Lived experience of avoidable healthcare harm in prisons in England: a qualitative study.
8 affiliations
- 1School of Sociology and Social Policy, Law and Social Sciences, University of Nottingham, Nottingham, UK.
- 2Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
- 3School of Medicine, University of Nottingham, Nottingham, UK.
- 4Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
- 5National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC), Manchester, UK.
- 6Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.
- 7Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
- 8Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. [email protected].
Abstract
Background
People in prison experience high rates of physical and mental health problems and although prison provides opportunities to improve health and wellbeing, they often experience worse health outcomes. This study aimed to explore the perspectives of staff and people in prison, considering their experiences of perceived avoidable healthcare-associated harm and the factors they felt influenced prevention of harm.Methods
Qualitative, semi-structured, interviews were conducted with 32 prison staff and commissioners and 23 people in prison across five prisons in England. Interviews were conducted between August 2022 and January 2024 and were analysed thematically.Results
Problems with access to timely and appropriate healthcare were commonly raised by participants in relation to issues around medication management and access to healthcare. Prison policies and practice were highlighted by participants as factors that influenced the prevention of harm; interviewees referred to the impact of staffing capacity and the skillsets of staff in terms of trauma and mental health, the impact this had on relationships between staff and people in prison, as well as challenges related to communication and coordination between teams within the prison.Conclusion
Experiences of perceived avoidable healthcare-associated harm in prisons centred on medication management issues and difficulties with accessing healthcare. Recruiting and retaining skilled staff and systems lacking communication and coordination were considered important factors influential to harm prevention. A systems-based approach is needed to improve patient safety considering how integration and communication can be improved but this is needed alongside improved health literacy and interventions to increase autonomy that are led by people in prison.
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BibTeX
@article{jordan2026lived,
title = {{Lived experience of avoidable healthcare harm in prisons in England: a qualitative study.}},
author = {Mel Jordan and Sandra Flynn and Ellie Thompson and Deborah Buck and Claire Muller and Noor Butt and Basharat Hussain and Jenny Shaw and Darren M Ashcroft and Antony Avery and Andrew Carson-Stevens and Richard N Keers and Isobel Joy McFadzean and Tim Millar and Maria Panagioti and Verity Wainwright},
journal = {Health \& justice},
year = {2026},
month = jul,
doi = {10.1186/s40352-026-00417-0},
url = {https://europepmc.org/article/MED/42900327},
note = {CC BY},
}
RIS
TY - JOUR
TI - Lived experience of avoidable healthcare harm in prisons in England: a qualitative study.
AU - Mel Jordan
AU - Sandra Flynn
AU - Ellie Thompson
AU - Deborah Buck
AU - Claire Muller
AU - Noor Butt
AU - Basharat Hussain
AU - Jenny Shaw
AU - Darren M Ashcroft
AU - Antony Avery
AU - Andrew Carson-Stevens
AU - Richard N Keers
AU - Isobel Joy McFadzean
AU - Tim Millar
AU - Maria Panagioti
AU - Verity Wainwright
PY - 2026
DA - 2026/07/01
JO - Health & justice
DO - 10.1186/s40352-026-00417-0
UR - https://europepmc.org/article/MED/42900327
AB - Background People in prison experience high rates of physical and mental health problems and although prison provides opportunities to improve health and wellbeing, they often experience worse health outcomes. This study aimed to explore the perspectives of staff and people in prison, considering their experiences of perceived avoidable healthcare-associated harm and the factors they felt influenced prevention of harm.Methods Qualitative, semi-structured, interviews were conducted with 32 prison staff and commissioners and 23 people in prison across five prisons in England. Interviews were conducted between August 2022 and January 2024 and were analysed thematically.Results Problems with access to timely and appropriate healthcare were commonly raised by participants in relation to issues around medication management and access to healthcare. Prison policies and practice were highlighted by participants as factors that influenced the prevention of harm; interviewees referred to the impact of staffing capacity and the skillsets of staff in terms of trauma and mental health, the impact this had on relationships between staff and people in prison, as well as challenges related to communication and coordination between teams within the prison.Conclusion Experiences of perceived avoidable healthcare-associated harm in prisons centred on medication management issues and difficulties with accessing healthcare. Recruiting and retaining skilled staff and systems lacking communication and coordination were considered important factors influential to harm prevention. A systems-based approach is needed to improve patient safety considering how integration and communication can be improved but this is needed alongside improved health literacy and interventions to increase autonomy that are led by people in prison.
SN - 2194-7899
ER -