News release – Route map aims to improve end of life care for people in prison

Published 13 September 2011, the good practice tool from the National End of Life Care Programme aims to help professionals working with people nearing the end of life in prison.

The route to success in end of life care – achieving quality in prisons and for prisoners is part of a cross-government drive to improve offender health. It is published amidst predictions that an aging prison population will see more deaths from natural causes in prisons.

The document, part of the programme’s route to success series for improving end of life care, is intended as a practical guide for both prison staff and health and social care professionals.

It emphasises the need for all those involved in a person’s care to work across service boundaries to identify those nearing the end of life and respond accordingly. Regular assessments and reviews, advance care planning and communication between professionals and services are vital to improving end of life care in prisons, it says.

It is particularly important that prison staff and NHS staff working within prisons form good communication channels with local community services.

The guide follows the nationally-recognised six step end of life care pathway, providing points and questions for prison, health and social care staff to consider at each step – together with case studies highlighting good practice.

The programme’s social care lead, Tes Smith, said: “The twin requirements of custody and care are recognised within the service with initiatives underway to improve health outcomes for offenders. However, those double imperatives can be particularly demanding when it comes to delivering end of life care in prisons.

“This resource sets out how staff, whether prison officers, managers or health and social professionals, can ensure that people in prison who are nearing the end of life receive appropriate and co-ordinated care while being treated with respect and dignity.”

While much of the good practice outlined in the end of life care pathway applies to all settings where people receive end of life care, the guide sets out some of the specific issues facing those involved in the care of prisoners. These include:

• The safety of the environment
• Policies around access to symptom control medication and use of morphine or syringe drivers
• Does a prison officer have to be present at all visits/treatments and at death?
• What is the process for considering compassionate release?
• Access to training and support for prison staff
• Are there policies to protect the dignity and privacy of people nearing the end of life?

Professor Louis Appleby, national clinical director for health and criminal justice said: “Those nearing the end of life should receive dignified care, whatever the setting. I welcome this guidance from the National End of Life Care Programme which provides much-needed practical advice to health and prison staff in how to best work together to plan for – and provide – high quality, accessible services for those in their care.”

“As the number of older and disabled people in prison grows, the Department continues to work with the National Offender Management Service to improve the health and wellbeing of this vulnerable group.”

The new publication complements Department of Health and HM Prison Service guidance and was produced after discussions with both organisations.

Download Route to success in end of life care – achieving quality in prisons and for prisoners