Yes, people in prison have access to healthcare. It is mandatory that all prisons in England have a healthcare team and a mental health team.

Prisons in England and Wales must have physical and mental healthcare teams available. Prison healthcare teams are required to:

• Assess health when someone first comes into prison, including physical and mental health, substance misuse, and whether there is a risk of self-harm
• Test for tuberculosis
• Provide health checks and screenings, including for Hepatitis B and C, HIV, sexually transmitted infections, learning disabilities, heart conditions, and cancers
• Promote health and wellbeing
• Supply medications
• Monitor chronic conditions
• Manage worsening health and health emergencies
• Explore the possibility of and treat mental health conditions
• Ensure continuity of care when coming into and leaving prison

All prisons in England and Wales are also required to have a dentistry service. The dentist service provider may be a separate organisation from the main healthcare provider in the prison, but people in prison will be able to submit an app to schedule a dentist appointment.

Prison healthcare teams include registered nurses and doctors. Prison mental health teams include psychologists and psychiatrists. Dentists, optometrists, specialists, and physical therapists may also regularly come into the prison to give appointments and hold clinics. In women's prisons, healthcare teams will also include professionals dedicated to women's health issues. 

Prison healthcare teams will also have different supportive staff, including medical assistants, administrators, and health educators to help manage the delivery of services and records.

Healthcare teams in prison have a duty of care to make sure the care given to people in prison is equivalent to the care given in the community. This includes physical and mental health services that are of the same level and quality as in the community. However, in prison, there are some key differences in how healthcare is delivered that have to do with security and safety protocols.

Please note that healthcare teams in prison are run by the NHS, not the prison. They have to meet NHS standards and also abide by the rules of the prison.

If a patient had an appointment or operation scheduled before coming to prison, it is important to let the prison healthcare team know. You can do this by contacting Safer Custody. If your loved one is in a London prison, you can contact Call PHILL (Prison Health Information and Liaison Line), which is a direct line to the healthcare team. If your loved one has a Pact Family Link Worker, you can also contact them.

If the appointment is scheduled in a local hospital, it is possible for your loved one to keep that appointment and be transferred their by the prison. If the hospital is not near the prison and the prison cannot transport the patient, then the prison healthcare team will have to make a referral to a local hospital.

The prison healthcare team will not bother to make a new referral if the patient will be released from prison before the date of their appointment.

If a patient has a very urgent appointment (e.g., an operation for cancer), they will be put on a 2-week referral route to make sure their appointments are scheduled quickly. 

There are often a lot of logistics to work out between the prison and the hospital, which may mean that an appointment or operation may be postponed, rescheduled, or cancelled, depending on the practicalities, security considerations, and the needs of the patient. 

When someone enters prison and goes through the healthcare induction process, the individual will be asked if they consent to be registered with the prison GP. If they say yes, then their records from their GP in the community (or from a previous prison) will be transferred to the prison. Here are some important things to note:

A new prisoner might say no to registering with the prison GP, perhaps because they don't understand the benefits of consenting or because they don't trust the prison system. Some people may simply prefer to have their records in one place, especially if they are serving a short sentence. Families can help by encouraging their loved one in prison to consent to register with the prison GP and share their community health records, where appropriate.

There can be mistakes when medical records are transferred into a prison, like technical errors. Families may want to help by advocating for their loved one in prison if this happens, which may mean sending important health documents into the prison's Safer Custody team, to Call PHILL (in London prisons only), or by contacting Pact's Family Link Worker at the prison.

If medical records are not held by the patient's GP, they will not be transferred to the prison healthcare team. This may be the case for someone who has had mental health treatment in the community. Families can help healthcare teams fill in the gaps here by sending in these records using Safer Custody, Call PHILL (in London prisons only), or by contacting Pact's Family Link Worker at the prison.

Yes, a diagnosis made on the outside should be recognised as valid by services in prison in the same way as it would be if your loved one was entering any new service in the community. Services in prison don't want to re-investigate or re-diagnose someone's neurodivergent condition if they don't have to.

