Understanding and learning from the impact of COVID-19 on probation's work to improve the health of people under its supervision

Gaining access to healthcare, particularly when transitioning from prison to probation, is a longstanding challenge. Probation plays a role in supporting access, and NHS England is currently piloting a RECONNECT service to promote continuity of care for released prisoners. Given the relatively poor health of people under probation supervision when compared to the general population (see https://probhct.blogs.lincoln.ac.uk/), and the wider benefits to be gained from improving the health of this population (e.g. reduced reoffending, improved compliance with probation, reduced avoidable use of A&E), it is vital that despite the pandemic, probation and their healthcare partners can continue to identify and address healthcare needs, including providing Community Sentence Treatment Requirements (CSTRs) that aim to promote improved mental health and reduced substance misuse.

Probation replaced office appointments with email, Skype and doorstep visits in response to the pandemic, and models of partnership working between health and justice agencies have adapted. This has changed how people under probation supervision are able to access healthcare. The nature and impact of these changes for those under supervision isn't fully understood. Concerns have been raised that existing difficulties that this vulnerable group have with accessing healthcare may be made worse. However, the pandemic may also have led to helpful innovations in how healthcare is provided that need to be
captured and spread.

Following discussions with several senior probation staff, NHS England and individuals with lived experience of the criminal justice system, we have created a proposal to address this knowledge gap and inform future policy and practice.

We will use data from probation staff surveys, conversations with staff on email or through interviews, and interviews with service users to improve
understanding of the nature and impact of Covid-19 responses on:
a) health-related probation practice,
b) the lived experience of seeking health support whilst under probation supervision, and
c) partnership working and pathways into care.

As well as University and probation staff, the team will include staff and peer researchers from Revolving Doors as this is key to enable us to capture service user views. We will work jointly with stakeholders so that findings can be shared and directly inform how services are provided in the future.