The quality of health care in prison: results of a year's programme of semistructured inspections.
OBJECTIVE
To assess, as part of wider inspections by HM Inspectorate of Prisons, the extent and quality of health care in prisons in England and Wales.


METHODS
Inspections based on a set of "expectations" derived mainly from existing healthcare quality standards published by the prison service and existing ethical guidelines; questionnaire survey of prisoners.


METHODS
19 prisons in England and Wales, 1996-7.


METHODS
Appraisals of needs assessment and the commissioning and delivery of health care against the inspectorate's expectations.


RESULTS
The quality of health care varied greatly. A few prisons provided health care broadly equivalent to NHS care, but in many the health care was of low quality, some doctors were not adequately trained to do the work they faced, and some care failed to meet proper ethical standards. Little professional support was available to healthcare staff.


CONCLUSIONS
The current policy for improving health care in prisons is not likely to achieve its objectives and is potentially wasteful. The prison service needs to recognise that expertise in the commissioning and delivery of health care is overwhelming based in the NHS. The current review of the provision of health care in prisons offers an opportunity to ensure that prisoners are not excluded from high quality health care.
Reed
J
J
HM Inspectorate of Prisons, Home Office, London. JohnReedCB@compuserve.com
Lyne
M
M
D002017:Budgets; D004739:England; D006282:Health Personnel; D006296:Health Services / Q000191:economics / Q000592:standards*; D006301:Health Services Needs and Demand; D006801:Humans; D008605:Mental Health Services / Q000191:economics / Q000592:standards; D010561:Personnel Staffing and Scheduling; D010604:Pharmacy; D011320:Primary Health Care / Q000191:economics / Q000592:standards; D011330:Prisons / Q000191:economics / Q000592:standards*; D011787:Quality of Health Care; D012017:Referral and Consultation; D012944:Social Support; D013192:Staff Development; D014852:Wales