Scotland

The Vision for Justice in Scotland  strategy (2022) sets out five aims which contribute to a vision of delivering a fair and effective justice system, tackling the underlying drivers of crime such as poverty, addiction, and adverse childhood experiences, and supporting people who are in contact with the justice system to help them move forward in life. 

Community Justice Scotland, is a national body created in 2017 to strengthen partnership working to prevent and reduce offending. It is supported by the Community Justice (Scotland) Act 2016 (legislation.gov.uk) which placed duties on a group of statutory bodies (including health boards) to contribute to community justice planning. The National Strategy for Community Justice, revised in June 2022, outlines key aims and priorities for delivering improvements to community justice in Scotland National Strategy for Community Justice - gov.scot (www.gov.scot) and the latest Community Justice Performance Framework published in March 2023 outlines 10 national performance outcomes and 9 indicators against which Local Authorities will measure performance  Community Justice Performance Framework - gov.scot (www.gov.scot).

The Scottish Government also publish a number of supporting policies that aim to provide alternatives to prison and encourage a shift towards community-based alternatives for those who would benefit from additional support to tackle the cause of their offending and change their behaviour to prevent reoffending and victimisation:

The Commission on Women Offenders (2012) proposed reforms for the treatment of women in the criminal justice system, much of which is being implemented.  The Scottish Prison Service published a Strategy for Women in Custody 2021-25 (sps.gov.uk) to ensure care for women in prison in Scotland was gender-specific and trauma-informed, and contributes to improved outcomes for women, their families and communities. Two new community custody units in Scotland were also opened in 2022, designed to support women successfully reintegrate back into their communities. 

The Scottish Governments policy on Violence against women and girls (VAWG) - gov.scot (www.gov.scot) outlines the vision of preventing gender-based violence, and the Equally Safe strategy - Violence against women and girls (VAWG) - gov.scot (www.gov.scot) outlines priorities for measuring progress.

The Scottish Prison Service Organisational Review, (2014), set out an assets-based, desistance focused and people centred approach.

The report of the Ministerial Group on Offender Reintegration (2015) set out cross-ministerial commitments to improve offender reintegration.

A Throughcare Strategy (sps.gov.uk) was published in 2018 by the Scottish Prison Service to enable Throughcare Support Officers to assist those in custody to successfully navigate the challenges they face when reintegrating into communities on release.

The Scottish Prison Service also published a SPS Family Strategy in 2017 to improve outcomes for people in custody and their families, based on the knowledge that positive relationships can reduce the likelihood of reoffending.

Prison Healthcare

On the 1^st November 2011, responsibility for health care of all prisoners in Scotland transferred from the Scottish Prison Service to the NHS. Nine NHS boards have prisons in their area, with all NHS boards having prisoners returning post-release. There has not been any formal evaluation of the transfer. Two reports, the first by the Royal College of Nursing in 2016, and then, in 2017, a report by the Scottish Parliament Health and Sport Committee (1.2Mb), both concluded that despite examples of good practice, overall, the ambition of an improvement in prison health had not been realised. In response, in 2017 the Scottish Government established the Health and Justice Collaboration Improvement Board made up of senior leaders from Health, Justice and Local Government. The board oversees the Scottish Government Health and Social Care in Prisons Programme, the remit of which is to drive improvement in both health and social care in prisons through partnership by removing structural barriers to delivery. 

The report, A New Vision for Social Care in Prisons, carried out by the University of Dundee (2018) provides a foundation based on academic research for policy and practice decisions around the delivery of health and social care in Scottish prisons.

The Mental Health Strategy 2017-2027 - gov.scot (www.gov.scot) (2017) outlined a number of actions to improve mental health outcomes for those who come into contact with the justice system, including the mental health needs of young offenders. It outlined the need to increase the mental health workforce in justice settings and the need to take trauma-based approach. It also includes the need for an evaluation of Distress Brief Interventions, including delivery in front line justice settings.

An Independent Review into the Delivery of Forensic Mental Health Services was announced in 2019 and the  Independent Forensic Mental Health Review: final report - gov.scot (www.gov.scot) published in 2021. This outlined a number of recommendations for change or improvements to forensic mental health services (also known as the Barron recommendations) for individuals requiring secure hospital provision, including transfer between community based and justice settings.

Rights, Respect and Recovery (2018) sets out Scotland’s strategy to improve health by preventing and reducing alcohol and drug use, harm, and related deaths. The Scottish Government have published a suit of policies supporting this, including on Naloxone provision to help reduce opioid-related drug deaths https://www.gov.scot/policies/alcohol-and-drugs/

HMIPS – Who Cares? (2020) is a follow up review of the lived experience of older prisoners in Scotland’s Prisons.

The Scottish Health in Custody Network encompasses both the Police Care Network and the Prison Care Network. Together, these networks work with partners to support the delivery of holistic, person-centred care in police custody and prison settings, with the aim of optimising health and wellbeing. This involves working closely with partners in the Health and Justice sector and in the third sector working with Public Social Partnerships and voluntary agencies.

The Network has evolved over the years and is now firmly embedded in all aspects of offender health, including the throughcare arrangements that are necessary to support people as they leave prison and reintegrate into the community.

The 5 Nations Health and Justice Collaboration (5 Nations) brings together representatives from The Republic of Ireland, Northern Ireland, Scotland, England and Wales. The emerging objectives of the 5 Nations collaboration relate to improving outcomes for those who spend time in prescribed places of detention (prisons, police custody, courts etc.) through improved collaborative working between these nations. This group links to the WHO health in prison project and global prison health research organisation (WEPHREN).

International

The United Nations Nelson Mandela Rules (adopted by the General Assembly on 17 December 2015), Rule 24 (in two parts), states that: 1) “The provision of health care for prisoners is a State responsibility. Prisoners should enjoy the same standards of health care that are available in the community, and should have access to necessary health-care services free of charge without discrimination on the grounds of their legal status” and 2) “Health-care services should be organized in close relationship to the general public health administration and in a way that ensures continuity of treatment and care, including for HIV, tuberculosis and other infectious diseases, as well as for drug dependence”.

The Moscow Declaration on Prison Health as part of Public Health (2003) argues that prison health should be an integral part of the public health system of a country.

The Ottawa Charter for Health Promotion (WHO (1986)) sets out that the prison setting is potentially an opportunity for health promotion.

Good Governance for Prison Health in the 21^st Century (743Kb) proposes that health ministries should provide and be accountable for health care services and advocate healthy conditions in prisons.