CN24 The perceptions of healthcare professionals on the provision of palliative and end-of-life care in prisons

Abstract

The health of incarcerated individuals is worse than the general population. As a result, they are at greater risk of developing life-limiting and chronic conditions, which require palliative and potentially end-of-life care. Understanding healthcare professionals’ perceptions of challenges and practicalities around providing palliative and end-of-life care in prisons is key to advance the state of services. Three databases were searched (CINAHL, EMBASE and MEDLINE) from 2011 to 2021. The PRISMA reporting guideline and Joanna Briggs Institute methodological guideline informed the searches. Search terms included ‘healthcare professionals’, ‘palliative’, ‘end of life care’, and accounted for differences in terminology, e.g. ‘prisons’ (UK) and ‘correctional facilities’ (USA). Critical appraisal of methodological quality and narrative synthesis of findings were conducted. 853 records were retrieved and screened. Six qualitative studies were retained, which were published between 2015 and 2021 in the UK (n=2), Australia (n=1), France (n=1) and USA (n=2). Barriers (compassionate release, the presence of prison staff, mistrust between HCPs and incarcerated individuals, the prison system and HCPs being unsure of the scope of their practice), facilitators (specialist facilities and compassionate release, training and education, and technology) and opportunities (education, development of policy and guidelines, utilising available resources and prison volunteers) for the provision of palliative and end-of-life care were found. The reviewed research was of reasonably good quality and fairly credible, with clear implications for practice. Barriers to palliative and end-of-life care in prisons have yet to be resolved. Specialist and general training for healthcare professionals is recommended for future practice. Revision and implementation of policies, such as allowing for healthcare professionals time with patients without prison officers present, the process of compassionate leave being simpler, and an unlocked door policy at the end-of-life are recommended.