“The links between poor health and reoffending have been long understood” according to agreement

Prisoner behind bars

This is a very important document, particularly for commissioners, prison health professionals, and prison workers because it is trying to overcome the vicious circle that faces offenders when they leave prison, which is finding housing and employment while maintaining their health and re-integrating back into society. Alcohol, drug misuse, other addictions, and mental health issues are all problems that offenders are at risk of and that require high quality healthcare. Because several organisations are involved with the welfare of prisoners, this agreement has been drawn up between the major parties to ensure that a robust co-commissioning strategy is in place.

Cartoon of an umbrella covering three people

The agreement covers health care for all remand and sentenced prisoners in all National Offender Management Service commissioned institutions


The agreement covers health care for all remand and sentenced prisoners in all National Offender Management Service commissioned institutions, including:

  • Primary care
  • Planned secondary care
  • Community care services
  • Public health (including infection control and substance misuse services)

The document describes not only all the clinical levels of service that are available to prisoners, such as dentistry, pharmacy, mental health services, end of life care, stoma care, physiotherapy, immunisation, screening, and podiatry, but also non-clinical, such as IT infrastructure, clinical governance, human resources, and funding. The agreement describes the roles and responsibilities of all the organisations involved in commissioning health care services for prisoners. It also describes the expected outcomes, principles and priorities of their joint working activities. Outcomes include:

  1. Prisoners receiving equitable services in line with the general population.
  2. Improving health and wellbeing, overcoming health inequalities, and helping protect prisoners from re-offending.
  3. Prisoners experiencing better health and wellbeing, through better health checks, treatment for addictions and/or mental health problems, and management of long-term conditions, such as diabetes.
  4. Seamless health and social care delivery as prisoners are re-introduced to society.
Five hands pointing fingers

Twelve priorities are listed and the organisations involved are committed to meeting these priorities by April 2014


Twelve priorities are listed and the organisations involved, namely the National Offender Management Service, NHS England, and Public Health England, are committed to meet these priorities by April 2014:

  1. Core service specifications to support commissioning
  2. Information and intelligence sharing
  3. Improving continuity of care
  4. Reviewing the commissioning arrangements for healthcare services in private finance initiative prisons
  5. Review and clarify responsibility for future funding
  6. Test substance misuse services as part of the Transforming Rehabilitation Strategy
  7. Reducing smoking and supporting smoke free prisons
  8. Managing prescribing and abuse of prescription medications
  9. Reviewing multi-agency approaches to managing serious risk of harm
  10. Integrating health and social care in prisons
  11. Improving the detection and management of tuberculosis among prisoners before or as soon as they enter the prison system
  12. Delivery of an ‘opt out’ blood-borne viruses testing programme.
Hands piled on top of each other

This agreement is between the National Offender Management Service, NHS England, and Public Health England


Although this agreement is between the National Offender Management Service, NHS England, and Public Health England, it involves everyone delivering care services to prisoners and former offenders. It is useful because not only does it describe in detail what is expected, but it also shows the governance structure from national to local level, so that everyone can understand what their role is. The list of priorities above, are described in far greater detail in the agreement, and commissioners need to think about what implications this might have on local services. How many prison services are in your area? Are you in touch with the other service providers delivering care to and rehabilitating offenders? There is not much time for these priorities to be met, so it is important to be thinking about what you can do at a local level.


National partnership agreement between: the National Offender Management Service, NHS England and Public Health England for the co-commissioning and delivery of healthcare services in prisons in England (PDF)
Ministry of Justice
October 2013

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Caroline De Brún

Caroline De Brún

Caroline has been a medical librarian in a variety of NHS and academic roles since 1999, working in academic, primary and secondary care settings, service improvement, knowledge management, and on several high profile national projects. She has a PhD in Computing and currently develops resources to support evidence-based cost and quality, including QIPP @lert, a blog highlighting key reports from health care and other sectors related to service improvement and QIPP (Quality, Innovation, Productivity, Prevention). She also delivers training and resources to support evidence identification and appraisal for cost, quality, service improvement, and leadership. She is co-author of the Searching Skills Toolkit, which aims to support health professionals' searching for best quality clinical and non-clinical evidence. Her research interests are health management, commissioning, public health, consumer health information literacy, and knowledge management. She currently works as a Knowledge and Evidence Specialist for Public Health England, and works on the Commissioning Elf in her spare time.

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