Perceptions of the effectiveness of health care for probationers

• DOI: https://doi.org/10.1108/IJPH-01-2020-0004
• Pages: 123-134
• Date: 02 April 2020
• Published date: 02 April 2020
• Author: Coral Sirdifield,Rebecca Marples,David Denney,Charlie Brooker
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Perceptions of the effectiveness of health

care for probationers

Coral Sirdifield, Rebecca Marples, David Denney and Charlie Brooker

Abstract

Purpose –This study aimsto investigate the views of commissioners,providers and criminal justice staff

on how effective current health-care provision is at meeting the health needs of people on probation.

Understanding perceptionsof what constitutes effective provision, wherebarriers are encountered and

where improvementscould be made is an important step towards improvingaccess to care for this hard-

to-reachgroup.

Design/methodology/approach –The research was part of a wider study. This paper focusses on

findings from casestudies conducted via semi-structured telephoneinterviews with 24 stakeholders ina

purposive sample from six geographical areas of England. Interviews were conducted by researchers

from a variety of backgroundsand an individual with lived experience of the criminaljustice system. Data

were analysedusing thematic analysis.

Findings –Participants provided examples of effective health-care provision, which largely involved

multi-agency partnership working. It was apparent that there are many barriers to providing appropriate

health-care provision to people on probation, which are underpinned by the complexity of this population’s

health-care needs, the complexity of the health-care landscape and problematic commissioningprocesses.

Practical implications –Improvements are neededto provide appropriate and accessible health care

that meets the needsof people on probation, thereby reducing health inequalities.These include shared

targets,improved funding, clearer pathwaysinto care and giving probation a voicein commissioning.

Originality/value –To the best of authors’ knowledge, this is the first study of commissioner, provider

and criminal justice staffs’ views on the effectiveness of current health-care provision at meeting the

healthneeds of people on probation.

Keywords Criminal Justice System, Health, Health care, Offender health, Probation, Commissioning

Paper type Research paper

Background

Internationally, there is a paucity of literature on the health needs of people on probation,

but the literature that does exist suggests that there is a high level and complexity of health

problems within this group when compared to the generalpopulation (Sirdifield et al.,2020;

Brooker et al., 2020;Sirdifield et al., 2019c). Often people on probation are not registered

with a general practitioner (GP) and do not engage with health services until they reach

crisis point. Indeed, people on probation encounter barriers to service access at the

personal level (e.g. a lack of motivation to attend and homelessness), service level (e.g. a

lack of appropriate provision for people with both a substance misuse problem and a

mental illness) and societal level (e.g. stigma) (Lang et al., 2014;Melnick et al.,2008;

Plugge et al., 2014;Pomerantz,2003;Revolving Doors Agency, 2013).

This highlights the need to commission and provide high-quality and accessible health

services that meet the needs of people on probation to improve the health of these

individuals and thereby reduce health inequalities. In addition, this would produce wider

community dividends through things such as improved compliance with probation and

reductions in both re-offending and avoiding use of expensive crisis care such as

Coral Sirdifield is based at

the School of Health and

Social Care, University of

Lincoln, Lincoln, UK.

Rebecca Marples is based

at the School of Law and

Social Sciences, University

of Suffolk, Ipswich, UK.

David Denney and Charlie

Brooker are both based at

the Department of

Criminology and Sociology,

Royal Holloway University

of London, Egham, UK.

Received 13 January 2020

Revised 30 January 2020

13 February 2020

Accepted 14 February 2020

Funding statement: This article

presents independent research

funded by the National Institute

for Health Research (NIHR)

under its Research for Patient

Benefit (RfPB) Programme

(Grant Reference Number

PB-PG-0815-20012). The views

expressed are those of the

author(s) and not necessarily

those of the NIHR or the

Department of Health and

Social Care.

The authors would like to thank

Dean Maxwell-Harrison for the

interviews that he conducted.

DOI 10.1108/IJPH-01-2020-0004 VOL. 16 NO. 2 2020, pp. 123-134, ©Emerald Publishing Limited, ISSN 1744-9200 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jPAGE 123