Equivalence of care in Secure Environments

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. It is well recognised from a legal perspective at international, regional (European) and local (UK) levels that health care provision in secure environments should be of an ‘equivalent’ standard to that provided in the wider community. We recognise the benefit to our patient group by striving for ‘equivalent’ care and furthermore recognise the benefits this provides to our society as a
whole.

At present, there is no resource setting out how equivalent care should be defined, measured or compared within the secure setting to that in the wider community and importantly this has implications where there are or have been specific limitations or variations in the care being provided within the secure setting.

It must be recognised that there are aspects of care provision within secure settings that require a different approach or service model than would otherwise be available in the wider community. It must also be recognised that within the community setting there will be considerable variation in the provision and availability of services for a number of demographic reasons. It therefore stands to reason that on occasion the care provided in a secure settings may be at least equivalent to that available in the wider community.

This paper will set out the salient literature containing the historical and current ethical and legal context in which the concept of ‘equivalence’ has evolved and provide a working definition of ‘equivalence’ in order that further discussion and refinement can take place.

Clinical Policy

Equivalence of care in Secure Environments in the UK Position statement (420 KB PDF) July 2018.

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