Safety recommendation
HSSIB recommends that HM Prison and Probation Service standardises the approach to the provision of prison officer escorts for outpatient appointments to protect the dignity of patients and reduce variability of escort slots. This will assist in reducing the likelihood of patients refusing to attend healthcare appointments, while balancing appointment availability, thus improving the continuity and equality of care.
Response:
A comprehensive review of escort provision, including longer term hospital admissions is currently being jointly undertaken between HMPPS and NHSE (and Wales). A priority of the review is to improve prisoner / patient access to health services, considering demand and understanding how this is influenced by factors such as age or gender. This work will also consider how to optimise appointment times, factoring in prison regimes, the timings of clinics, and the geographical proximity of health facilities.
Separate work is underway to improve standardisation of resource allocation across the estate across a range of service areas including escort provision, in the longer term this work will support greater consistency of provision. The review recognises the need to reduce demand through improved access to (and uptake of) telephone and video consultations, and telemedicine services, drawing on best practice from across the health sector and beyond.
Actions planned to deliver safety recommendation:
- Model actual demand for outpatient escorts. By when: February 2026. Organisational lead: Head of Workforce Modelling. Resources in place to deliver actions: Joint working arrangements between HMPPS and NHSE, with identified leads from each department. Other dependencies identified: Access to anonymised patient data. Qualitative research and analysis. Other data sets.
- Improve access to (and uptake of) telemedicine. By when: February 2026. Organisational lead: Head of Workforce Modelling. Resources in place to deliver actions: Joint working arrangements between HMPPS and NHSE, with identified leads from each department. Other dependencies identified: Qualitative research and analysis. Secondary Care engagement.
- Preventative action (recommendations). By when: February 2026. Organisational lead: Head of Workforce Modelling. Resources in place to deliver actions: Joint working arrangements between HMPPS and NHSE, including the Health & Wellbeing team. Other dependencies identified: Qualitative research and analysis. Sufficient evidence supporting ‘what works’ to consider whether the need for medical appointments might be reduced, through tackling the root causes of poor health and the use of Social Prescribing.
- Escorts - Workforce Delivery Model. By when: April 2026. Organisational lead: Workforce Delivery Project Senior Lead. Resources in place to deliver actions: Limited project team. Other dependencies identified: Assurance and testing of all WDMs, including affordability.
Response received on 21 February 2025.