Prisoners in Scotland are predominately young, male, white and come from the more deprived areas of Scotland. They have multi-layered and complex health needs and are often in prison for a very short time. This creates huge challenges for detection, assessment and delivery of integrated care, both within prison and in the transition between prison and the community.
Care has to be delivered in the context of the prison setting. Scotland has one of the highest imprisonment rates in Western Europe. The prison population is at an all time high with overcrowding and constant movement of prisoners. It is a setting where custody and order must also be effective at all times.
A guiding principle for prison health is that health care in prison should be equivalent to that delivered in the community. It is also an opportunity to reach some of those ‘hardest to reach’ in the community and so tackle health inequalities, which remain a major challenge in Scotland.