Prisoners: introduction

People in prison generally have multi-layered and complex social and health care needs, with high levels of substance misuse and mental ill health reported. This creates challenges for the provision of support and continuity of care, both within prison and for the transition from and back into the community. 

The profile of the Scottish prison population is also changing over time. An ageing population together with increases in the number of individuals on remand and changes in the types of offences committed mean there are an increasing number of individuals who are legally required to be housed separately. This can create difficulties with managing prison populations within the existing prison estate. 

Prison rules can also lead to some people being adversely impacted. For example, those on remand cannot access the same support mechanisms as those with a custodial sentence, which can lead to increased isolation and health risks, and increased risk of becoming unemployed or homeless whilst in prison - even if they are ultimately acquitted. An analytical review on the conditions and treatment of remand prisoners, and their experiences of life on remand, is due to be published by HM Inspectorate of Prisons for Scotland in 2025. (HM Chief Inspector's Annual Report 2023-24) 

Care in prison should be equivalent to that delivered in the community and provides an opportunity to reach some of those underserved in the community and so tackle health inequalities, which remain a major public health challenge in Scotland. 

There is little national routine reporting from health and care services delivered in prisons and the last comprehensive national health care needs assessment on the health of Scottish prisoners was conducted in 2007 (Graham L, 2007 (1.5Mb)) although there have been local and thematic needs assessments carried out since. Public Health Scotland (PHS) previously launched a Prison Health and Care Dashboard and is now working in collaboration with the Scottish Prison Service (SPS) to develop a new prison surveillance system, linking prison records to patient level health data to inform on the health needs and outcomes of those in prison in Scotland and how this is changing over time.