5th Report - Ageing prison population

At the very least, older prisoners will remain a significant proportion of the prison population. It is likely that the size of the cohort will rise further after increases in police numbers and changes to sentencing come into effect. It … Read more At the very least, older prisoners will remain a significant proportion of the prison population. It is likely that the size of the cohort will rise further after increases in police numbers and changes to sentencing come into effect. It is important that the size of the older prisoner population can be predicted as accurately as possible, so the prison system can prepare and be resourced most appropriately. In its response to this report, the Government should publish updated projections for the ageing prison population for the next five years. These should factor in, as far as possible, the effects of its planned increases to police numbers and changes to sentencing policy. (Paragraph 28) Accommodation for older prisoners Show less

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It is welcome that the new prison places planned as part of the Government’s expansion of the estate will be designed to better accommodate older prisoners and others with disabilities or limited mobility. However, the number of new places delivered … Read more It is welcome that the new prison places planned as part of the Government’s expansion of the estate will be designed to better accommodate older prisoners and others with disabilities or limited mobility. However, the number of new places delivered under existing expansion projects has been limited. In addition, much of the existing prison estate is unsuited to the needs of older prisoners, and there is a substantial backlog of maintenance works. We recommend that the long-term prison estate strategy in development specifically addresses the provision of reasonable adjustments and physical adaptations necessary to meeting the needs of the ageing population in existing prisons. In its response to this report, the Government should also update the Committee on the timeframe for publishing the long-term estate strategy in light of the Covid-19 pandemic, especially given the greater propensity of older people to contract the disease. Show less

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We are concerned that HMPPS is not consistently fulfilling its duties towards older and disabled prisoners, as required by the Equality Act 2010. These prisoners should not be housed in establishments where the physical design prevents them receiving equitable treatment. … Read more We are concerned that HMPPS is not consistently fulfilling its duties towards older and disabled prisoners, as required by the Equality Act 2010. These prisoners should not be housed in establishments where the physical design prevents them receiving equitable treatment. In its response to this report, the Government should set out what processes are in place to ensure that older and disabled prisoners are accommodated in an appropriate setting. Show less

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It can be very difficult to accommodate some older individuals on the prison estate. Steps taken by some prisons to develop specific wings or units for older prisoners are welcome, though the variability of individual needs should be considered. Good … Read more It can be very difficult to accommodate some older individuals on the prison estate. Steps taken by some prisons to develop specific wings or units for older prisoners are welcome, though the variability of individual needs should be considered. Good practice around the accommodation of older prisoners should be shared more widely. Ageing prison population 45 We recommend that all prisons housing a significant number of older prisoners designate appropriate accommodation for those with more complex health and care needs. We further recommend that the Ministry use the expansion of the prison estate to develop additional accommodation that is specifically adapted for older prisoners. The viability and cost of developing bespoke forms of custody for those with disabilities or nearing the end of their lives should also be explored. (Paragraph 45) Regimes and activity for older prisoners Show less

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There needs to be greater recognition across the prison estate that some older prisoners will be unable to engage with the normal regime. Suitable activities and forums should be available to older prisoners to support their welfare and rehabilitation. We … Read more There needs to be greater recognition across the prison estate that some older prisoners will be unable to engage with the normal regime. Suitable activities and forums should be available to older prisoners to support their welfare and rehabilitation. We commend the excellent work done by some establishments, but provision of these is lacking in many prisons. HMPPS should ensure that guidance and best practice on regime provisions for older prisoners is applied across the prison estate. We recommend that all prisons have a designated older prisoner lead, who can ensure that the older prison population has a voice and is managed most appropriately. (Paragraph 55) The health and social care of older prisoners Show less

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An ageing prison population will increase pressure on prison healthcare. To ensure an equivalent standard of care as in the community, it is important that prison healthcare services are appropriately resourced, and staff have awareness of age- related health conditions. … Read more An ageing prison population will increase pressure on prison healthcare. To ensure an equivalent standard of care as in the community, it is important that prison healthcare services are appropriately resourced, and staff have awareness of age- related health conditions. We recommend that all prison healthcare teams have a designated older prisoner lead, and that training on age-related health-issues is available to all prison staff. The Government must also ensure that prison healthcare services are resourced in line with the needs of an older population. Show less

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Continuing to incarcerate prisoners with severe dementia, who may no longer remember or understand why they are imprisoned, raises practical and ethical 46 Ageing prison population considerations, especially as their condition is very difficult to manage on the prison estate. … Read more Continuing to incarcerate prisoners with severe dementia, who may no longer remember or understand why they are imprisoned, raises practical and ethical 46 Ageing prison population considerations, especially as their condition is very difficult to manage on the prison estate. Equally, the Committee recognises that a significant element of this cohort are convicted for historic sexual offences. Particular attention must be given to the feelings of victims of such cases, both because of the nature of the offending itself and because of delays often experienced in bringing such perpetrators to justice. We recognise that some of those victims may consider that alternative custody arrangements and potential early release of some individuals risks adding to the suffering that they have already endured. This must be taken into consideration. The Government should review whether alternative arrangements for housing prisoners with advanced dementia would be more appropriate in some circumstances. Show less

