistent and up to date manner.

Before carrying out any interviews with nurses and prisoners the researchers carried out a complete and systematic review of the literature and this collected material has been a valuable resource for nurses.

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