Health Inequalities within the Criminal Justice System

Health Inequalities within the Criminal Justice System: A capacity, partnership and network building event for Yorkshire and Humber. 

Background/ rationale

The health and justice national landscape has undergone some radical changes recently, alongside other public services. The main drivers around health and justice are to work with an increasingly multidisciplinary focus within the wider context of addressing health inequalities and reducing re-offending.

It was felt that there was a necessity to create a space for those working in this area regionally to think about these issues and the relationships with other agendas. The idea of a regional event was proposed to further explore the connections between research and practical actions for informing our evidence-based practice. It was further suggested that by providing an opportunity to build on existing partnerships could be built on to develop a joined up approach to operating in the health and justice in South Yorkshire (SY).

A regionally-based health and justice SY event steering group, hosted by the Public Health Hub at Sheffield Hallam University (SHU) organised the event at Sheffield Town Hall in October. The event was supported by Public Health England and the National Institute of Health Research, Collaborations and Leadership in Applied Health Research and Care for Yorkshire and Humber (CLAHRC YH) and Public Health England. The steering group members represented the Public Health Hub, Department of Criminology and Centre for Health and Social Care Research (SHU), Public Health England and Sheffield Teaching Hospitals Trust.

The Event 

The event attracted over 60 delegates from a wide range of agencies, from Commissioners; to community and prison delivery staff; and a number of those with first-hand experience of accessing health services in the region. The event attracted delegates from all over the region, while representatives from National Offender Management Service and the Office of the Police and Crime Commissioner were also in attendance.

Delegates were welcomed by Dr Katherine Albertson of Sheffield Hallam University and introduced the facilitator for the day, Professor Chris Bentley, Associate Professor at SHU, and former head of the Health Inequalities Support Team at the Department of Health.

Dr Albertson launched the event, setting the wider context and outlining the eye-watering health inequalities experienced by this cohort.

Delegates broke into discussion groups to produce a SWOT analysis of current provision for the health of those in the criminal justice system- identifying gaps and barriers and examples of good practice and potential solutions. Key themes were drawn out by Professor Bentley for a whole group discussion.

This was followed by the keynote address by Paul Moore, Health and Justice Lead for Yorkshire and Humber at Public Health England. Paul described the changes in the health commissioning landscape where responsibility for the prisons now lies with NHS England rather than local Primary Care Trusts. He then outlined changes in prisons where people where people will spend the last three months of their sentence in a prison close to home, preparing for release. And to probation, where Community Rehabilitation Companies will take over lower risk people and ensure that everyone leaving prison receives supervision.

Delegates were asked to explore the challenges and priorities for the health of people in contact with the criminal justice system in the light of the changes outlined. Key points were highlighted about the health pathways in the criminal justice system; the critical points for intervention and support for maximum health gain were and where opportunities for improvement locally may lie.

The room broke for 5 specific topic based discussion groups around gaps and opportunities raised in key health areas in the criminal justice system: blood-borne viruses; long term conditions and health needs of older offenders; mental health; substance misuse and women's health services. Each of these groupings was facilitated by those with expertise in these areas, drawn from SHU staff and representatives from wider local expert groups.

The day ended with a plenary, gathering in the key aspects of the day's discussions and the identification of research opportunities and areas of further regional interest. Key areas highlighted on the day were summarised as requiring future focus on:

1. Systems for information sharing and effective and timely retrieval

 2. Need assessment and systems 'fit'

3. A need for regional knowledge-exchange seminar series

4. A research and evaluation focus on the flashpoints in the pathway- Liaison and diversion and rehabilitation in prison

Feedback from the event

Event evaluation forms contained some excellent ideas for the future, highlighted that the event had proved extremely useful to the delegates and contained some feedback, including:

"Great for Commissioners to come face to face with discussions with front line workers and key themes emerging

"A very proactive event – lots of information sharing"

 "Lots of key people in the audience to share experiences and suggest useful key reports"

Next steps

The day closed on an upbeat fashion, with emerging connections and partnerships made and cemented throughout the day's activities. A commitment was made by those attending to build on these collaborations to address health needs from an evidence-based perspective.

Authors

Dr Kathy Albertson, Catherine Homer, Anna Ryan and Judy Stevenson all SHU, Prof Chris Bentley, Dr Ray Poll (STH NHS FT) and Paul Moore (Public Health England).