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Rebalancing Act

A resource for Directors of Public Health, Police and Crime Commissioners and other health and justice commissioners, service providers and users

People in contact with the criminal justice system (CJS) include those in prison and other prescribed places of detention as well as those living in the wider community. There are for example offenders serving community sentences; those in the community on licence, and those ‘known to the police’. Nearly 2 million people a year in England have contact with police forces resulting in a record on the Police National Computer (PNC). Among this population are many who experience significant issues with health problems (including physical and mental health and substance misuse) which are often complicated by social issues such as
unemployment, indebtedness, homelessness or social isolation. We describe such people as having “multiple and complex needs” which means typically that no one agency or organisation working alone can address those needs. Further, there are often strong links between such needs and offending/ reoffending behaviour - so reducing criminal behaviour and improving community safety can be an outcome of addressing these health and social care needs. Finally, people in contact with the CJS often experience significant health inequalities: a higher burden of disease and less access to health services, including preventive services. Addressing the health needs of this population can contribute to reducing inequalities in wider society.

In 2013, Revolving Doors Agency, working with Public Health England and the Probation Chiefs Association, published Balancing Act- A briefing for Directors of Public Health: Addressing health inequalities among people in contact with the criminal justice system. Directors of Public Health (DsPH) not only have a legal duty to address health inequalities experienced within their local authority boundaries, but also have a strong track record of good practice and innovating in this area. However, people in contact with the CJS were often not ‘visible’ in Joint Strategic Needs Assessments or Health and Wellbeing Strategies published by DsPH although clearly were among groups included among those experiencing health inequalities. “Balancing Act” was an attempt to improve the visibility of this group and support DsPH in developing evidence-based health and social care needs assessments. Developments in recent years have added to the responsibilities of DsPH, and have created new partners who, we believe, have a common interest in addressing health inequalities among people in contact with the CJS. Chief among these are Police and
Crime Commissioners (PCCs), and police services, as there is a growing recognition of the associations between health and social inequalities, and offending and reoffending. Therefore, we realised a need to ‘rebalance’ our approach - recognising PCCs, police forces and other criminal justice agencies as key partners in addressing health equalities as well as the role of health agencies in reducing reoffending by addressing healthrelated drivers of criminal behaviour.

This new resource, Rebalancing Act, is therefore intended to support a broad range of stakeholders at local, regional and national level, to understand and meet the health and social care needs of people in contact with the CJS and through this engagement reduce offending and improve community safety.