It shouldn't matter if the diagnosis was made by a private service or the NHS, or whether it was made when your loved one was a child -- it should be treated in the usual way. Prison support and healthcare teams are expected to accept the diagnoses that have been made by other professionals following the same process as services in the community.

It may be possible, however, that prison mental health teams will reassess the medications your loved one is taking to ensure it is the appropriate dose or to make sure that it meets the security requirements of the prison.

No, prisoners almost always have to get any medication they need re-issued by the prison healthcare team from the inside. They're not allowed to take in their own medication from home unless there are very specific circumstances. 

An exception might be made if your loved one needs specialist medication that isn't stocked in the prison pharmacy and is critical for their health. In these circumstances, a prison healthcare team might be able to accept the patient's own medication for a limited time, until they can get what is needed in stock. They would change to medication issued by the prison healthcare team as soon as possible. They'd also need to ensure that any security concerns could be addressed.

Possibly -- it depends on what equipment is needed, whether there are security concerns, and whether the equipment could be issued from within the prison instead. 

The healthcare team have to give their approval and agree that the equipment is important.

Glasses, hearing aids, a wheelchair, catheter, stoma bag, a prosthetic leg, or a CPAP machine are examples of things that might be allowed from home. All these items would have to go through security.

Sometimes the healthcare team may work with the GP or hospital to get suppliers to deliver medical equipment directly to the prison. They might allow you to bring in equipment on a short-term basis whilst this is being organised. Stoma bags, for example, can take 6-8 weeks to be delivered to the prison by suppliers, so in the meanwhile healthcare teams may accept stoma bags from home being used. 

Always make arrangement in advance and get written confirmation from the prison healthcare team before sending in equipment. Don't just turn up at the prison and drop it off, otherwise there's a risk of delays or things going missing.

Steps to follow:

• Contact the prison healthcare team to confirm the necessity of the equipment.
• Obtain approval and written confirmation before sending anything.
• Ensure items are correctly labelled and packed for security checks.
• Check for possible delays in receiving or replacing the equipment inside the prison.

If contact lenses are needed for a clinical reason, they are more likely to be approved. If the contact lenses are being requested for purely cosmetic reasons, they almost certainly will not be approved.

It can be hard to look after non-disposable contact lenses in a prison environment, so healthcare teams are often reluctant to issue these.

Prison healthcare teams make an assessment about whether a patient can have their medication 'in possession' or not at the point of reception (i.e., when someone first comes to prison). This assessment is primarily about health and safety and has nothing to do with the person's offence or their behaviour. 

When someone first comes to prison, they usually won't be allowed to have their medication in possession. However, once they're settled in and know the medical team, this assessment can change. Your loved one will be more likely to be allowed to have their medication in possession (i.e., kept in their cell) if they have been compliant with picking up and taking their medication when they're supposed to. 

Medication that is considered 'tradeable' in prison must always be collected by your loved one from the pharmacy hatch. If your loved one takes medication that is not considered tradeable, they may potentially be allowed to keep it with them in their cell. 

'Tradeable medication' means drugs that could be used as currency in prison. This might be medication that gives you a 'buzz' or helps you sleep. If your loved one had this kind of medication in their cells, it could put them at risk of bullying, so the healthcare team keeps it in the pharmacy and dispenses it from the hatch, one dose at a time. In some circumstances, the healthcare staff at the hatch will check the person's mouth to make sure they have swallowed it.

Medication such as asthma inhalers, antibiotics, and epi-pens are usually allowed in possession. Some medication needs to be stored in the fridge (for example, insulin), so this will always need to be collected from the hatch even if it isn't considered tradeable. Stimulant medication (for example for ADHD), must always be collected from the hatch.

Where possible and safe, medication for long-term conditions will be allowed in possession. Prison healthcare teams are generally in favour of long-term medication being kept in cells because it helps patients take responsibility for their own health and puts them in a better position to look after themselves when they are released. 

If a person's wellbeing changes while they are in prison or there are particular concerns about them (for example, if they are put on an ACCT), then it is likely that they will have to collect their medication from the hatch so that the healthcare team can keep an eye on them.

