title: Nursing care of prisoners: staff views and experiences.
abstract: OBJECTIVE
  This paper is a report of a study of the views and experiences of nurses and other prison healthcare staff about their roles and the nursing care they provide to prisoners.
  
  
  BACKGROUND
  Nurses have become the key providers of healthcare in prison settings in England, replacing the previous prison service-run system. However, there is very little evidence about the health services they provide to meet the health needs of prisoners.
  
  
  METHODS
  A ethnographic study was conducted. Participants were 80 healthcare staff working in 12 prisons of all security categories in England. Twelve individual interviews with general healthcare managers and 12 key informant focus group discussions with healthcare staff were undertaken in 2005 using a semi-structured interview schedule. Issues investigated included participants' thoughts and experiences of nursing roles and delivery of primary healthcare. The group discussions and interviews were analysed to identify emerging themes.
  
  
  RESULTS
  Participants gave accounts of day-to-day processes and the healthcare routine. They saw their work as identifying and meeting the health needs of prisoners and maintaining their health, and identified major influences that shaped their daily work, including new ways of working in primary care. They identified how policy and organizational changes were affecting their roles, and acknowledged the conflict between the custody regime and healthcare delivery.
  
  
  CONCLUSIONS
  The move towards a NHS-led primary healthcare service within prisons, predominantly delivered by nurses, has made positive changes to healthcare. Healthcare managers have benefited from the involvement of the local NHS in improving the health of prisoners.
authors.affiliation: Reader Health Economics University of the West of England, Bristol, UK. jane.powell@uwe.ac.uk
authors.forename: Jane
authors.initials: J
authors.lastname: Powell
authors.forename: Francesca
authors.initials: F
authors.lastname: Harris
authors.forename: Louise
authors.initials: L
authors.lastname: Condon
authors.forename: Terry
authors.initials: T
authors.lastname: Kemple
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards*; D004739:England; D005260:Female; D017144:Focus Groups; D006293:Health Promotion; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009740:Nursing Staff / Q000523:psychology; D011320:Primary Health Care; D011329:Prisoners; D011330:Prisons; D036301:Qualitative Research; D013222:State Medicine; D011795:Surveys and Questionnaires; D014218:Triage / Q000592:standards; D055815:Young Adult