Wainwright Lucy, Senker Sarah, Canvin Krysia, Sheard Laura
Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK.
Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Worsley Building, Leeds, LS2 9JT, UK.
Health Justice. 2023 Feb 7;11(1):6. doi: 10.1186/s40352-023-00212-1.
The impact of COVID-19 has been exceptional, particularly on the National Health Service which has juggled COVID affected patients alongside related staff shortages and the existing (and growing) health needs of the population. In prisons too, healthcare teams have been balancing patient needs against staffing shortfalls, but with additional strains unique to the prison population. Such strains include drastic lockdown regimes and prolonged isolation, the need to consider health alongside security, known health inequalities within prisoner groups, and an ageing and ethnically diverse population (both groups disproportionately affected by COVID). The aim of this paper is to contribute to emerging research on the impact of COVID-19 on prison healthcare.
We conducted 44 in depth interviews (over phone or video) across three groups: prison leavers, healthcare staff and decision makers, between July and December 2021. Framework analysis was undertaken.
Three themes were found. First, we found that Covid-19 had a significant impact on prison healthcare which involved reduced access and changes to how healthcare was delivered. This affected the health of prisoners by exacerbating existing conditions, new conditions being undiagnosed and mental health needs increasing. Second, the pandemic impacted on healthcare staff through creation of stress, frustration and exhaustion due to minimal staffing levels in an already under-resourced system. Third, an emerging conflict was witnessed. People in prison felt neglected regarding their healthcare needs but staff reported doing the best they could in an unprecedented situation. Healthcare staff and decision makers felt that prison healthcare was seen as a poor relation when compared with healthcare in the community, with no extra resource or staffing for Covid-19 testing or vaccinations.
The Covid-19 pandemic has significantly impacted almost all aspects of prison healthcare in the UK. This includes delivery of healthcare by staff, receipt of it by people in prison and the management, planning and commissioning of it by decision makers. These three groups of people were all affected detrimentally but in vastly different ways, with some participants describing a sense of trauma. Health needs that were exacerbated or went unmet during Covid urgently need to be addressed in order to reduce health inequalities. In order for welfare and wellbeing to be maintained, and in some cases repaired, both prisoners and staff need to feel heard and recognised.
新冠疫情的影响极为特殊，尤其是对国民医疗服务体系而言，该体系在应对感染新冠的患者时，还要应对相关工作人员短缺以及民众现有的（且不断增长的）健康需求。在监狱中，医疗团队也一直在平衡患者需求与人员短缺的问题，但监狱人群还有一些独特的额外压力。这些压力包括严格的封锁制度和长期隔离、在考虑健康问题时还要兼顾安全、囚犯群体中已知的健康不平等现象，以及老龄化和种族多样化的人群（这两个群体受新冠影响的比例过高）。本文旨在为新冠疫情对监狱医疗影响的新兴研究做出贡献。
2021年7月至12月期间，我们对三组人员进行了44次深度访谈（通过电话或视频），这三组人员分别是刑满释放人员、医护人员和决策者。采用了框架分析法。
发现了三个主题。首先，我们发现新冠疫情对监狱医疗产生了重大影响，包括医疗服务的可及性降低以及医疗服务提供方式的改变。这通过加剧现有病情、新病情未被诊断以及心理健康需求增加，影响了囚犯的健康。其次，疫情给医护人员带来了压力、挫败感和疲惫感，因为在一个资源本就不足的系统中人员配备极少。第三，出现了一种新的冲突。监狱中的人觉得他们的医疗需求被忽视了，但工作人员表示在这种前所未有的情况下已尽了最大努力。医护人员和决策者认为，与社区医疗相比，监狱医疗被视为较差的一方，没有额外的资源或人员用于新冠病毒检测或疫苗接种。
新冠疫情严重影响了英国监狱医疗的几乎所有方面。这包括工作人员提供医疗服务、监狱中的人接受医疗服务以及决策者对其进行管理、规划和委托。这三组人员都受到了不利影响，但方式截然不同，一些参与者描述了一种创伤感。为了减少健康不平等，迫切需要解决在新冠疫情期间加剧或未得到满足的健康需求。为了维持并在某些情况下修复福利和福祉，囚犯和工作人员都需要感到自己的声音被听到且得到认可。