In certain prisons, commonly YOIs, people in prison may be given a toothbrush and toothpaste when they arrive. In other prisons, they will have to buy these in the canteen. 

Products such as mouthwash will usually be available to buy in the canteen Dental floss often isn't allowed in prisons for safety and security reasons, but interdental brushes or teepee brushes may be available for purchase. 

If you are concerned about the safety and wellbeing of your loved one in prison, please find more information here.

If you or your loved one feels that no one is listening, please read more about how to make your voice heard here. 

If your loved one in prison has filled out a healthcare app and has been waiting without a response for some time, please note that healthcare teams have waitlists for patients, much like in the community. It is very possible that things are happening behind the scenes, even if your loved one has not been told what is happening.

You are able to share health-related information about your loved one in prison using the Safer Custody portal. You will need to fill out a Safer Custody contact form for your loved one’s prison, include as much detail as possible about your loved one’s condition and needs, and you can also attach any important documents or doctors’ letters. If your loved one is in a London prison, you may also contact Call PHILL (Prisoners’ Health Information and Liaison Line), which reaches the prison healthcare teams directly. If your loved one is in HMP Wandsworth, Downview, Elmley, or Huntercombe, you can also contact a Pact Family Link Worker. For more guidance on how best to make yourself heard, please click here. 

All health information is welcome, relevant, and can be an asset to prison healthcare teams. If you feel something is important to include, please do so. While there may be some restrictions on the health-related information that prison healthcare teams can share with you, there are no restrictions on what you can share with them.

If your loved one is uneasy about sharing their feelings or concerns with you, you can come up with a code word or phrase between the two of you. You two can agree that, when your loved one says this word, it means that they do not feel safe, they do not feel well, or they need help. This may allow your loved one to let you know that something is going on without worrying about others overhearing. For more information about what to do if you are concerned about your loved one’s safety or wellbeing, click here. 

All prisons have a Mental Health team that offers medications, counselling (talk therapies), and/or other forms of therapy, depending on the patient’s needs. Mental health conditions are addressed when a prisoner first arrives in prison when they go through the healthcare screening process. Prisoners can also fill out a healthcare app at any time to request an appointment with a member of the Mental Health team. To find out more about mental health services in prison, click here. 

Some families and carers have shared with us that the mental health support their loved one had been receiving changed suddenly or was stopped altogether. There could be a number of reasons for this that may not have been made clear enough to your loved one. For example:

• The Mental Health team may have stopped your loved one’s talk therapy if they felt your loved one was not engaging with the treatment.
• Your loved one’s medications have been reassessed and re-prescribed. Mental health professionals in prison healthcare teams have safety and security considerations that they must take into account in a prison environment, which could mean your loved one’s medication or dosage might change. 

If your loved one in prison does not feel these changes are in their best interest, they should fill out a healthcare app and request an appointment with the Mental Health team to review their treatment. You can also express your concern by contacting Safer Custody. If your one is in a London prison, you can contact Call PHILL (Prison Health Information and Liaison Line), which is a direct line to the healthcare team. If your loved one is in HMPs Wandsworth, Downview, Huntercombe, or Elmley, you can also contact a Pact Family Link Worker.

Yes, prison health services will accommodate disabilities. Disabilities should be picked up during the healthcare screening process when a prisoner first enters prison, or a prisoner can fill out a healthcare app and get an appointment with a member of the healthcare team to discuss their needs. If the right kind of specialist care is not available in the prison, the prison will either bring in a specialist or arrange the appropriate appointments with hospitals in the community. The prison will be able to bring patients to and from their appointments in the community.

Support for neurodiversity varies from prison to prison. Some prisons have significant specialist facilities, such as dedicated neurodiversity wings, whilst others don’t have the same resources. 

All prisons should have a Neurodiversity Support Manager (NSM) who is responsible for coordinating care for those with neurodiversity needs. This is a key person who should be able to help your loved one access what’s available to them. 

It is worth you or your loved one asking what’s available. Potential support might include occupational therapy (OT), help with sensory needs, psychological support, and help with speech and language needs. 

