Title: The development of a national policy strategy for older adults in the criminal justice system
Funder: Department of Health and Social Care

Abstract: The absolute number and overall proportion of people aged 50 and over in prison in England and Wales is growing. This is because we have an aging population generally, changes to sentencing policy have resulted in people going to prison for longer and people going to prison later in life for historical offences. Historically, prisons have largely accommodated young men and the increase in older people has brought challenges around the provision of a suitable physical environment (cells/bathrooms/stairs) and regimes (work/education/non-vocational activities/age-specific health and social care services) for potentially frail, less mobile individuals. Our research and findings from HM Inspectorate of Prisons have highlighted the struggles experienced by both prisoners and staff on a daily basis trying to access/provide adequate facilities in the absence of central guidance from HMPPS and NHS England. Frontline staff and managers would be assisted in the development of quality services for this group if they were able to access centrally ratified guidance in terms of a national strategy for the management of older people in contact with the criminal justice system, with particular emphasis on their treatment within the prison estate. To inform such a national strategy we will conduct a synthesis of the available evidence already published in this field, starting with our research group s body of evidence following over a decade of research in this field. Gaps in knowledge will be identified and augmented by a realist review of national and international research, practice and policy evidence. Once we have triangulated all existing published evidence, we will conduct a series of nominal group meetings with policy, practitioner, third sector and service user informants to further hone &ldquo;what good looks like&rdquo; in the context of the evidence, in the English (health and social care) and English and Welsh (criminal justice & prison estate) setting(s). All data will be triangulated for a final time and presented in the form of a national strategy which provides clear guidance for frontline workers and managers to base the development of high quality and sustainable services for this demographic.

Lay abstract: The number of people aged 50 and over in prison in England and Wales is growing. This is because we have an aging population, people are going to prison for longer and more people are going to prison later in life for crimes they committed a long time ago. Prisons were built for young fit men whereas older people in prison have more health and social care needs than younger people living in prison and people who are the same age who live in the community. Often prison services do not meet the needs of older adults, for example house units usually have lots of stairs, doorways too narrow for walking frames or wheelchairs and showers and toilets which are not safe enough for people who are unsteady on their feet. There is often no access to specialised older adult services such as memory clinics or old age psychiatrists. Some prisons provide help for this group well, other do not. We want to develop a national plan for the care of older people in prisons that prison staff can use to properly develop good services for this group. For this study, we will firstly bring together all the findings from a number of research studies we have already completed in this area. We will then see where there are gaps in our knowledge and fill those gaps by looking at research completed by other people, and by interviewing a range of experts. We know that there are gaps in the information around how older people should be treated by the police, courts and probation services in particular. We will then get together a group of senior managers from health, social care, older adult and prison organisations and a separate group of individuals who have experience of living in prison. We will talk about the findings from studies that have been completed so far with each of these groups. We will discuss what the plan for older adults should look like and ask them to come to an agreement about this. We have also set up a group of older individuals who have experience of living in prison to involve them in the research process throughout the study. All of this information will be brought together to make the plan for older adults in prison in England and Wales. We will make sure we tell individuals from health, social care, older adult and criminal justice organisations about the plan. We hope the government will make this plan into law to ensure it is taken seriously.

Research activity codes: 8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: GENERIC HEALTH RELEVANCE