Scotland
The Vision for Justice in Scotland strategy (2022) sets out five aims which contribute to a vision of delivering a more community-centred, preventive, fair, trauma-informed, and modernised justice system. Related to prisons, the vision sets out the aim to support rehabilitation, use custody only where there is no alternative, and work to reduce reoffending and revictimization. The Vision sets the improvement of health and wellbeing as an integral part of rehabilitation and recovery for people in prison.
A three-year Delivery Plan (2023-2026) lays out detailed reforms across justice, including around prison estate modernisation (HMP Highland opening and HMP Glasgow rebuild). A Measurement Framework was released alongside the Delivery Plan to track outcomes.
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, and the 2023 Community Justice Performance Framework outlines 10 national performance outcomes and 9 indicators against which Local Authorities will measure performance. Technical guidance was updated in 2025.
There are various supporting policies that aim to prevent crime and recidivism, provide alternatives to prison, and support reintegration into the community. Examples are provided below.
In response to pressures related to increased prison populations, and related overcrowding, the Scottish Government passed an Emergency Bill in 2024 to allow eligible short-term prisoners to be released after serving 40% of their sentence, instead of 50%. The Prisoners (Early Release) (Scotland) Act 2025 now enables automatic early release for people with short-term prison sentences (4 years or less) at 40% of sentence (for non-sexual/domestic abuse cases), reduced from 50%.
Over the past decade, The Scottish Prison Service (SPS) has moved away from a purely custodial model towards one that prioritizes the individual in custody, focusing on their potential and assets. SPS have a Strategic Plan for 2023-2028, provide annual reports, conduct a survey of people in prison highlighting good practice and areas for improvement, and hold seven organisational values including respect, integrity, compassion, and humility.
HM Inspectorate of Prisons for Scotland (HMIPS) has a statutory duty to inspect and monitor the conditions in which prisoners are held and the treatment they receive. NHS Healthcare Improvement Scotland (HIS) works with HMIPS to manage the healthcare element of inspections in prison. Inspection reports are published, including Annual Reports, reports for inspection by establishment, and thematic reports (e.g., for Prisoner Transport Services, Young People’s Experiences, Older People's Experiences, and Prisoner Progression).
Young people and the justice system
Children (Care and Justice) (Scotland) Act 2023 includes various measures aiming to improve children and young people’s experiences of the care and justice systems. Key changes are that the Act defines a child as anyone under the age of 18 and ends the use of Young Offender Institutes or prisons for children who have been remanded or sentenced. Children may be remanded or sentenced in secure residential accommodation or secure hospital. In secure accommodation, children should, by law, be treated as ‘looked after’ by the Local Authority, who have same duties towards the child as any ‘looked after’ child. The first operation report was published by the Scottish Government in 2025.
SPS refreshed its Vision for Young People in Custody in 2021, emphasising a child-centred approach, prioritising welfare and development, rehabilitation, education, and an environment to support young people to have a positive future.
SPS published its refreshed Family and Parenting Strategy 2024-2029 to improve outcomes for people in custody and their families, based on the knowledge that positive relationships can reduce the likelihood of reoffending.
Women and the justice system
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 (Bella Centre and Lilias Centre) were also opened in 2022, designed to support women to successfully reintegrate back into their communities. A Scottish Government funded evaluation of CCUs and of the operation of the Scottish Prison Service Women’s Strategy in the women’s estate is underway (SPAROW project). The Scottish Government’s policy on Violence against Women and Girls outlines the vision that women and girls live free from all forms of violence and abuse, as well as the attitudes that perpetuate it. The Equally Safe strategy outlines priorities for measuring progress.
Reintegration
A National Voluntary Throughcare Service ‘Upside’ was launched in April 2025, following a review of third-sector throughcare provision. This is delivered via a partnership of eight third-sector organisations, led by Sacro, and replaces previously fragmented support for people on release from prison. Community Justice Scotland will commission and oversee this service.
Scottish Government provide statistics related to Justice Social Work, including diversions, community payback, and throughcare.
