Health and the justice system

9. Additional investment in services for people experiencing a mental health crisis will make a real difference for people who need support, and will help ease pressures on police services. The NHS also commissions health care for children, young people and adults across secure and detained settings, which include prisons, secure facilities for children and young people, police and court Liaison and Diversion services and immigration removal centres. Adults, children and young people will receive health screening on entering prison and a follow-up appointment within seven days, or sooner as required. This will be supported by the full roll-out of the health and justice digital patient record information system across all adult prisons, immigration removal centres and secure training centres for children and young people. This will include the digital transfer of patient records before custody, in custody and on release.

10. Health and justice services are provided to some of the most vulnerable members of our society. Many people within the justice system experience greater problems than the rest of the population but do not regularly access timely healthcare. The NHS is already working with partners across government to improve the wellbeing of people in prison, reduce inequalities and address health-related drivers of offending behaviours [189]. A priority in services for this group of patients is improving continuity of care. The care after custody service, RECONNECT, starts working with people before they leave prison and helps them to make the transition to community-based services that will provide the health and care support that they need. 250,000 people churn through prison annually and 57% serve sentences of 12 months or less. Over the next five years RECONNECT will engage and support more people after custody per year.

11. Since 2017, five parts of England have been testing a new Community Service Treatment Requirement (CSTR) programme. This enables courts to require people to participate in community treatment, instead of a custodial sentence. CSTR sites have provided community treatment for people who would otherwise have been sentenced inappropriately. We will build on this by expanding provision to more women offenders, short-term offenders, offenders with a learning disability and those with mental health and additional requirements.

12. We will invest in additional support for the most vulnerable children and young people in, or at risk of being in, contact with the youth justice system. The development of a high-harm, high risk, high vulnerability trauma-informed service will provide consultation, advice, assessment, treatment and transition into integrated services. This will provide support to, and help to address the complex and challenging needs of vulnerable children and young people.

13. The NHS also supports the justice system to provide healthcare support to victims. Across England, 47 sexual assault referral centres currently provide health support for people who have been a victim of sexual assault. We will expand provision to ensure survivors of sexual assault are offered integrated therapeutic mental health support, both immediately after an incident and to provide continuity of care where needed.


189. HM Government & NHS England (2018) National Partnership Agreement for Prison Healthcare in England: 2018-2021. Available from: