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Your health in prison

Information about health services in prison, how to access them, and how to complain if something goes wrong.

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Can I access healthcare services in prison?

You should be able to get the same quality and range of healthcare as you would in the community.

There will be a place in the prison where the healthcare services are located.

Can I see a doctor or nurse in prison?

If you need to see a doctor or a nurse, speak to a prison officer on your wing or put in an application form.

Nurses and pharmacists will be able to deal with many problems without you needing to see a doctor. But ask to see a doctor if you think you still need to.

You can ask to see someone else in the healthcare team if you are not happy with what the doctor, nurse or other member of healthcare staff has told you about your health problem.

Can I see a dentist or an optician?

Tell prison staff if you need to see a dentist or an optician.

Any treatment you get will be free unless it is not for medical reasons.

You will be able to get free glasses or other things for your eyes if you need them.

Can I see a specialist?

If your health problem cannot be dealt with by healthcare staff at the prison, one of these things may happen:

  • The prison may get a specialist healthcare person to come into the prison to see you
  • You may be moved to another prison to get the healthcare
  • You may need to be taken to a hospital outside the prison. If this happens, the prison will still be in charge of you.

How do I get my medication in prison?

You cannot keep any medicines you bring with you into prison.

Tell the staff on reception, a doctor or a member of the healthcare team if you are taking any medicine.

A doctor in the prison will prescribe you the medicine you need. You can get this medicine from the chemist in the prison.

You may be allowed to keep your medicine with you after this. Staff will decide if you can do this and let you know.

Some medication is controlled in prison so you may not be able to take the same medication you did in the community. The Royal College of General Practitioners has guidance on this entitled ‘Safer Prescribing in Prisons Guidance for clinicians’.

Can I get support with my mental health?

Many people have mental health needs. You should speak to healthcare staff if:

  • You had a psychiatrist or community psychiatric nurse or spent time in hospital because of mental illness.
  • You were taking medication in the community for your mental health.
  • You feel worried or upset.
  • You feel low or depressed.
  • You feel anxious or frightened.
  • You have difficulty sleeping or feel very tired.
  • You think people are talking about you.
  • You are hearing voices inside your head.
  • You feel very angry.
  • You feel confused or forgetful.
  • You keep thinking the same thoughts over and over.

External appointments

You may sometimes need to attend healthcare appointments outside of the prison.

The Prevention of Escape – External Escorts Policy Framework includes guidance about escorts and the use of restraints during these visits.

Escorts

For an escort to take place it must be considered necessary. This includes considering if your healthcare needs could be met in prison, if you could be released on temporary license (ROTL) to attend the hospital and if the appointment could be postponed until after release without compromising your health.

External escorts must consist of at least two prison officers, with at least one of them being the same legal gender as you, unless there are exceptional circumstances.

When escorting transgender prisoners, it is recommended that, where possible, the second member of staff is the same gender as the prisoner’s identified gender if this differs from their legal gender.

An escort risk assessment must be completed if you are admitted into hospital. Healthcare staff must be included in this process.

Restraints

As part of the escort risk assessment, staff will consider whether there is a need for restraints. They will consider any medical concerns and security risks related to this.

The policy states that restraints will not be routinely used in some circumstances, such as on a tetraplegic or paraplegic prisoner. See the policy for more details.

The policy also provides further guidance about the use of restraints for people who are seriously or terminally ill, pregnant people and mother and baby escorts.

What if there is reason to remove the restraints?

Restraints should only continue to be applied in hospital if necessary and proportionate.

If clinical staff advise that restraints are obstructing medical treatment in a non-emergency situation, a decision to remove them will be made by the duty manager.

However, in a medical emergency, restraints may need to be removed immediately, and escorting staff must comply with requests to remove them.

What about my privacy?

Your privacy must be considered as part of the escort risk assessment, particularly if you are having an intimate examination or procedure.

Privacy should be accommodated if it does not compromise the security of the escort.

Privacy screens and escort chains can be considered. Escort chains can be used to allow you more movement and privacy whilst medical staff are examining you, when using the toilet or if you are admitted to hospital overnight. However, the policy states ‘escort chains are not to be used as a less secure form of restraint… If no restraints are to be used, then this includes the use of both the D Cuff escort chain or an escort chain’. If you are pregnant, staff will not be present in the delivery room or any room where an intimate examination is taking place, unless you request it or there are exceptional reasons.

Under normal circumstances restraints must be removed for the duration of an operation once you are placed under anaesthesia. Restraints must be re-applied as soon as you exit the theatre and are in recovery.

Please see the Prevention of Escape – External Escorts Policy Framework for further details.

Family visits in hospital

As far as possible, hospital visits must seek to replicate prison visits.

They will be approved on an individual basis and visitors should book visits in advance via the standard prison visits booking procedures.

Visitors must produce identification in line with the Management of Security at Visits Policy Framework.