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An ageing prison population will increase demand for social care services in prisons. While the Care Act 2014 has brought some improvements, standards of provision are highly variable across the estate. A more strategic and coordinated approach is needed to … Read more An ageing prison population will increase demand for social care services in prisons. While the Care Act 2014 has brought some improvements, standards of provision are highly variable across the estate. A more strategic and coordinated approach is needed to improve consistency and ensure effective collaboration between prisons, local authorities and other organisation involved in delivering care. In its response to this report, the Government should update the Committee on the progress of the action plan for social care in prisons in England and Wales, published following HMIP and the CQC’s joint thematic report. The Government should also set out its plans for the future provision of social care in prisons Show less

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Prisoners applying for early release on compassionate grounds should have their applications processed in an efficient and timely manner. This is especially important for terminally ill prisoners near the end of their lives. We recommend prisons identify a single member … Read more Prisoners applying for early release on compassionate grounds should have their applications processed in an efficient and timely manner. This is especially important for terminally ill prisoners near the end of their lives. We recommend prisons identify a single member of staff to have overall responsibility for progressing an application for compassionate release. (Paragraph 97) Ageing prison population 47 The release and resettlement of older prisoners Show less

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There is a shortage of suitable accommodation for older prisoners following their release, which can undermine their rehabilitation and prevent them from successfully re-integrating into society. We are particularly concerned about reports of older individuals being released to no-fixed abode. … Read more There is a shortage of suitable accommodation for older prisoners following their release, which can undermine their rehabilitation and prevent them from successfully re-integrating into society. We are particularly concerned about reports of older individuals being released to no-fixed abode. With the older prison population likely to rise further, and the number of prison places set to increase, the Government must ensure that there is suitable provision of age-appropriate post-release accommodation, including housing for those with complex health or care needs. Show less

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Prisons, local authorities, and health and care providers do not always work together effectively to ensure continuity of older prisoners’ health and social care. This can have a detrimental impact on an individual’s health and their efforts to re-integrate into … Read more Prisons, local authorities, and health and care providers do not always work together effectively to ensure continuity of older prisoners’ health and social care. This can have a detrimental impact on an individual’s health and their efforts to re-integrate into society. The development of the new RECONNECT service is welcome, but we recommend that the Government implement further measures to promote integration between organisations involved in continuity of prisoners’ health and social care. Show less

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We are concerned about reports of older prisoners being released without prescription medication or without being registered with a GP. We recommend all older prisoners are supported to register with a GP prior to release; where a prisoner is unable … Read more We are concerned about reports of older prisoners being released without prescription medication or without being registered with a GP. We recommend all older prisoners are supported to register with a GP prior to release; where a prisoner is unable to do so, they should be provided with guidance and formal ID so they are able to register once they are released into the community. We further recommend that HMPPS implement safeguards to ensure all prisoners are provided with any prescription medication on their release. (Paragraph 112) A national strategy for older prisoners Show less

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A clear definition of the older prisoner is necessary for establishing a more strategic approach to the cohort and the ageing prison population. We do not take a view on what that definition should be, but whatever age threshold is used should be based on firm evidence, and we encourage …

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We praise prison staff, HMPPS and MoJ officials for their work in responding to the Covid-19 pandemic. The virus has brought into sharp relief many of the issues affecting the prison system, including the particular health vulnerabilities of older cohorts. Amid the focus on protecting prisons from Coronavirus, HMPPS must …

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Older prisoners are disproportionately affected by cancellations to external medical appointments, and their health can be seriously impacted by non-attendance. While increasing the number and availability of prison staff to escort prisoners to appointments is important, we also recommend that the Government review increasing the use of telemedicine and other …

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The prevalence of dementia in prisons is poorly understood and prison staff can lack awareness of the condition. All older prisoners should have access to screening services for dementia, and prison officers who work with older prisoners should receive training on recognising and managing its symptoms.

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Peer support or ‘buddy’ schemes can be an effective way to help meet the care needs of older prisoners. We commend the good work done by some prisons in partnership with third sector organisations to develop such initiatives. Prisons must ensure that prisoners providing care to other inmates are suitably …

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The ageing prison population has and will continue to increase the need for end-of- life and palliative care in prisons. We welcome the publication of the Dying Well in Custody Charter and the good practice at some establishments. But standards are not consistent across the estate. In addition, as mentioned …

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Older prisoners can experience greater levels of institutionalisation and be less able to live independently following their release compared to younger cohorts. Many will require additional support to prepare them to re-join society. Release programmes and guidance that are age relevant, focusing on issues such as using technology, finding accommodation, …

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We disagree with the argument that older prisoners’ needs are too wide-ranging to generalise. Though it is important to treat each prisoner as an individual, there is a commonality among older prisoners which warrants a specific approach to their management. The MOD: Older Prisoners shows that the MoJ recognises this; …

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An ageing prison population creates specific pressures on the prison system. Currently, the response to these and the treatment of older prisoners is highly inconsistent across the prison estate. Though the Model for Operational Delivery: Older Prisoners contains useful operational guidance, it is not enough to address this inconsistency and …

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