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Prisons and Probation Ombudsman for England and Wales report examines end of life care for prisoners

3rd April 2013

The Prisons and Probation Ombudsman (PPO) for England and Wales, Nigel Newcomen, has published Learning from PPO Investigations – End of Life Care, a report examining end of life care for prisoners in England and Wales between January 2007 and October 2012.

Compiling a review of 214 investigations into foreseeable deaths of natural causes in custody the report looks at how the Prison Service in England and Wales is responding to the challenges of a growing population of elderly prisoners.

An ageing prison population is increasingly an issue for European policy makers as more prisoners are dying of terminal illnesses and old age than ever before. Those aged 60 and over have become the fastest growing segment of prison populations in England and Wales, increasing by 142 per cent in the past ten years. The Irish prison population has similarly increased by 70 per cent in the past six years, as gardaí have solved more historical crimes and the judiciary has leaned towards longer sentencing. The PPO’s report is a warning to Irish penal policy makers as the Irish prison population similarly ages.

The report found that the majority of prisoners in England and Wales (85%) in the sample received care judged to be equivalent to that they could have expected to receive in the community. However, overall the PPO found that care was ‘not universally good’. Examples of inadequate care include findings that over a quarter (29%) of prisoners did not have a palliative care plan to ensure they and their families received appropriate care and support.  Restraints were also often used disproportionately and inhumanely on terminally ill prisoners and improvement was needed in ensuring family involvement.

In concluding the report the PPO compiled a number of ‘Learning Points – Resulting implications for practice’ including:

1. Prisons should implement an end of life care plan for every prisoner diagnosed with a terminal illness guided by the National End of Life Care Programme.

2. Prisons should use restraints proportionately, giving due weight to a prisoner’s current health and mobility when assessing the risk they pose to the public.

3. Prisons should ensure timely completion of applications for early release on compassionate grounds.

4. Prisons should ensure that families are involved in every key stage in the prisoner’s end of life process. (the palliative care planning)

This review of services fits into the context of the UK Government White Paper: ‘Caring for our future: reforming care and support’. The White Paper previously addressed the needs of elderly prisoners and recognised that the social care needs of prisoners have, in the past, been neglected due to the lack of clarity about where responsibility lies. In an Irish context the Inspector of Prisons, Justice Michael Reilly has voiced concerns about support for elderly prisoners In Irish prisons.

Read more:

To read the full report please press here: http://www.ppo.gov.uk/docs/Learning_from_PPO_investigations_-_End_of_life_care_final_web.pdf

PPO for England and Wales Press Release: http://www.ppo.gov.uk/docs/End_of_life_care_thematic_press_notice.pdf

UK Government White Paper addressing care for elderly prisoners: https://www.gov.uk/government/publications/caring-for-our-future-reforming-care-and-support

Irish Prison Service Three Year Strategic Plan 2012 - 2015: Strategy for Management of Older Persons (Page 49): http://www.irishprisons.ie/images/pdf/strategicplanfinal.pdf

Irish Times: Concerns over care of rising number of elderly inmates: http://www.irishtimes.com/news/concerns-over-care-of-rising-number-of-elderly-inmates-1.953786

Irish Independent: Concern for elderly in jail report: http://www.independent.ie/breaking-news/irish-news/concern-for-elderly-in-jail-report-26839575.html

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