Prison health is public health - RCGP launches new position statement on care in secure environments

Publication date: 18 July 2018

The Royal College of GPs has published a position statement that sets out how 'equivalence of care' between secure and non-secure settings should be defined – something that has previously been unclear.

According to the College's Secure Environments Group, people in prison should be 'afforded provision of or access to appropriate services or treatment,' which are 'at least consistent in range and quality with that available to the wider community'.

The position is clear that 'equivalence' does not mean that care provision in secure environments should be 'the same' as that provided in the community.

It draws evidence from a variety of national and international health organisations, and attains to the principles that prison health is public health, and that those living in secure environments have the right to an equitable standard of healthcare.

The full definition is: 'Equivalence' is the principle by which the statutory, strategic and ethical objectives are met by the health and justice organisations (with responsibility for commissioning and delivering services within a secure setting) with the aim of ensuring that people detained in secure environments are afforded provision of or access to appropriate services or treatment (based on assessed need and in line with current national or evidence-based guidelines) and that this is considered to be at least consistent in range and quality (availability, accessibility and acceptability) with that available to the wider community in order to achieve equitable health outcomes.

Publication of the position follows Dr Jake Hard - Chair of the RCGP's Secure Environments Group - giving evidence to the House of Commons' Health Select Committee last month, where he made clear that improving care in secure environments can impact on patients living both in and out of secure environments.

Dr Hard, said: "Maintaining and improving good health in prisons is not only right, but crucial to maintaining public health in general, as the vast majority of people in prison will be reintroduced into the community at some point."

Publishing the College's definition of 'equivalence' – and having it accepted by the medical community and Government - is seen as the first step in improving the health of patients in secure environments.

Dr Hard added: “It is almost such an obvious principle that it does not seem that a definition should be required but it remains an area of wide debate. If the definition is agreeable then this further enables commissioners, healthcare providers and inspectors can use the College's position to help assess the care being provided in secure environments.

"Ultimately, the goal of providing 'equivalent' care requires improved partnership working between the healthcare providers and security authorities and where possible, by integration with community services.

"We hope that our position statement will go some way to highlight this, as well as reiterating the importance of ensuring all aspects of prison health are properly considered and improved upon for those needing it both now and in the future."

Further Information

RCGP Press office: 020 3188 7633/7574/7575
Out of hours: 0203 188 7659

Notes to editor

The Royal College of General Practitioners is a network of more than 52,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.

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