If a visitor arrives unannounced, staff should give them all the information needed to book a visit. There may be occasions where the prison will allow the visit to go ahead if identification can be confirmed but this will be assessed on an individual basis.

Visitors will remain under the same restrictions as when visiting the prison and will need to adhere to the prison prohibited items list.

Visitors cannot give you any items during the visit.

Complaints about healthcare

If you are not satisfied with the service you have received you may wish to make a complaint. You should speak to the healthcare team in the prison to do this.

Healthcare services should have their own complaints process and be able to give you information on this. This is a separate complaints system to the one used by the prison.

If you are not happy with the response you can submit a complaint to NHS England. You can contact them at:

NHS England

PO Box 16738

Redditch, B97 9PT

Tel: 0300 3112 233

You should include the following:

  • your name and address
  • the name of the service you want to complain about
  • a clear description of what you want to complain about and when it happened
  • any relevant documents you have

NHS England advise that they need consent to share the complaint with the service so they can investigate it. They suggest you include the following line in order to speed up the process:

“I give permission for my complaint to be shared with (insert name of GP / dental surgery, etc) in order for NHS England to carry out an investigation”

It is worth noting that NHS England is only obligated to investigate complaints made within 12 months of the date of the incident.

NHS England have a guide which goes into further detail about how to make a complaint about healthcare entitled ‘Giving feedback or making a complaint about your health care’.

If you are not happy with the response by NHS England you can then ask the Parliamentary and Health Service Ombudsman to look at your complaint.

All post should be sent to their main office as follows:

The Parliamentary and Health Service Ombudsman

Citygate

Mosley Street

Manchester

M2 3HQ

You can also write to the ombudsman at

The Parliamentary and Health Service Ombudsman

Millbank Tower

Millbank

London

SW1P 4QP

You can also call them on 0345 015 4033, Monday to Thursday 9am to 4pm and Friday 8.30am to 12pm.

NHS complaints advocacy services

An NHS complaints advocacy service can support you with making a complaint about the treatment or care you have received from an NHS service.

They can support you if you are yet to start the NHS complaints process, or if you are part-way through the process. They cannot support you if the complaint has already been fully investigated.

NHS complaints advocacy services are independent of the NHS, free, confidential, and you do not need any support needs to access them.

Some advocacy services will accept referrals for complaints about things that happened more than 12 months ago, but if NHS England refuse to investigate due to the time frame, the advocacy service is unlikely to be able to help you further.

A trained advocate can support you with the following:

  • provide information about how the NHS complaints process works
  • help you understand what you can expect to achieve from the NHS complaints process
  • give you an opportunity to speak confidentially to someone who is independent of the NHS about the complaint
  • help you to write a complaint letter and ensure that it is sent to the right people
  • help you to monitor the progress of the complaint with the organisation or individual responsible
  • put you in touch with other people or services that might be able to help
  • help you to prepare for any meetings that may be offered as part of the NHS complaints process

NHS complaints advocates are not medically trained, not able to offer legal advice, and cannot tell you what you should do. They also cannot support you with claims for compensation due to medical negligence.

Which advocacy service you should contact will depend on where you are currently living.

In prison, you should contact the provider for the area in which your current prison is based, even if you are complaining about a healthcare service in another area.

Below are some of the main providers and the general areas they cover. Contact numbers are not currently cleared across prisons so you will need to request they are cleared before you can call them. Alternatively, you can write to them using the addresses provided below.

Voiceability

  • Provides services across England including in Bedfordshire, Doncaster, Essex, Hampshire, Lincolnshire, Manchester, North Northamptonshire, Northumberland, Oxfordshire, Warwickshire and Wolverhampton.
  • Write to: VoiceAbility, c/​o Sayer Vincent, 110 Golden Lane, London, EC1Y 0TG
  • Call: 0300 303 1660

POhWER

  • Covers many areas of England including Birmingham, Cambridgeshire, Hertfordshire, Leicestershire, Norfolk, Peterborough, Suffolk, Surrey and some London boroughs.
  • Write to: POhWER Support Centre, Hertlands House, Primett Road, Stevenage, Hertfordshire, SG1 3EE
  • Call: 0300 456 2370

The Advocacy People

  • Covers the South of England, including Dorset, Kent, East Sussex, Milton Keynes, Wiltshire, West Berkshire, and the London boroughs of Southwark and Wandsworth.
  • Write to: The Advocacy People, PO Box 375, Hastings, East and West Sussex, TN34 9HU
  • Call: 0330 440 9000

Llais

  • Covers NHS complaints advocacy in Wales. Contact them for details of local services or ask a friend or family member to look online.
  • Write to: Llais, 3rd Floor, 33 – 35 Cathedral Road, Cardiff, CF11 9HB
  • Call: 02920 235 558.

Please note that the areas listed above are not comprehensive and may be subject to change.