Prisoners missing out on hospital treatment

New research from the Nuffield Trust has found that four in ten hospital appointments made for prisoners are cancelled or missed.

Analysis of prisoners’ use of hospital care in England, drawing on over 110,000 patient hospital records for prisoners at 112 prisons in 2017-18, also found that prisoners receive around a quarter less hospital care than expected compared to the general population, and there are signs of lapses of care within prison for certain groups.

The Nuffield Trust also publishes new information on the number of pregnancies and births in prison, revealing that over one in ten pregnant prisoners gave birth either in prison or on their way to hospital in 2017/18. The think tank says this points to wider problems meeting the health care needs of pregnant women in prison.

The health charity says these findings raise concerns about how prisoners are able to access hospital care, highlighting the legacy impact of a drop in frontline prison staff alongside the burgeoning prison population. This, the Nuffield Trust says, is likely to have reduced the numbers of prison escorts to transport and guard prisoners whilst at hospital, meaning cancelled appointments and restricted access to hospital care for all but the most urgent of cases.

Prisoners had 24 per cent fewer inpatient admissions and outpatient attendances than the same age and sex demographic in the wider population, and 45 per cent fewer attendances at accident and emergency departments in 2017/18. Additionally, 40 per cent of outpatient appointments for prisoners were not attended (32,987 appointments), double the proportion of non-attended appointments in the general population. Over three quarters of missed appointments were cancelled in advance or recorded as people simply not turning up on the day. The value of latter equated to around £2 million for the NHS.

The research, funded by the Health Foundation, points to a number of key recommendations for the public authorities involved in prisoner health. These include publishing data on pregnancies and births within prison, providing greater transparency over prisoner escort numbers, and making better use of hospital data.

Dr Miranda Davies, senior fellow at the Nuffield Trust, said: “The punishment of being in prison should not extend to curbing people’s rights to healthcare. Yet our analysis suggests that prisoners are missing out on potentially vital treatment and are experiencing many more cancelled appointments than non-prisoners.

“As well as the moral case for high quality prisoner health, improving prisoners’ access to hospital care makes sense from a practical and financial perspective too. Delays in treating conditions such as cancer or diabetes early can result in longer and more complex treatments when prisoners do eventually get to hospital. Ensuring prisoners receive the healthcare they need is also a vital part of rehabilitation and could help ensure people leave prison less likely to reoffend.”