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Prison healthcare possibly the most important setting for improving quality and access – 22 February 2024

By 28th February 2024Previous Seminars


Dr Laura Sheard

Associate Professor, University of York
Honorary Principal Research Fellow, Bradford Institute for Health Research


The quality and safety of healthcare in prisons in the UK has had relatively little attention paid to it, in contrast with the abundance of research on these topics in the hospital environment. Prison based medicine is often viewed as a Cinderella area of healthcare provision; largely hidden away from public scrutiny whilst being an underfunded, undervalued and an unattractive sector for healthcare professionals to work in with a high number of complex patients living in overcrowded conditions. Only a few studies have examined everyday primary care provision in prisons (for example, asthma, diabetes or high blood pressure). Yet, the prison setting represents a unique opportunity to intervene and improve the healthcare trajectories of some of the most marginalised people in society.

In this presentation, Laura spoke about the importance of prison healthcare, how it can be improved and she is passionate about this topic. Laura drew on her own experience of the four years she worked in HMP Leeds alongside findings from several mixed methods studies she led in particular “Qual-P” which focused on understanding and improving the quality of and access to everyday primary care in prisons in the North of England.

A large part of the presentation discussed the major factors which influence the quality of primary care. These are: chronic understaffing; high variability of quality between sites, little to no quality measurement; excessive Did Not Attend rate; community-prison interface incompatibility including IT systems and opioid prescribing; facilitative relationships between healthcare staff and patients.