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Authors: Jan Cassidy and Woody Caan

This study of HMP Birmingham in England was part of a much larger investigation of health needs assessment (HNA), in the context of a new “HNA Toolkit” developed by Public Health England for use in the prison service. 

In 2015, details of prison healthcare in HMP Birmingham had figured in the authors’ analysis of documents. In 2018, a crisis in Birmingham typified problems developing more widely in England and Wales. Was the crisis predictable from the initial HNA?

The study found that the recommendations embodied in the 2015 HNA were not acted upon; the eventual problems that combined to overwhelm the running of HMP Birmingham were predictable from the issues identified in the HNA using the PHE toolkit. 

Lessons from this case study could inform more coherent commissioning of prison health services. This in turn could promote timely developments for improved health and morale in the prison, amongst prisoners and staff. Longer term, this might help to avoid future crises.


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