Developing gender-specific evidence-based standards to improve the health and wellbeing of women in prison in England: a literature review and modified eDelphi survey

• DOI: https://doi.org/10.1108/IJPH-02-2019-0010
• Date: 27 August 2019
• Pages: 17-28
• Published date: 27 August 2019
• Author: Lucy J. McCann,Jo Peden,Emily Phipps,Emma Plugge,Eamonn J. O’Moore
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Developing gender-specific

evidence-based standards to improve

the health and wellbeing of women in

prison in England: a literature review

and modified eDelphi survey

Lucy J. McCann, Jo Peden, Emily Phipps, Emma Plugge and Eamonn J. O’Moore

Abstract

Purpose –There are significant health inequalities experienced by women in prison. They face distinct

challenges and have particular and complex needs, specifically with regard to their physical and mental

health. The purpose of this paper is to describe the approach taken to develop a set of health and wellbeing

standards for the women’s prison estate in England, which can be applied elsewhere.

Design/methodology/approach –A structured literature review of standard healthcare databases and

grey literature was used to inform development of suggested standards. A multidisciplinary expert panel

provided consensus on the standards through an online survey and women with a history of contact with the

criminal justice system were consulted through consensus groups.

Findings –A total of 549 papers were included in the final review. From this, 127 standards were

identified for inclusi on in the Delphi process. Con sensus was achieved on all sta ndards; this,

combined with the analysis of qualitative feedback provided by both the survey and the consensus

groups, resulted in the development of 6 overarching principles and 122 standards, across

ten topic areas.

Originality/value –These standards are the most extensive that are known to exist for health and wellbeing

of women in prison and the first to be developed in England. The process used ensures the standards have

high validity, acceptability and feasibility and can be used to support those developing similar methodologies.

There are few papers which document the development of standards to improve health and to the authors

knowledge, only one other paper has been published detailing the development of health standards in prison

settings specifically.

Keywords Women’s health, Public health, Women prisoners, Standards, Health, Wellbeing

Paper type Research paper

Background

Of the 85,000 people in prison in England and Wales, approximately 5 per cent are female.

Although this represents a small proportion of the total prison population, the actual number of

women in prison is increasing, more than doubling over the last 25 years, from 1,562 in 1992 to

3,975 in 2017 (MoJ, 2018a). Furthermore, of the total number of people sent to prison over the

course of each year, approximately 10 per cent are women, highlighting the high proportion

serving short sentences. In 2017, this number totalled 8,474 (MoJ, 2018b).

Women involved in the criminal justice system face distinct challenges and have particular, and

complex, needs (Anders et al., 2017), specifically with regard to their physical and mental

health. The inequalities in health and wellbeing facingwomeninprisonaresignificant,notjust

Received 14 February 2019

Revised 19 May 2019

25 June 2019

Accepted 26 June 2019

Lucy J. McCann

and Jo Peden are both based

at the National Health and

Justice Team, Public Health

England, London, UK.

Emily Phipps is based at

the Oxford School of

Public Health, University of

Oxford, Oxford, UK.

Emma Plugge is based at the

WHO UK Collaborating Centre

for Health in Prisons

Programme, Public Health

England, London, UK.

Eamonn J. O’Moore is based

at the National Health and

Justice Team, Public Health

England, London, UK and the

WHO UK Collaborating Centre

for Health in Prisons

Programme, Public Health

England, London, UK.

DOI 10.1108/IJPH-02-2019-0010 VOL. 16 NO. 1 2020, pp. 17-28, © Emerald Publishing Limited, ISSN 1744-9200

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INTERNATIONALJOURNAL OF PRISONER HEALTH

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PAG E 17