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Lookup NU author(s): Dr Sue BellassORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2023 Royal College of General Practitioners. All rights reserved. Background: Primary care for routine healthcare conditions is delivered to thousands of people in the English prison estate every day but the prison environment presents unique challenges to the provision of high-quality health care. Little research has focused on the organisational factors that affect quality of and access to prison health care. Aim: To understand key influences on the quality of primary care in prisons. Design and setting: This was a qualitative interview study across the North of England from 2019 to 2021. Method Interviews were undertaken with 43 participants: 21 prison leavers and 22 prison healthcare professionals. Reflexive thematic analysis was undertaken. Results: The overarching organisational issue influencing quality and access was that of chronic understaffing coupled with a workforce in flux and dependence on locum staff. This applied across different prisons, roles, and grades of staff, and was vocally discussed by both patient and staff participants. Intricately related to understaffing (and fuelled by it) was the propensity for a reactive and sometimes crisis-led service to develop that was characterised by continual firefighting. A persistent problem exacerbated by the above issues was unreliable communication about healthcare matters within some prisons, creating frustration. Positive commentary focused on the characteristics and actions of individual healthcare professionals. Conclusion: This study highlights understaffing and its consequences as the most significant threat to the quality of and access to prison primary care. Strategies to address health care affecting prison populations urgently need to consider staffing. This issue should receive high-profile and mainstream attention to address health inequalities.
Author(s): Sheard L, Bellass S, McLintock K, Foy R, Canvin K
Publication type: Article
Publication status: Published
Journal: British Journal of General Practice
Year: 2023
Volume: 73
Issue: 735
Pages: e720-e727
Online publication date: 28/09/2023
Acceptance date: 05/06/2023
Date deposited: 17/07/2025
ISSN (print): 0960-1643
ISSN (electronic): 1478-5242
Publisher: Royal College of General Practitioners
URL: https://doi.org/10.3399/BJGP.2023.0040
DOI: 10.3399/BJGP.2023.0040
PubMed id: 37666512
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