Debate: Prison nursing

This resolution passed. 

Nursing staff are on the frontline of delivering health care to those in prison, yet they increasingly find themselves unable to provide high-quality, personcentred care to their patients.

Of those respondents to the RCN’s 2017 Safe Staffing Survey who work in prisons, 64% said that care was compromised on their last shift. Of all respondents to the survey, those working in prisons rated the quality of care most poorly (Royal College of Nursing, 2017).

RCN Scotland’s 2016 report on prison health care, Five Years On, found that morale amongst nursing staff in prisons has fallen dramatically in the last five years. Of those working in Scottish prisons, 50% of those surveyed in 2016 felt satisfied with their job, down from three-quarters of those surveyed in 2011. Less than two-thirds of respondents in 2016 felt that prison nursing is a rewarding career, compared with 90% in 2011 (Royal College of Nursing, 2016).

As in the rest of the UK, responsibility for health care in Scottish prisons has transferred from the Prison Service to the NHS in recent years. Staffing pressures, poor opportunities for development and training, and a lack of understanding in the NHS of prison nursing has contributed to staff feeling undervalued and unsupported. RCN Scotland has recently been invited to join a Scottish Government work-stream on governance and leadership in prison health care.

Many people in prison come from our most deprived and disadvantaged communities, and have very poor health. They are often disengaged from mainstream health services before and after any prison term. A period of imprisonment therefore presents a unique opportunity to turn around their health outcomes and life chances.

In Wales, prison nurses are working to get prison nursing (and medicine) recognised as specialty fields. Many prison nurses who love the work want to stay but feel there is a lack of progression opportunities and that their prison experience is not recognised for the expertise they have (Walsh and Freshwater, 2009). The RCN in Wales has previously called on the Welsh Government to improve provision of specialist education for prison nursing staff, specifically in the areas of mental health and learning disabilities, in order to best meet the needs of vulnerable individuals within prison settings.

In Northern Ireland, all prison nurses are employed by the South Eastern Health and Social Care Trust. The RCN works in partnership with the Trust to provide continuing professional development for prison nurses in order to enhance their skills and competencies. Nursing plays a leading role in tackling health inequalities that people in prison face.

The environment that nursing staff in prisons face every day is tough. Overcrowding, increased drug use, violence and the number of suicides have left the prison system in crisis. Across the UK, the prison population is ageing, bringing fresh challenges for those providing care. The challenges faced by prison nurses mean this under-served population are not having their essential needs met.

Despite this, members are passionate about their work and the difference they make to those in prison. In the 2016 Scottish survey, 89% of respondents said they would go the ‘extra mile’ at work (Royal College of Nursing, 2016). But they need to feel valued and supported in the vital work they do. We need a sustainable and vibrant nursing workforce that can make a real difference to the lives of people in prison. 

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