1. abertay.ac.uk Prison Health Symposium Glasgow 2016 “Male ex-prisoners experiences of health and healthcare in prison and in the community” James Fraser School of Social and Health Sciences, Division of Nursing and Counselling

2. abertay.ac.uk Background In November 2011 prisoner healthcare in Scotland became the responsibility of a partnership between the Scottish Prison Service and the National Health Service.

3. abertay.ac.uk Aim The purpose of this study was to investigate male ex-prisoners’ experiences of healthcare in and out of prison in order to explore the unheard voices of its service users.

4. abertay.ac.uk Method considerations No hypothesis or theory generation Gender Setting - Institutional influences upon responses Research Fatigue of participants Literacy of group Ethics

5. abertay.ac.uk Ethics Voluntary participation Informed Consent Anonymity and confidentiality Safety of participant and researcher

6. abertay.ac.uk Method chosen Qualitative study - Ethically approved by Abertay and EoSRES Phenomenology Recruitment via gatekeeping organisations in community Semi-structured interviews Thematic analysis

7. abertay.ac.uk Results 29 participants were interviewed with nine consenting to being recorded. 4 major themes – agency - structure - inconsistencies - desistance from crime

8. abertay.ac.uk Results Analysis of the data revealed that participants experienced healthcare in terms of their agency with regard to issues such as vulnerability, choices, isolation and stigma. The structure and delivery of healthcare also played a part in the use of services with evidence of issues and inconsistencies between the SPS and the NHS being perceived as difficulties for participants. It also reflected that healthcare might also play an important part in the role of desistance from crime and help prevent men from entering the “Revolving door” rotation between prison and the community.

9. abertay.ac.uk HOPE Healthcare may have a part to play as an assisted desistance strategy. Health spoken in terms that appeared to equate as a “social capital” Provided a focus for future Did not wish to let themselves or others down.

10. abertay.ac.uk Conclusion Study not generalisable or transferable It helps to make the voices of the service users heard. The participants experiential accounts raise themes which would appear to contradict the aims, policies and procedures of healthcare provision for this group.

11. abertay.ac.uk References Brutus, L., et al., 2012. Better health, better lives for prisoners: A framework for improving the health of Scotland’s prisoners. Edinburgh: Scottish Public Health Network. Scottish Government. 2007. Potential Transfer of Enhanced Primary Healthcare Services to the NHS. Report to Cabinet Secretaries for Health and Wellbeing, and Justice. Edinburgh: The Scottish Government. Scottish Government. 2011. National Memorandum of understanding between the Scottish Ministers, acting through the Scottish Prison Service and ‘NHS Scotland’. Edinburgh: The Scottish Government. To discuss further please e-mail: 1007977@abertay.ac.uk