Accessing Healthcare in Prison

How patients get help with their health needs

If your loved one in prison has a health need, concern, or wants an appointment with healthcare, they should fill in a Healthcare Application form, often called an “app”, on the wing.

Depending on the prison, this may be a paper form or a digital form on a wing kiosk. Paper forms should be available on every wing. Some prisons have kiosks, but others do not.

Annual health reviews and preventative screening are arranged by healthcare, so your loved one will not need to submit an app for these. For other health concerns, it is important that they submit an app. If your loved one does not, healthcare may not know they need support.

Supporting your loved one to fill out a healthcare app

Your loved one can use a healthcare app for any health-related issue, including physical health, mental health, dentistry and optometry.

If your loved one is struggling with the healthcare app process, you could encourage them to:

Make sure to write in neat handwriting that others will be able to understand
Be specific about the health issue. Explain the problem, symptoms and what they need next.
If your loved one has trouble reading or writing, remind them they can ask for help to fill in the app, for example from a Peer Worker, Pact Worker or their POM (Prison Offender Manager). There may also be “easy-read” versions of the healthcare app form available.

How healthcare apps work

After completing a healthcare app, your loved one should submit it. Digital apps are submitted on the kiosk, and paper apps go in the healthcare box on the wing.

It is worth reassuring your loved one that asking for help is important. Some people feel uncomfortable sharing health information, asking for support with an app, or putting a paper app in the box. Healthcare information is private, and healthcare boxes are locked so only healthcare staff should be able to access the forms.

Paper apps are collected in different ways but are usually picked up from each wing once a day by a Peer Worker or someone from healthcare.

All paper and digital apps go to the Healthcare Admin team, who arrange triage and appointments.

Once the app has been processed, a qualified nurse will triage your loved one. This means they will check the issue, assess what is needed, and either provide care or book an appointment with the right healthcare professional. This is similar to community healthcare, where there may be steps before seeing a GP.

If your loved one needs to see a doctor or specialist, or have a procedure, they will be put on the right waiting list, as they would be in the community. They should be told when this happens. If they are not, they can ask an officer on the wing or submit another healthcare app for confirmation.

For security reasons, patients are not usually told their appointment time in advance. On the day, they will get a movement slip telling them they have an appointment and what time it is. This can be frustrating or worrying, especially if your loved one wants reassurance or more notice. However, it is standard practice because of prison security rules.

Clashing appointments

Patients are usually told about healthcare appointments on the day, so an appointment may clash with work, education or a social visit. Encourage your loved one to prioritise healthcare appointments where possible. Some people worry they may get in trouble for missing work or education, but this should not happen. If your loved one is worried, they can ask healthcare for a note explaining their absence. Please note that if they choose to miss their healthcare appointment for something else, they may go back to the bottom of the waiting list and have to wait again.

Security measures around appointments

For security reasons, families are not allowed to know when a healthcare appointment will take place. Families and carers also cannot accompany patients to medical appointments or procedures, even in a community hospital. They can, however, arrange a formal visit if their loved one is recovering in hospital.

If you visit your loved one in hospital, prison staff will be present and may take security precautions. This means your loved one may be handcuffed to the bed or secured to a prison officer with a long chain, although this does not always happen. If your loved one is pregnant, they will not be handcuffed to the hospital bed.

Prioritising appointments

Like healthcare teams in the community, prison healthcare teams face challenges. Depending on the prison, the Healthcare Admin team and healthcare team may be short-staffed, and there may be long waiting lists for appointments or procedures.

In the NHS, care is based on clinical need. This means people with the most urgent and serious health problems are treated first. The same applies in prison healthcare. As a result, patients may wait a long time for an appointment, procedure or treatment. This can be difficult for both the patient and their family, especially if the patient is in pain or worried about their condition. If your loved one has been waiting for a while, it may help for them to follow up with healthcare for an update on their treatment or place on the waiting list.

Wait times for appointments

If a patient has waited a long time without being told they are on a waiting list, it may be worth submitting another healthcare app. They should make it as clear and detailed as possible. If the app does not include enough information, the Healthcare Admin team may not be able to process it, and a nurse may not be able to triage them.