NHS Health Check Programme: a qualitative study of prison experience

Background: NHS Health Checks began in England in 2009 and were subsequently introduced into English prisons. Uptake has been patchy and there is limited understanding about factors that may limit or enhance uptake in prison settings. Uptake of this programme is a key policy in reducing the risk of cardiovascular disease and death in these settings.

Method: Semi-structured focus groups were conducted with groups of prisoners (attendees and non-attendees to the health check), prison healthcare staff, custodial staff and ex-prisoners (n = 50). Participants were asked about their awareness and experiences of the NHS Health Check Programme in prison.

Results: All groups highlighted barriers for not attending a health check appointment, such as poor accessibility to the healthcare department, stigma and fear. The majority of participants expressed a lack of awareness and discussed common misconceptions regarding the health check programme. Methods of increasing the uptake of health checks through group-based approaches and accessibility to healthcare were suggested.

Conclusions: This study reports on prisoner, staff and ex-prisoner perspectives on the implementation of NHS Health Checks within a restrictive prison environment. These findings have potentially substantial implications for successful delivery of care within offender healthcare services.