Understanding and improving the quality of primary care for people in prison: a mixed-methods study.

Background: People in prison are generally in poorer health than their peers in the community, often living with chronic illness and multimorbidity. Healthcare research in prisons has largely focused on specific problems, such as substance use; less attention has been paid to conditions routinely managed in primary care, such as diabetes or hypertension. It is important to understand how primary care in prisons is currently delivered in the United Kingdom and how it can be improved, in order to reduce health inequalities.

A service-user digital intervention to collect real-time safety information on acute, adult mental health wards: the WardSonar mixed-methods study.

Background: Acute inpatient mental health services report high levels of safety incidents. The application of patient safety theory has been sparse, particularly concerning interventions that proactively seek patient perspectives.

Objective(s): Develop and evaluate a theoretically based, digital monitoring tool to collect real-time information from patients on acute adult mental health wards about their perceptions of ward safety.

An evaluation of a public partnership project between academic institutions and young people with Black African, Asian and Caribbean heritage.

Background: This project (named Reinvent) aimed to promote Public Involvement (PI) in health research. Academics worked with a community group, the Eloquent Praise & Empowerment Dance Company, to develop a community partnership with young people from Black African, Asian and Caribbean heritage communities. The goal of this paper is to evaluate the Reinvent project for key learnings on how to engage and build partnerships with young people from Black African, Asian and Caribbean heritage communities.

Understanding the impact of Covid-19 on the delivery and receipt of prison healthcare: an international scoping review.

Background: People being held in prison are particularly vulnerable to Covid-19 infection, as places of detention are high-risk environments for spread of infection. Due to this risk, many prisons across the globe introduced measures to reduce the risk of Covid-19 transmission. The pandemic changed almost all aspects of prison life, including prison healthcare provision.

The quality of prison primary care: cross-sectional cluster-level analyses of prison healthcare data in the North of England.

Background: Prisoners have significant health needs, are relatively high users of healthcare, and often die prematurely. Strong primary care systems are associated with better population health outcomes. We investigated the quality of primary care delivered to prisoners.

Understanding the organisational influences on the quality of and access to primary care in English prisons: a qualitative interview study.

Background: Primary care for routine healthcare conditions is delivered to thousands of people in the English prison estate every day but the prison environment presents unique challenges to the provision of high-quality health care. Little research has focused on the organisational factors that affect quality of and access to prison health care.

Aim: To understand key influences on the quality of primary care in prisons.

'Trying to battle a very slow version of the system that exists outside': Experiences of waiting for healthcare in English prisons.

Prison has been described as the ultimate form of time-punishment - a place where time is no longer a commodity for individuals to spend, but is ordered by a system which symbolises its power through the control of segments of people's lives. As such, a prison sentence epitomises the experience of waiting. Yet anticipating release is not the only form of waiting within carceral life; waiting for healthcare in its various forms also shapes people's temporal experience.

"It was really poor prior to the pandemic. It got really bad after": A qualitative study of the impact of COVID-19 on prison healthcare in England.

Background: The impact of COVID-19 has been exceptional, particularly on the National Health Service which has juggled COVID affected patients alongside related staff shortages and the existing (and growing) health needs of the population. In prisons too, healthcare teams have been balancing patient needs against staffing shortfalls, but with additional strains unique to the prison population. Such strains include drastic lockdown regimes and prolonged isolation, the need to consider health alongside security, known health inequalities within prisoner groups, and an ageing and ethnically diverse population (both groups disproportionately affected by COVID).

Interventions to improve the implementation of evidence-based healthcare in prisons: a scoping review.

Background: There are challenges to delivering high quality primary care within prison settings and well-recognised gaps between evidence and practice. There is a growing body of literature evaluating interventions to implement evidence-based practice in the general population, yet the extent and rigour of such evaluations in incarcerated populations are unknown. We therefore conducted a scoping literature review to identify and describe evaluations of implementation interventions in the prison setting.

Mapping review of interventions to reduce the use of restrictive practices in children and young people's institutional settings: The CONTRAST study.

Restrictive practices are often used harmfully with children in institutional settings. Interventions to reduce their use do not appear to have been mapped systematically. Using environmental scanning, we conducted a broad-scope mapping review of English language academic databases, websites and social media, using systematic methods.

