A survey of primary and specialised healthcare provision to prisons in England and Wales

Background: Prison health care in England, including primary care, is now incorporated into the National Health Service; the impetus for the change is in part due to concern about standards of health care within prisons. The demographic characteristics and health status of patients within prisons are relatively well understood, as are the problems faced by health care professionals. Less is known about current health careprovision. Aims: To describe the organisation of primary health care and specialised services in prisons and compare services available to different types of prison. Method: A piloted questionnaire was sent to the governors of all prisons in England and Wales for completion by the health care manager. Findings: Completed questionnaires were received from 122 (89%) of 138 prisons. The survey showed a low use of information technology (IT). Problems were reported with the recruitment and retention of general nurses in more than 50% of prisons. Prisoners in category A/B (higher security) prisonshad available to them a greater range of health care services compared with those in other prisons. The results suggest that provision of services for chronic diseases and improvements in IT are needed. Problems with the recruitment and retention of general nurses need addressing. The reasons why lower-security prisoners are receiving a narrower range of specialised health care services compared with higher-securityprisoners need justifying.