To access support, encourage your loved one to submit an application, or an “app”, either electronically on the kiosk or using the paper form to be referred to the NSM. They could also speak to wing staff, healthcare staff, or a Listener and ask for a referral. If they struggle with communication, they can ask for help from a member of staff, a Listener, or a member of organisations like the Shannon Trust (who help people in prison with literacy issues).

If your loved one is sensitive to noise, they may be able to get ear defenders, depending on the prison. For security reasons, ear defenders usually have to be purchased by the prison. It’s unlikely that families or carers will be able to send them in from home, unless this has been specifically agreed with the prison and the healthcare team in advance.

Practical ways that families can help include a) making sure your loved one is referred to the Neurodiversity Support Manager and b) sending in any relevant documentation about your loved one’s neurodivergence and their needs.  

It’s helpful for the teams in prison to see any relevant paperwork you have – for example, documents about their diagnosis, care plans, clinical letters, a communication passport, interactions with community support or prescribed medication. It’s also helpful if you can provide any relevant information about their triggers, needs, and any coping strategies that help your loved one.  

It’s worth sending the documents to both the prison healthcare team and also to the Neurodiversity Support Manager. Some prisons will have an email address on their website you can use, whilst others will accept paperwork sent in the post. To send in the hard copies of the documents, keep the originals and make two sets of photocopies. Send them to the prison in two separate envelopes – address one as “For the attention of the Neurodiversity Support Manager” and the other as “For the attention of the Healthcare Team”.  You can also fill out a Safer Custody form online, if you feel the issue is urgent.

Possibly, but this can’t be done at every prison. There’s no harm in asking whether this is available at the prison your loved one is at – the Neurodiversity Support Manager should know.  

Your loved one can submit an app to request a neurodiversity assessment, or it’s possible that someone at the prison might notice their needs and make a referral on their behalf. Families can make a request by writing to the prison, addressing their message ‘FAO the Neurodiversity Support Manager’.

The prison should have a system for monitoring prisoners who are neglecting themselves. For example, if they are not eating or drinking or are losing significant weight. Staff will be responsible for flagging this to the healthcare team. When officers do a ‘roll check’ for all prisoners, they are responsible for checking that prisoners are alive, safe, and well.  

Each prison will have different wait times for the different types of appointments. In some cases, wait times for a particular appointment (e.g., dentistry) can be similar to or even better than in the community. However, other wait times may feel frustratingly long. Long waitlists are usually because there are a small amount of healthcare professionals managing big caseloads or because healthcare teams have to prioritise the waitlist, so that the most urgent cases are seen to first.  

In some prisons, the healthcare team may send your loved one a letter in the internal post to let them know an appointment has been scheduled for a certain date. This will only be the case for appointment inside the prison. For security reasons, your loved one will not be told in advance about a healthcare appointment that requires them to leave the prison.

Some healthcare services require that specialists come into the prison on certain days of the week. There is usually a number of appointments available that are given to patients based on need, with most urgent cases being seen to first. 

If your loved one is not being seen to and their health issue is worsening, encourage them to submit another app, speak to healthcare staff or officers to highlight the urgent need, or (in extreme cases) request emergency intervention through the healthcare team.

When it’s time for your loved one’s appointment, an officer will come to collect them from their cell and take them to their appointment.  

The officer may not know or be able to inform them of the nature of the appointment or who it is with (for example, whether it is to see the dentist, GP, optician etc). Your loved one may need to go with the officer without knowing all the details in order to receive the appointment. It might be worth giving your loved one a heads up about this – if they don’t go with the officer, they won’t get the appointment. 

It’s not uncommon for people in prison to miss their healthcare appointments. It varies by prison, but NHS figures suggest that somewhere between 10% and nearly half of healthcare appointments in prison may be missed. 

Sometimes people in prison skip their healthcare appointments voluntarily because they decided to do something else with their time or because the issue went away on its own. Missed appointments are costly and may impact on the care of other patients. If you can, please encourage your loved one to attend their appointments whenever possible.  

