National Institute for Health and Clinical Excellence (NICE)
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People in prison should receive the same level of care as those outside, says NICE

People in prison should receive the same standard of healthcare as those in society.

When finalised, the NICE guideline will support their health and wellbeing throughout time spent in prison. It will also assist prisoners upon their release back. Draft recommendations include:

  • Ensure every person admitted to prison receives a healthcare assessment before they are allocated to a cell. This should include questions about their physical and mental health
  • Promoting health and wellbeing in the prison population by offering inmates tailored advice about exercise (detail on-site facilities), diet (highlight the healthier options available) and sexual health (reducing sexually transmitted infections)
  • Help people who are being released from prison to register with a GP and provide a post-release care plan detailing any significant events (e.g. hospital admissions) to happen to the person whilst in prison.

The number of prisoners aged 60 years and over increased by 164% between 2002 and 2015 across England and Wales. It is the largest growing age group in the prison population.1 Older prisoners interviewed upon entering prison for the first time expressed concerns about accessing health care and receiving medication.2

Professor Mark Baker, Director for the Centre of Clinical Practice at NICE, said:“Our prison population is getting older, meaning they are more likely to have complex, chronic healthcare needs. Delivering the care they need in such a restrictive environment is difficult, but no less important than for anyone else. People in prison should receive the care they need, and this should be comparable to treatment available beyond the prison gates.”

People in prison are at a higher risk of chronic ill-health (for example asthma and diabetes) than those outside.3 It is estimated that more than 80% of male prisoners aged 60 and over suffer from a chronic illness or disability.4 With some research suggesting that prisoners over 50 years of age have levels of illness comparable to 60 year olds living outside of prison.5

Richard Bradshaw, former Director of Offender Health and Chair of the NICE guideline committee, said: “We know that people in prison are a vulnerable population with a high health need, which requires close attention and careful management.

“The consultation for this draft guidance is now open and we welcome comments on our suggested recommendations. We want to ensure that these people receive the care they need to promote wellbeing, prevent deterioration, assist in rehabilitation and reduce re-offending.”


  1. Prison Reform Trust, ‘Prison: the facts’, Bromley Briefings Summer 2015.Accessed online.

  2. Senior J, et al (2013), ‘Health and social care for older male adults in prison: the identification of current service provision and piloting of an assessment and care planning model’, Health Services and Delivery Research. Accessed online.

  3. Conford, C. S et al (2008) ‘A survey of primary and specialised healthcare provision to prisons in England and Wales’, Primary healthcare research development.Accessed online.

  4. HM Chief Inspector Prisons (2004), ‘no problems – old and quiet’, older prisoners in England and Wales.

  5. Prison Reform Trust, ‘Doing Time: the experiences and needs of older people in prison’.

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

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