Secure environments group

The RCGP Secure environments group is committed to the delivery of health care in the health and justice system to prisoners and detainees which is of the highest possible standards.

Working in secure environments such as prisons, secure hospitals, secure training centres young offender institutions and immigration removal centres presents unique challenges. Our resources provide guidance for GPs and primary care teams working in this area.


Foundation and establishment of the SEG

In December 2001 the Department of Health and HM Prison Service published the Report of the Working Group on Doctors Working in Prisons. Among a wide range of important recommendations, the group asked for the establishment of a series of lead medical posts across the prison estate. These posts were appointed to by Regional Prison Health Development Teams and were mandated to support areas of clinical governance and to contribute to the modernisation process.

The Secure Environments Group was established in 2004 by Dr Cliff Howells and Dr Mark Williamson. Their vision set the scene for much of the work undertaken in Secure Environments today.

Founders' biographies

Dr Cliff Howells initially worked with the Royal Navy and then in NHS General Practice. He joined the Prison Service in 1992 working in a variety of prisons and later as a health adviser. He joined the Department of Health as Medical Director for the Task Force and subsequently Prison Health, leading projects for Primary Care, Clinical Governance, Pharmacy and Medical staffing. He now works as a GP in Southampton and provides Prison Health with medical advice.

Dr Mark Williamson spent 10 years in general practice on Teesside, during which he was a GP trainer, an LMC vice chair and a Health Authority non-executive.  He left to become a medical adviser at the East Riding and Hull Health Authority. During that time, he became interested in and has since dedicated much of his time and energy to improving health services for offenders firstly at a local then regional and now national adviser level. In addition to supporting the establishment of the Hull York Medical School, he has also worked as a PCT medical director. 

SEG membership (or those who attend meetings) can be divided into the following categories: Prison GPs, Forensic Medical Examiners, Offender Healthcare Managers (often non-clinical i.e. not medics), Representatives from other professions and patient / service user reps.  SEG have adopted the ‘hub and spoke’ model whereby they are the hub and they attended by representatives from all Strategic Health Authorities (SHAs) of the UK as well as reps from Scotland, Northern Ireland and Wales.

Group outputs

Key activities and resources include:

The Annual Health and Justice Summit

This is a 2-day learning (CPD) and networking event for primary care staff working in secure environments.  This is a unique event which has grown in popularity over the past decade and provides an opportunity for networking and relevant CPD/workshops.

Previous Health Justice Summits

  • 1st H&JS 2010 – Increasing hope; reducing risk: Making drug treatment work across prisons and in wider secure environments
  • 2nd H&JS 2010 – Offender health: Who cares, who commissions, how do we make it better?
  • 3rd H&JS 2013 – The wider determinants of health and justice
  • 4th H&JS 2016 – Improving patient experience in secure environment healthcare
  • 5th H&JS 2017 – Aging well in secure environments
  • 6th H&JS 2019 – Continuity of Care: Improving the primary care/secondary care interface
  • 7th H&JS 2019 – Journeys through justice – leadership and transformation
  • 8th H&JS 2021 - Communities of practice in secure care
  • 9th H&JS 2022 - Just health? – principles and practice to promote health equity and inclusion in uk and global justice settings
  • 10th H&JS 2023 - Building bridges in health and justice
  • 11th H&JS 2024 - Championing excellent care & empowering teams