Other times, people in prison may miss an appointment due to factors outside of their control. This may be because:

• they were feeling unwell
• they had an important call, visit, or court date
• they had another, conflicting appointment
• they were not picked up by the officers, or there were not enough officers to escort them
• there was an incident in the prison and there was a lockdown
• there was an administrative issue, and they didn’t receive their movement slip
• they were not aware of the appointment
• they were moved to segregation

If your loved one has been unable to attend their appointment for reasons outside their control, please encourage them to speak to an officer or member of healthcare staff to reschedule the appointment. 

Usually, if your loved one misses their appointment for reasons out of their control, it will be rebooked automatically. However, if they repeatedly choose to miss their appointment, it will not be rebooked. For example, if someone skips their appointment three times in a row, they will have to submit another healthcare and start the process again.

Appointments are prioritised so that urgent and emergency cases are seen first. The healthcare staff use a triage system, so patients with the highest risks are treated at the first available opportunity and are not expected to go to the back of the queue.  

Dentistry services in the prison have to fit in with the prison regime and security requirements. The dentist often can’t see patients without the prison’s help – for example, in a closed prison your loved one may need to be escorted to their dental appointment or enabled to attend by an officer. There can be challenges around this if there aren’t enough officers, especially if several officers are required to bring the person to attend the appointment. Things like lockdowns, court dates or being moved to a different prison may create barriers for your loved one seeing a dentist in custody.   

There can also be challenges for dentistry providers to deliver their service in a prison environment. For example, the fixtures and fittings in the dentistry room will be owned by the prison, including the dentist’s chair. If these get broken, the dentistry provider will need to work with the prison to get it fixed – they can’t do this independently.  

All this being said, NHS figures record that many people do manage to see the dentist and receive treatment whilst they are in prison. There may be no reason why your loved one wouldn’t be one of those who do receive care, so it’s worth them maximising their chances by submitting an app. 

Yes, they should be able to get pain relief. If needed, dentists in prisons can give your loved one anaesthetics whilst they are doing a procedure, in the same way a dentist would give pain relief whilst doing a procedure in the community. 

In some prisons, the main healthcare provider (rather than the dentistry provider) will be responsible for giving pain relief after dentistry treatment. If your loved one needs pain relief after their treatment that requires a prescription, the main healthcare provider will need to organise this because managing and dispensing prescribed medication is their responsibility within the prison. It may be worth your loved one checking with the dentist during their appointment to make sure the right pain relief is organised for them afterwards.  

Paracetamol and ibuprofen are available for purchase on most prison canteens. Like in the community, there will be limits on how many packets your loved one will be able to buy for safety reasons.  

On the prison canteen, there should be basic products to buy like paracetamol, ibuprofen, creams and multivitamins. This is relatively consistent across prisons in England and Wales.  

Some prisons also have a pharmacy shop with additional products. Whether buying from the canteen or the pharmacy shop, your loved one will have to pay for the products. 

There will be limits on how much they can buy. For security reasons, there may be only travel-size versions available for products such as emollients. Just as in the community, they will only be allowed to buy a limited amount of ibuprofen or paracetamol for safety reasons. 

Many prisons use paper apps as a back-up system if the kiosks are out-of-order or inaccessible. If your loved one doesn’t have access to a kiosk or laptop, they should ask the officers or a member of the healthcare team if they can fill out a paper app. It may be worth asking at the pharmacy hatch to find out what system the healthcare team uses. 

If your loved one is registered with the GP in the prison, then their medical records will be transferred automatically if they move prisons. This should happen instantly at the point of transfer.

Prison and prison healthcare teams have specific procedures in the event of a health emergency. If a patient needs to be transferred to a hospital, there is typically an emergency ambulance transfer available every day. (This is in addition to weekly hospital transfers for scheduled appointments).   

Please be aware that the healthcare practitioners in the prison decide which issues are urgent and/or emergencies. Because they tend to their cases based on need, a sudden health issue may still not be considered as urgent as another patient’s. 

When someone is admitted to hospital, they are able to contact anyone on their PIN, with approval. Calls will be facilitated by the prison officers who escorted them to hospital. 

Whether or not prison staff will notify a patient’s family or loved ones will likely depend on the situation.

