Developing health and wellbeing in prisons: an analysis of prison inspection reports in Scotland

Abstract Background The Scottish Prison Service (SPS) has been long regarded for its progressive policy approach to health promotion in prison. It is one of the few countries with a strategic plan implementation. Given paucity understanding relation concept promoting prison, this study assessed routinely collected prison inspection data understand and distil learning regard practical implementation health-promoting prisons. Methods Her Majesty’s Chief Inspector Prisons Scotland (HMIPS) oversees independent all This desk-based analysed openly accessible reports from public repository. sample was limited using 2018 revised Standards ensure comparability between reports. Eight unique meeting criterion were downloaded January October 2020. prisons had their inspections undertaken May Data which focused on ‘health wellbeing’ inductively coded NVivo 12 support thematic analysis. Results are presented against values principles outlined SPS’ own framework All institution contained evidence fairness justice understandings inequalities recognised by staff. There also examples mutual (peer) people prison; good relationships staff prisoners; strong leadership. Conversely, some environmental conditions hindered development – included staffing shortages practices fostering inequity. Even where reported as having activities place these narrow range individual risk factors such smoking cessation or substance misuse. Far less attention paid wider determinants. Conclusions at forefront attempts embed philosophy system. Inspection focusing analysed, but analysis suggests that more could be done setting. way inspectors assessing wellbeing particular areas very narrow, focus exclusively healthcare without appreciation how other life can impact.