The number and proportion of people in prison who are aged over 50 has been steadily increasing. This trend is projected to continue for the next 5 years and beyond. Older people in prison have a variety of needs; high prevalence of long-term chronic disease, disease risk factors, reduced mobility levels, and sensory impairment are just some of the needs this population group have. Prison services, regimes and the physical estate have not historically been designed around such needs and effectively responding to them can be challenging. Much has already been done in recent times to improve the health and wellbeing of this group, but further action is required if this is be improved further and meet equivalence with age- matched community peers.
An initial and fundamental step in the process of improving health and wellbeing of older people in prison is to fully ascertain the nature and level of need that exists among that cohort within a specific prison establishment. This is not necessarily a static phenomenon for an individual prison due to prisoner churn, prison re-rolling and the prison reconfiguration programme. However, undertaking a formal Needs Assessment at a prison level is an evidence-based way to fully characterise the needs of this group. When this approach covers the key themes outlined in this document, detailed insight into the nature and extent of need can be generated. In turn, this understanding of need should then inform the commissioning and delivery of services to meet the identified need. At the very least, this involves health and social care to be considered together in a holistic way and requires collaboration from a number of partner organisations.
This document aims to provide guidance to those commissioning or undertaking Health and Social Care Needs Assessments of the older prison population. It has been written by Public Health England’s Health and Justice Team, with significant input from partner organisations from across the health and justice system, including input from service users. The document is structured around 13 chapters which each address a key theme that should be considered when undertaking a needs assessment of older people in prison. Each chapter has a common structure to it, to guide the reader systematically through the document and the process of undertaking a needs assessment.
This document should provide an important contribution to improving the health and wellbeing of older people in prison.