Adapting a proven person‑centred approach to help people in prison with chronic or progressive conditions identify and communicate their support needs, enabling more meaningful conversations with healthcare staff and improving the quality and consistency of care in prison settings.
Why is the research needed?
Person-centred conversations enable patients to work with health care professionals to identify and address their support needs. This ensures that care is driven by the needs of patients rather than those of the healthcare providers. It is particularly important in palliative and end of life care. The NHS recommends person-centred care but there is little guidance on how to provide it. In a prison environment, both healthcare professionals and prisoners with chronic or progressive health conditions face well-documented challenges in putting person-centred care into practice.
What are we doing?
In an earlier project, we developed a way to support person‑centred care for people with chronic or progressive conditions called the Support Needs Approach for Patients (SNAP). SNAP uses a set of questions (the SNAP Tool) contained within the How are you? booklet. These questions help patients reflect on areas where they need more support and prompt a needs‑led conversation between the patient and a healthcare professional to address those needs together.
SNAP was first developed for people with chronic lung disease, but it has since been shown to support person‑centred conversations across a wide range of chronic physical conditions. In this project, we are adapting SNAP, both the SNAP Tool and the needs‑led conversation, for use with people in prison who have chronic or progressive health conditions. This work involves focus groups with prisoners, former prisoners, prison healthcare staff and prison officers. We will then test the prison‑adapted SNAP with two to three prison healthcare teams and speak with those involved about how useful it is in this setting. Finally, we will investigate the feasibility of a future Realist Evaluation of the prison-adapted SNAP for prisoners with progressive conditions.
How are we working with communities, services and organisations?
Marie Curie are supporting us to build networks in prison healthcare, recruit healthcare professionals and plan how to share our findings with the right individuals and organisations. We are working with the West Midlands Cancer Alliance, who have promoted the study among prison healthcare professionals and helped identify prison healthcare teams interested in taking part.
We are collaborating with EP:IC, an established prison research consultancy, who are using their expertise to support data collection inside prisons. They are also running our Public and Patient Involvement groups, drawing on their network of former prisoners. We are also partnering with Health Innovation East, who are supporting our stakeholder engagement work and helping us share findings with relevant organisations.
Members of our Study Management Group bring experience and strong links across the prison service, the voluntary sector and prison research networks, strengthening the reach and relevance of the project.
What will the impact and benefits of this research be?
Adapting SNAP for use in prison healthcare could enable a person-centred approach to identifying and addressing the support needs of individuals with chronic or progressive conditions in prison. This in turn has the potential to address some of the healthcare inequalities experienced by people in prison by taking into account each individual imprisoned patient’s views, background and experiences.
What do we have planned for knowledge mobilisation and implementation?
A national stakeholder roundtable meeting will be held to consider the findings of the study, to generate policy recommendations regarding the wider implementation of the prison-adapted SNAP. Health Innovation East will assist both with the stakeholder roundtable and sharing our findings with relevant individuals and organisations. Marie Curie will also help us think about how and where to share our findings.
Related papers, outputs and resources
In addition, we will be producing:
- Prisons-adapted SNAP Tool
- Prisons-optimised SNAP
- SNAP training for prisons
- Academic outputs
- End of project webinar
- Policy/prison community-focused communications
Who is involved?
- Joint Principal Investigator: Professor Morag Farquhar, University of East Anglia
- Joint Principal Investigator: Dr Carole Gardener, University of East Anglia
- Zubaa Akhtar, University of East Anglia
- Dr Sarah Hanson, University of East Anglia
- Dr Jane Senior, University of Manchester
- Professor Lynn Saunders, University of Derby
- Dr Annelise Matthews, Northampton Healthcare NHS Foundation Trust and Cambridgeshire Secured Services
- Ms Maria O'Neill, Northampton Healthcare NHS Foundation Trust and Cambridgeshire Secured Services
- Anita Dockley, Justice Futures
- Dr Lucy Wainwright, EP:IC
Get in contact
Email Professor Morag Farquhar or Carole Gardener at m.farquhar@uea.ac.uk or carole.gardener@uea.ac.uk.
The study is funded by Marie Curie
