Safety recommendation
HSSIB recommends that NHS England/Department of Health and Social Care, working with healthcare service providers and their healthcare teams at prisons which hold remand prisoners, reviews and amends the process for GMS registration of patients on remand.
This is to ensure a consistent approach to GMS registration across the prison estate, which acknowledges the potential negative impact short-term changes in care provision may have on the continuity of care for patients who have been remanded in custody.
Response:
We agree with this recommendation. We recognise the unique challenges associated with the remand population, where frequent transfers and shorter stays often disrupt continuity of care. We recognise the need for a consistent and patient-centred approach to registration for remand prisoners.
Actions planned to deliver safety recommendation:
- Conduct targeted review of GMS registration processes for remand populations in collaboration with healthcare providers and patient representatives, by early 2026. Resources in place: Policy and commissioning teams. Legal team Input from remand-holding establishments. Other dependencies identified: Coordination with DHSC, HMPPS, and prison healthcare teams. Additional comments: Review will focus on unique needs and challenges of remand populations.
- Explore the best way to enable functionality that would provide access to the full Electronic Patient Record through technical changes or access to other digital products, by 2026/27. Resources in place: GPIT programme teams; collaboration with digital teams and prison healthcare providers. Other dependencies identified: Dependent on digital infrastructure, interoperability standards, and stakeholder engagement HMPPS – sentencing review. Additional comments: Aims to improve continuity of care and reduce administrative burden for short-term prisoners.
- Undertake a consultation process with professional bodies, prison healthcare teams, and patient representatives to explore the Scottish model of mandatory registration after six months, by end 2026. Resources in place: Policy and commissioning teams. Legal oversight support from DHSC and external stakeholders. Other dependencies identified: Regulatory implications; technical enablers; alignment with existing NHS registration frameworks. Additional comments: Primary Care team to assist with coordination and stakeholder engagement.
- Continue development of a digital pathway for pre-release registration to support continuity of care post-release, by end 2026. Resources in place: Online Registration Team, NHS England (Primary Care to assist). Other dependencies identified: Digital development teams; collaboration with prison healthcare and commissioning teams. Additional comments: Integration with prison release planning systems and NHS registration platforms.
- Consider the technical requirements and possibilities for temporary care information following release to be held in the National Data Repository, by end 2026. Resources in place: Digital architecture and data governance teams; support from Primary Care. Other dependencies identified: Dependent on national data strategy, IG compliance, and system capabilities. Additional comments: Exploration will inform future data integration and continuity of care improvements.
The long-term ambition is to reduce disruption to patient care and ensure that GMS registration processes for remand prisoners are consistent, equitable, and support seamless continuity of treatment.
Response received on 20 October 2025.