There are arrangements in place so that the appropriate member of staff can reach out to a family member or loved one about a patient’s health. If someone in prison has suffered sudden, life-threatening harm, their wishes on who they would like to be contacted must be obtained where possible.

If this is not possible, careful consideration must be given as to which family members or loved ones can be contacted. In some circumstances, this may include people with whom the patient was not going to contact, such as estranged family members and/or people for whom contact restrictions are in place. 

If the patient is not able to share their wishes, prison staff must contact the next of kin or a nominated person and given an accurate account of what has happened, any treatment that has been given, whether the patient is in hospital, and information about visiting the patient.

Every prison has different rules, so there is no one-size-fits-all answer. However, it is often possible (and worth asking for) a visit after a medical emergency or in a special, health-related circumstance. In some cases, it may be possible to visit a patient in the hospital (although there will be strict security measures in place and the patient will likely be handcuffed to their hospital bed). There are also instances where social visits can be scheduled for patients who have received particularly difficult diagnoses and require support from their loved ones. Booking these types of visits may be done through communication with the Duty Governor, the Orderly Officer, or via the standard Visits Booking procedures.

Assessment, Care in Custody and Teamwork (ACCT) is the care planning process for prisoners who are at risk of self-harm or suicide. 

HMPPS recognises the fact that prisoners who have a positive relationship with their family and significant others can benefit from having them involved in the ACCT case management process. This involvement can be an extra source of compassion and support, which can help reduce distress and improve mental wellbeing. With the consent of the prisoner, the ACCT Case Manager can liaise with family or significant others throughout this process. Family members may then be able to contribute to the patients’ care plan or come to case review meetings, either in person or via teleconference. 

Prison staff are responsible for asking the patient whether they would like a family member or trusted loved one to be involved in their ACCT process and for liaising with the family member or loved one. Please note that patients must consent to having anyone in the community involved.

Exercise facilities vary from one prison to another. Some sites may have a gym, sports halls, or exercise yards, whilst others may have outdoor AstroTurf or football pitches. Some prisons have football teams and regular park runs, and some may offer yoga or wellbeing activities. Some prisoners have physical exercise (PE) departments with links to local football teams through the Twinning Project.

Some prisons have PE courses available, although these do not ensure extra exercise time. They provide a qualification for future employment opportunities. 

PE activities are overseen by Physical Education Instructors who are specialist officers who have completed specific qualification to provide exercise and physical activity safely to prisoners. 

At some prisons, enhanced prisoners may get increased access to facilities. There may also be initiatives for specific wings, for example Incentivised Substance Free Living, which promote wellbeing by offering additional exercise sessions.

The prison and organisations in the prison can help your loved one register with a GP in the community. Someone in prison can also choose to do this on their own when they are released.

When a patient is getting close to their release date, the prison and organisations within the prison will start a process for making sure their healthcare will be continued in the community. If a patient is registered with the GP in the prison, the GP will be responsible for transferring their medical records to a GP in the community. If someone in prison is not registered with the GP in the prison, this will fall to the person in prison (and/or their carer in the community). People in prison can request to leave prison with a copy of their medical records from their time in prison. To read more about resettlement and health, click here.

Yes, someone in prison can have a copy of their medical records from the time they were in prison when they are released. They will have to ask for this before they are released. The GP in the prison will be able to transfer medical records to the GP in the community, if the patient is registered with the GP in the prison. If the person in prison is not registered with the GP in the prison, they will be responsible for sending their medical records to a new GP.

Everyone is different – some people may feel uncomfortable accepting support while they are in prison, and others may not trust the prison system to act in their best interest. As a trusted loved one, you have a big role to play in nudging them towards accepting the help that is offered to them.

You know your loved one best – what they are and are not comfortable with. Families and carers have told us that it can often be helpful to frame ‘accepting help’ as allowing someone else to take an issue off their plate for them. This way, they don’t have to worry about it and can focus on what matters more to them.

You can support your loved one’s health by encouraging them to register with the GP in the prison whilst they are inside. This can make things like transferring medical records and finding a GP in the community easier when they are released. You can also support your loved one by encouraging them to engage with Release and Resettlement programmes in the prison, so that they are sufficiently prepared for their release.