The issues of prisoner healthcare are not new, but in publishing this report including the direct experiences of people who have been through the prison system, we hope to bring these concerns to the forefront of thinking, and engage in collaborative discussions about solutions.
In order to explore the issues with physical healthcare in prison, we carried out a survey of people who have been released from prison and have received support from Nacro with their resettlement journey. We asked people to complete the survey if they had been released from prison in the last five years, although it is important to acknowledge that their survey responses may relate to more historic experiences. 101 people completed the survey between May and October 2024.
This briefing examines:
- the physical health of people in prison, and how this is generally worse than people in the community;
- the impact of imprisonment on physical health, including the impact of overcrowding and unsanitary conditions, lack of purposeful activity and poor quality diets;
- the problems and barriers to accessing healthcare services, including difficulties in accessing treatment and lengthy waiting lists, missed appointments, issues with medication, feeling ‘unseen’, and issues on transfer between prisons and on release.
Nacro Physical Healthcare Survey key findings:
- Almost half (43%) said they did not get the treatment they needed from the medical professionals they saw
- Three quarters of people (75%) said they were aware of people not able to get the medication they needed whilst in prison and 65% said that they saw people using other people’s medication. 64% said that they knew people who used illegal substances because they couldn’t get the medication they needed
- 60% said they had a longer period of pain and discomfort because they did not get the treatment they needed, and 12% said that because they did not get the treatment they needed they were then not able to work when they were released from prison
- A third of people (34%) who reported they had appointments at a hospital outside prison during their sentence were not able to attend the appointment
- One third of people (34%) were aware of people who had resorted to doing dentistry on themselves or others because they were unable to see a dentist
- 40% waited for a month or longer for a GP appointment, and a further 7% said they never got an appointment
- More than one in three (38%) waited longer than three months for a dentist appointment, with a further 24% saying they never got an appointment
- Over a third of people (35%) who needed to see an optician said they never got an appointment
Summary of our main recommendations
We set out recommendations at the end of this report which we believe will help people in the
justice system get the support they need with their health. These are grouped as follows:
- Tackling the overuse of imprisonment: Policies that aim to reduce overcrowding and reduce our reliance on imprisonment by providing community alternatives must form part of the solution.
- Limiting the impact on physical health: We set out recommendations that we believe will help to tackle the fundamentally unhealthy environment of prisons.
- Overcoming the barriers to accessing healthcare services: We set out recommendations to address the issues that prevent people from getting the treatment and support they need.