Prison Healthcare
As of 2025, there are 17 prisons, within nine Health Boards (no prisons in the Borders, Fife, Orkney, or Shetland) in Scotland, managed by the Scottish Prison Service (one is managed privately under contract to SPS). Barlinnie Prison in Glasgow, the largest in Scotland, is being replaced by a new prison, HMP Glasgow, which is due to open in 2028. The prison establishments cater to different categories of prisoner, relating to sex, age, crime type and length of sentence, with varying levels of security. The SPS is an Executive Agency of the Scottish Government, with autonomy to carry out its executive functions, whilst directly accountable Scottish Ministers.
On the 1st November 2011, responsibility for health care of all prisoners in Scotland transferred from the Scottish Prison Service to the NHS. There has not been any formal evaluation of the transfer. Two reports, the first by the Royal College of Nursing in 2016, and a report by the Scottish Parliament Health and Sport Committee (Haughey et al, 2017), both concluded that despite examples of good practice, overall, the ambition of an improvement in prison health had not been realised. They found remaining issues related to: equity of access to healthcare; national oversight, leadership and budget; and reporting and data.
The Healthcare within justice strategy NHS HIS 2024-2027 was published by NHS Scotland to make improvements in some of these areas. Amongst other things, the strategy set out the requirement for NHS boards / HSCPs to have an identified executive lead for healthcare in justice in their Annual Delivery Plans. The ‘Healthcare within Justice’ team in HIS exists to lead improvement in healthcare provision in Scottish justice settings through inspection of prisons and police custody centres and collaboration at a national level.
The Scottish Health in Custody Network encompasses both the Police Care Network and the Prison Care Network. The aim of the Network is to work across geographical and organisational boundaries to support a ‘Once for Scotland 'approach to the planning, design and delivery of an integrated, holistic, person-centred care for those in the criminal justice system. This involves working closely with partners in the Health and Justice sector and in the third sector working with Public Social Partnerships and voluntary organisations.
The National Prison Care Network undertake various roles, including mapping and providing intelligence on the prison workforce on an annual basis, to support recruitment and retention of prison healthcare workers; rolling out a Target Operating Model for Prison Healthcare, which sets out a framework to support high quality, consistent care across all prison establishments; Continuous Professional Development webinars; and maintaining guidance and peer support forums. If you would like to find out more about the work of the Network, please contact the Network Programme team via nss.prisoncare@nhs.scot.
Public Health Scotland and SPS have a Prison Health & Wellbeing collaboration that is currently using administrative data from SPS and NHS to provide data and evidence on the health and healthcare for people in prison, in order to support improvements. This will expand to Community Justice settings, in collaboration with Community Justice Scotland.
With regards to particular healthcare needs of people in prison, the Scottish Government commissioned a series of four needs assessments, which published in 2022 and explored: social care; mental health; substance use; and physical health.
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.
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 people who come into contact with the justice system. 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. The Mental health strategy for Prisons 2024-2034 was launched by SPS in 2024 and aligns with the overarching Scottish Government strategy, and with actions embedded into SPS’s operational planning.
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.
The SPS Alcohol and Drug Recovery Strategy 2024-2034 emphasises the accessibility of MAT, stigma reduction, post-release support, and supply within prisons. It operates in alignment with broader policies, such as the National Mission on Drug Deaths (2021-2026).
Reflecting concern about progress, The Scottish Parliament launched an inquiry into substance misuse in prisons in 2025.
International
The universal human right to health is contained in the Universal Declaration of Human Rights (1948). For full realisation of these rights, equal access to curative and palliative health services should not be denied or limited for anyone, including prisoners or detainees (stated by the International Covenant on Economic, Social and Cultural Rights, UN 1966). The WHO Moscow Declaration on Prison Health as part of Public Health (2003) recommended “penitentiary health must be an integral part of the public health system of any country” to ensure quality of care, connected surveillance and monitoring, and continuity of care.
In 2013, the WHO published Good Governance for Prison Health in the 21st Century (to which NHS Health Scotland contributed), which proposed that health ministries should provide and be accountable for health care services and advocate healthy conditions in prisons. Subsequently, the United Nations Nelson Mandela Rules, adopted in 2015, stated 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 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 21st Century (743Kb) proposes that health ministries should provide and be accountable for health care services and advocate healthy conditions in prisons.
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).
