Dying Behind Bars: How can we better support people in prison at the end of life?

This report aims to:

1. Examine the current state of the end of life care received by people in English prisons.
2. Outline the provision of end of life care in prisons, with particular focus on the work of hospices and other charitable organisations.
3. Understand the unique challenges that end of life care providers face when delivering support to people in English prisons.
4. Establish what different stakeholders can do to improve the end of life care received by people in English prisons and their loved ones.

This report demonstrates that the current need for end of life care for people in prison is not being adequately met. Given the increasing and ageing prison population, this must be addressed as a matter of urgency.

Recommendations include:

• End of life care for imprisoned people should be a UK-wide policy priority. The current provision of and unmet need for end of life care in prisons should be established across the four nations. 
• HM Prison and Probation Service and the prison system should review their policy and practice on the use of restraints, especially concerning seriously and terminally ill imprisoned people.
• The compassionate release process should be comprehensively reviewed and amended to ensure that it is used in a consistently fair and timely manner.
• The provision of bereavement support within prisons should be established at a national level and hospice services should explore the possibility of supporting or providing this care.
• National organisations should support and facilitate the sharing of good practice across the palliative and end of life care system for those providing care for people in prison. Hospice services should assess the need for palliative and end of life care support for imprisoned people in their community and proactively engage and work closely with local specialist organisations supporting prison health and care services to ensure that need is met.

This report was researched and written by Rini Jones, former Policy and Advocacy Officer at Hospice UK.

Thanks to:

• Colleagues at Hospice UK, contributing member hospices, and clinical staff working with imprisoned people
• Ann Norman, Royal College of Nursing and Juliet Lyons CBE, Independent Advisory Panel on Deaths in Custody
• the organisations RECOOP, Hanham Secure Health, and Clinks.

For more information about this work please email our Policy, Advocacy and Clinical Programmes team.