Project

Peer support’ for improved social care and health of older prisoners: in search of effective, implementable and sustainable solutions for Her Majesty’s Prison Service (MH33)

Background and Rationale for new research:

With growing prison populations and spiralling costs whilst budgets are under strain, providing good governance of prison health and social care is one of the top priorities on many local, national and international agendas. An opportunity presents itself to conduct a suite of high priority applied prison health research projects in partnership with four regional prisons (HMPs Norwich, Bure, Littlehey, Hollesley Bay), the RECOOP Charity (Norwich), the Cambridgeshire County Council, Public Health England, and the Universities of Cambridge and East Anglia. In this instance, the collation and mapping of the evidence and policy on sustainable and effective support offered for the social and healthcare needs of older prisoners in the region as well as a more in-depth exploration and evaluation of a particular approach (“buddying”/peer review) currently operating informally in several prisons. This regional prison project will also inform a UK-wide collaboration for an NIHR HS&DR grant application currently being set up with UK prisons and researchers, as well as the development of a comparative EU prison proposal to the European Commission. Moreover, based on collaborations in over 40 countries globally, an opportunity would also arise for a DfID or other grant looking into global prison health in low-and middle-income countries. Recently, in the UK, a start has been made with some significant work on health needs assessments and developing healthcare pathways for older prisoners including two large studies led by Professor Jenny Shaw (University of Manchester, Offender Health Research Network) funded by NIHR HS&DR as well as case studies of ‘good practice’ from the US, UK, Belgium and Japan in caring for older prisoners (The Mental Health Foundation, Losing Track of Time, 2012). This research, mainly focusing on health, points out the significant need for complementary work on provisions for unmet social care needs of older prisoners. Findings of this recent research, prison health needs assessments and wider priorities in ageing research highlight the following pivotal social care issues in prisons

Outline of research objectives:

The overall aims of the study are:

  • To understand current policy and practice context governing and influencing possible implementation of a new care intervention into HMPS;
  • To assess the feasibility of buddying/peer support approaches to meeting health and social care needs of older prisoners while adhering to security and equity concerns and the efficient use of scarce resources.

Proposed methods:

  • Narrative and systematic literature reviews and reviews of grey literature (including project level evaluations, JSNAs, prison and health needs assessments) to identify and ‘model’ peer support interventions.
  • PPI: holding an ‘Over 50’s forum’ in all 4 prisons as an advisory function to this project as well as informing the development of a nationwide prison study.
  • Case studies of prisons’ current mechanisms and interventions around social care for older prisoners (if any).
  • Stakeholder interviews (key prison personnel and social and health care commissioners and providers (including VCS)) to identify current level of need and intervention, and to explore implementation context.

Expected Output of Research / Impact and added value:

  • Production of an implementation plan for a peer support/buddying pilot in each partner HMPs, with a view to securing new funding under CLAHRC to support implementation and evaluation.
  • Publication of 2-3 papers in peer reviewed journal with linked briefing papers
  • Building partnerships with commissioners and providers as well as voluntary organisations and older prisoner around frailty prevention, avoidance of reoffending and successful resettlement.
  • Develop testable hypotheses of what kind of peer support interventions work, in what way, in which circumstances and at what cost to support cost-effective social care needs interventions in HMPS, and to inform training and support programmes for those in caring roles within prisons.

Proposed Development Work:

This initial prison project would be a starting point for further regional applied and needs-based prison health research in partnership with the regional prisons and partners, such as, for instance: investigations into / evaluations of the proposed smoking ban in prisons, substance abuse in prisons, and prison IAPT services. Furthermore, this project would also form the basis for the development of a UK-wide NIHR HS&DR prison project bid, a comparative EU prison proposal to be funded by the European Commission, and (potentially) also a global prison health project in low-and middle-income countries with DfID or other internal funding.

For further information on the project, contact Dr Tine Van Bortel at the Institute of Public Health, University of Cambridge

email: tv250@medschl.cam.ac.uk