Prisoners in England are 41 to 67 times more likely to experience avoidable harm linked to poor healthcare than the general public, according to new research.
A review of medical case notes, published in the journal BMJ Quality & Safety, estimates there could be between 3,000 and 3,700 cases of avoidable healthcare-related harm in prisons each year.
In 2024, around 98,000 people were held in prisons or youth offender institutions in England and Wales.
Responsibility for prison healthcare was handed over to the Department of Health and Social Care in 2006, with the aim of matching community standards.
However, overcrowding, staff shortages and rising levels of self-harm and substance misuse have raised concerns about quality of care.
Researchers reviewed medical records from 18 prisons in England, screening more than 15,000 files and analysing 7,147 in detail. These included prisoners with multiple long-term conditions and a random sample of others.
They discovered 247 incidents of avoidable harm affecting 244 prisoners over 12 months.
The most common issues were pain or discomfort (40%), delays in care (37%) and worsening medical conditions (31%).
Of these, 209 incidents were classed as significant, including cases of severe harm or death, with 27 deaths directly linked.
In one distressing case, a prisoner expressing suicidal intent was not referred for mental health support and later took their own life.
Meanwhile, advanced cancer was missed in another case despite repeated warnings, leading to emergency surgery and intensive care.
Researchers estimate 3,412 avoidable harm incidents per 100,000 patient-years, which equates to around 34 per 1,000 prisoners annually.
Experts note that no firm conclusions can be made because the medical records they reviewed were often incomplete and they only looked at a small number of prisons.
That being said, the study concluded: ‘Efforts in prisons will not give prisoners ‘special treatment’ not afforded to the rest of the population, but will reduce health inequalities faced by a population with complex healthcare needs.
‘This stark disparity underscores the urgent need for government and policy action. Delivering safe, equitable healthcare in secure environments remains a major challenge that demands focused attention.’
Image: Matthew Ansley/UnSplash
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