Quality indicators and performance measures for prison healthcare: a scoping review.

Background: Internationally, people in prison should receive a standard of healthcare provision equivalent to people living in the community. Yet efforts to assess the quality of healthcare through the use of quality indicators or performance measures have been much more widely reported in the community than in the prison setting. This review aims to provide an overview of research undertaken to develop quality indicators suitable for prison healthcare.

To what extent are patients involved in researching safety in acute mental healthcare?

Background: There is a growing need to involve patients in the development of patient safety interventions. Mental health services, despite their strong history of patient involvement, have been slow to develop patient safety interventions, particularly in inpatient settings.

Methods: A systematic search was undertaken of both academic and grey literature.

The relationship between workforce characteristics and perception of quality of care in mental health: A qualitative study.

Background: Mental health services worldwide are under strain from a combination of unprecedented demand, workforce reconfigurations, and government austerity measures. There has been relatively little research or policy focus on the impact of staffing and skill mix on safety and quality in mental health services leaving a considerable evidence gap. Given that workforce is the primary therapeutic intervention in secondary mental health care this constitutes a major deficit.

Seeking assistance in later life: how do older people evaluate their need for assistance?

Background: legislation places an onus on local authorities to be aware of care needs in their locality and to prevent and reduce care and support needs. The existing literature overlooks ostensibly 'healthy' and/or non-users of specific services, non-health services and informal assistance and therefore inadequately explains what happens before or instead of individuals seeking services. We sought to address these gaps by exploring older adults' accounts of seeking assistance in later life.

Carer involvement in compulsory out-patient psychiatric care in England.

Background: There is an expectation in current heath care policy that family carers are involved in service delivery. This is also the case with compulsory outpatient mental health care, Community Treatment Orders (CTOs) that were introduced in England in 2008. No study has systematically investigated family involvement through the CTO process.

Mental health, coercion and family caregiving: issues from the international literature.

This article summarises current knowledge about two aspects of family care for people with mental illness: potentially pressurising or coercive aspects of family life; and family carers' experiences of being involved in coercive service interventions. There is a paucity of studies on these topics, especially outside Europe, North America and Australasia, and further research is recommended.

Identity in recovery from problematic alcohol use: A qualitative study of online mutual aid.

Aim: To explore how engagement with online mutual aid facilitates recovery from problematic alcohol use, focusing on identity construction processes.

Design: Qualitative in-depth interview study of a maximum variation sample.

Setting: Telephone interviews with UK-based users of Soberistas, an online mutual aid group for people who are trying to resolve their problematic alcohol use.

Patient, psychiatrist and family carer experiences of community treatment orders: qualitative study.

Purpose: Current literature on personal experiences of community treatment orders (CTO) is limited. This paper examines participants' experiences of the mechanisms via which the CTO was designed to work: the conditions that form part of the order and the power of recall. We also report an emergent dimension, legal clout and participants' impressions of CTO effectiveness.

Trust, deals and authority: community mental health professionals' experiences of influencing reluctant patients.

The emphasis on care in the community in current mental health policy poses challenges for community mental health professionals with responsibility for patients who do not wish to receive services. Previous studies report that professionals employ a range of behaviors to influence reluctant patients. We investigated professionals' own conceptualizations of such influencing behaviors through focus groups with community teams in England.

The use of leverage in community mental health: ethical guidance for practitioners.

Background: Leverage is a particular type of treatment pressure that is used within community mental health services to increase patients' adherence to treatment. Because leverage involves practitioners making proposals that attempt to influence patients' behaviours and choices, the use of leverage raises ethical issues.

Aim: To provide guidance that can assist practitioners in making judgements about whether it is ethically acceptable to use leverage in a particular clinical context.

Leverage and other informal pressures in community psychiatry in England.

Purpose: Informal practices aimed at managing psychiatric patients in the community setting fall outside legal and policy provision or guidance. "Leverage" is an informal practice whereby practitioners attempt to influence patients' treatment adherence by, for example, making patients' access to subsidised housing conditional upon adherence to treatment or by making treatment adherence a condition of patients' avoidance of financial control. Lower rates of leverage are reported in the UK compared to the USA, possibly due to differences between the US and European social welfare systems.