The ageing prison population and increasing prisoner palliative care needs:effects, challenges and conflicts for prisoners and prison staff

Background: The need to improve palliative care in UK prisons is increasingly urgent; the prison population has doubled over the past decade, with men over 60 the fastest growing group. The majority of older prisoners have multiple and complex healthcare needs and many will die in prison. Aims: This paper draws on a Marie Curie funded project being carried out by researchers at Lancaster University between 2013 and 2016, entitled ‘Both sides of the fence: using action research to improve end of life care for prisoners’. An ageing prison population and increasing prisoner palliative care needs come at a time of increasing financial constraints and funding cuts for prisons, with project data illustrating significant healthcare needs among this prison’s ageing population. Methods: The research is being conducted in partnership with prisoners and staff at a prison in the North West of England with a high number of older and disabled prisoners. Phase 1 of this action research study, of focus in this paper, has involved interviews and focus groups with people both inside and outside the prison including healthcare staff, governors, prison officers, chaplains, prisoners, and specialist palliative care staff (n=60). Results: As a result of the increasing palliative care needs of prisoners, a number of consequences for both prisoners and prison staff are presented in this paper. With prisoners and prison staff living or working in close proximity to illness and death, this includes the changing roles of prison staff, and the challenges and conflicts that these changes bring. Conclusions: Drawing on data from one prison with a high number of older and disabled prisoners, this paper illustrates some of the effects, challenges and conflicts for both prisoners and prison staff as a result of the increasing palliative care needs of prisoners