The Older Prisoner Health and Social Care Assessment and Plan (OHSCAP) versus Treatment as Usual: A Randomised Controlled Trial

Katrina Forsyth, Roger T Webb, Laura Archer Power, Richard Emsley, Jane Senior, Alistair Burns, David Challis, Adrian Hayes, Rachel Meacock, Elizabeth Walsh, Stuart Ware, Jenny Shaw

Research output: Working paper



Older adults are the fastest-growing subgroup among prisoners in England and Wales and have more health and social care needs than their younger counterparts and those the same age living in the community . We hypothesised that the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) would significantly increase the proportion of met health and social care needs three months after prison entry, compared to treatment as usual (TAU).


A parallel randomised controlled trial (RCT) was conducted at ten prisons in the North of England. Males aged 50 and over received the OHSCAP or TAU. The allocation procedure was minimisation with a random element. The OHSCAP process involved individuals having their needs assessed, care plans being created and reviewed. TAU encompassed the standard prison health assessment.

The trial was registered with the UK Clinical Research Network Portfolio (ISRCTN ID: 11841493) and was closed on 30th November 2016.


Data were collected between 28th January 2014 and 06th April 2016. 249 older prisoners were assigned TAU of which 32 transferred prison; 12 were released; 2 withdrew and 1 was deemed unsafe to interview. 253 prisoners were assigned the OHSCAP of which 33 transferred prison; 11 were released; 6 withdrew and 1 was deemed unsafe to interview. Consequently, data from 202 participants were analysed in each of the two groups. There were no significant differences in the number of unmet needs as measured by the Camberwell Assessment of Needs – Forensic Short Version (CANFOR-S). The mean number of unmet needs for the OHSCAP group at follow-up was 2.03 (SD=2.07) and 2.06 (SD= 2.11) for the TAU group (RR = 0.088; 95% CI -0.276 to 0.449, p = 0.621).

No adverse events were reported.


Those received the OHSCAP did not experience an improvement to the meeting of the needs in comparison to the TAU g. This was largely due to the OHSCAP not being implemented as planed due to a national prison crisis.

The OHSCAP was fundamentally not implemented as planned, partly due to the national prison staffing crisis that ensued during the study period. Therefore, those receiving OHSCAP did not experience improved outcomes compared to those who received TAU.
Original languageEnglish
PublisherResearch Square
ISBN (Electronic)2693-5015
Publication statusPublished - 9 Dec 2020


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