Safety recommendation
HSSIB recommends that NHS England/Department of Health and Social Care ensures that the General Medical Services registration process, for patients in prison, is designed using informed consent principles, providing patients sufficient time, advice and support to understand what registration means for them. This is to ensure patients are making informed decisions about their healthcare provision, therefore improving patient safety.
Response:
We agree with this recommendation. NHS England and DHSC recognise the importance of supporting patients in prison to make fully informed choices about their healthcare registration. Following a review of current policy options and operational dependencies, we propose the following actions and indicative timeframes.
Actions planned to deliver safety recommendation:
- Initial scoping review completed, with engagement of healthcare providers, clinicians, and patient representatives to understand current challenges, by Mid 2026. Resources in place: Existing policy and commissioning teams including NECS and support from prison healthcare providers. Other dependencies identified: Coordination with DHSC, HMPPS, and digital registration systems. Additional comments: This review will inform future policy development and operational changes.
- Updated guidance issued, supported by the development of staff training resources on informed consent, by late 2026/27. Resources in place: Policy and clinical teams. NECS and collaboration with DHSC and HMPPS. Other dependencies identified: Dependent on completion of scoping review and stakeholder input. Additional comments: Guidance will reflect best practice and legal standards.
- Evaluation of implementation and patient feedback to ensure consistency across the estate, by 2028. Resources in place: Policy and commissioning teams. Other dependencies identified: Requires integration with future policy cycles and operational planning. Additional comments: Findings will inform future updates to guidance and training.
Our long-term aspiration is to establish a fully consistent, patient- centered registration process in every prison, ensuring that informed consent is embedded as a principle of care.
Response received on 20 October 2025.