Description

The objective of the study is to identify the most important local and generalisable issues, and how to achieve improvements in the health status and address health needs of prisoners in London. Combined retro and prospective needs assessments were carried out in eight London prisons, between 1999- 2001, using the University of Birminghams tool kit. Results were systematically appraised through a randomly allocated peer appraisal. More than 140,000 prisoners either on remand for a short term or sentenced for a specific period of time were involved.

The main results show many gaps in current service provision. Primary care, mental health and substance misuse services cannot be provided effectively without being an integral part of the NHS. Current prison regimes and environment are major hindrances to progress towards any effective programmes to provide the health care prisoners require.

The study concluded that selective rather than comprehensive health needs assessment exercise might be more effective. Subjective impressions should be an integral part of the assessment. However, it is important that developments such as market testing do not jeopardise partnership work to integrate prison healthcare into healthcare for the local community. There is a danger that political imperatives may override any logical scientific assessment of needs and appropriate responses.