This report, written in collaboration with the Royal College of Nursing (RCN), sets out proposals to reduce the number of preventable natural deaths in prisons. It identifies how natural deaths occurring in prison might be prevented, where possible, and end-of-life care managed with dignity and compassion.
Drawing together insights from an extensive expert roundtable in November 2019, prisoner consultation and wider research, the analysis covers primary care and chronic disease management, care of older prisoners, dementia care, social care provision, compassionate release, palliative care, culture, workforce and training.
These findings lead to 15 recommendations grouped into the following themes:
- Improve join-up and information sharing across services and departments.
- Implement improvements to primary and secondary care.
- Take steps to improve provision and care for specific vulnerable groups.
- Improve end of life care across the prison estate.
- Enhance the profile of prison healthcare as a career.
- Improve learning and investigations.
Ann Norman, the RCN’s Professional Lead for Criminal Justice, said:
"We are seeing a growing number of natural deaths in custody and this has now reached an unacceptably high level. These deaths may be prevented if there is adequate care, particularly for those prisoners with long-term chronic conditions. The Government must act now to make sure that prisoners’ health is properly managed, as it would be in the community.”
Juliet Lyon, Chair of the Independent Advisory Panel on Deaths in Custody, said:
“Many so-called natural deaths in prison can and should be avoided. Our report draws together information from health and justice experts, investigators and people in prison to examine how such deaths could be prevented and how end of life care can be managed with dignity and compassion. During Covid-19, the struggle to identify prisoners who, for clinical reasons, would have been shielded in the community and the failure to effect safe temporary release for all but a few, has thrown the challenges presented by the poor health of the prison population into sharp relief.”