Title

HEALTH

Unlocking care in prisons

The needs of elderly men in the prison population need to be addressed urgently, says government and public sector expert at PA Consulting Amanda Kelly. 'We should question who we are imprisoning and whether there is an alternative', she adds.

The prison service is the largest residential care provider for elderly men in the UK. Over 60s are the fastest growing sub-group in the prison population, reflecting longer sentences and an increased focus on identifying and prosecuting sex offenders – 42% of male prisoners aged 50 or over have been convicted of a sexual offence, as highlighted in the Government publication The older prisoner cohort.

Why is this something we need to address? Well, for the simple reason that 60% of prisons are over-crowded and many are unsuitable for an ageing population, as reported by the National Audit Office Improving the prison estate report. The prison infrastructure can make it difficult to meet even basic needs of older prisoners. The level of engagement with social workers is variable and, anecdotally, the feeling is that this may be driven as much by the prison leadership as by the needs of prisoners.

Given these challenges, we should question who we are imprisoning and whether there's an alternative. Elderly prisoners are generally compliant and non-violent. Almost 60% have complex health problems and, as reported by the Prison Reform Trust's Care not custody 2018 report, 59% reveal they have a long-standing illness or disability. And according to a report published by Public Health England, (Better care for people with co-occurring mental health and alcohol/drug use conditions), 90% have at least one moderate or severe health condition, with more than half having three or more.

A strategy for elderly prisoners is in development, which is a welcome opportunity to address future social care needs.

We see three main priorities for this strategy to address:

1. Cultural change: Prison staff will be key to unlocking the opportunity to better embed social care in prisons.

2. Integrate social care: Changes to process and policies will show social care is an important part of responding to prisoners' needs.

3. Rethink the prison estate: Victorian prisons are inherently unsuitable for older prisoners – particularly those with mobility issues.

We are at a tipping point where prisons' ability to meet the needs of these prisoners is severely constrained. The catalyst for change must not be a tragic event that could be avoided.

You can read an extended version of this article here.

Amanda Kelly  is a government and public sector expert at PA Consulting

This article is sponsored content for The MJ.

HEALTH

Transforming public services in Liverpool City Region

By Kirsty McLean | 24 October 2025

Kirsty McLean reveals how the Liverpool-based Office for Public Service Innovation – working with the Cabinet Office’s Test, Learn and Grow programme – is la...

HEALTH

Test, Learn and Grow: Sheffield's family hubs

By Cllr Tom Hunt | 24 October 2025

Cllr Tom Hunt says Sheffield is aiming to build on the success of its Test, Learn and Grow pilot by launching a bold new Total Place approach that brings tog...

HEALTH

Cambridgeshire local government reorganisation debate heats up

By Paul Marinko | 24 October 2025

Cambridgeshire CC has backed the creation of two unitary authorities amid simmering tensions on reorganisation.

HEALTH

The emperor's new clothes revisited?

By Ian Miller | 23 October 2025

Ian Miller says local authorities’ final reorganisation proposals can ‘wax lyrical on all sorts of things about new councils’, but little of it can be guaran...

Popular articles by Amanda Kelly