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Offender Health

Offender Health

The term 'offender' refers to people who come into contact with the criminal justice system because they have committed or are suspected of committing a criminal offence. They may have been given a custodial (prison sentence) or non custodial penalty e.g. a fine, community based order etc.

The principle of equivalence.

Offenders often experience significant problems gaining access to health care services which can add to problems of social exclusion, and puts offenders at risk of continued offending. Responsibility for offender health care lies within the NHS and the North East offender health commissioning unit which aims to give offenders access to the same quality and range of health care services as the general public receives in the community.


Losing your freedom shouldn't mean losing your health or the opportunity to regain it. We operate a philosophy of providing non-judgemental and equivalent care to all of our patients.
Prisoners have an opportunity to consider health needs and concerns that they may not have been able to deal with and get help with on the outside. Prisons and custodial settings can provide a unique opportunity to reduce health inequalities through health promotion, health education, and disease prevention measures, and engaging offenders in primary care, mental health, and drug services.

Local Prisons


HMP Durham was built in the early 19th century and has been undergoing a major refurbishment programme during the last ten years. This is the oldest prison in the cluster and its role is a Category B local prison serving the courts in the area, holding approximately 981 remand and sentenced prisoners. The prison has six residential units and a busy reception/first night centre.

The prison regime includes both full time and part time education, workshops (both production and training such as bricklaying, data input, woodwork and contract work), works and gardens. There are other features e.g. integrated resettlement strategy which provides advice and guidance on a wide range of resettlement issues such as accommodation, finance, benefits, training development through job clubs and community involvement. Post release support is also provided through the Continue to Work programme as well as a coordinated approach to involving families.

Healthcare is provided 24 hours a day, consisting of a 20 bed in-patients unit, a primary care facility which has a GP surgery, dentistry, optician, physiotherapy and podiatry services. There are also chronic disease clinics, smoking cessation clinics and general health promotion. There is a mental health facility providing primary mental health support, which includes links with colleagues at the Hutton Centre in Middleborough and St Nicholas Hospital in Newcastle. HMP Durham also benefits from a pharmacy which supplies a service to Low Newton Prison.


The prison has 734 male prisoners serving sentences more than four years, some Cat A remand prisoners are held at HMP Frankland. Frankland is a High Security Dispersal Prison.

Each of the wings - A to D holds 108 men. Wings F and G, opened in 1998 holds 206 prisoners. During 2009 an additional wing was built, to hold 150 prisoners.

The Westgate unit holds approximately 80 prisoners who are categorised as DSPD (Dangerous and Severe Personality Disorder). This unit has a separate regime to the main prison and is self contained. The unit is ten minutes walk from the main prison. The Westgate unit assesses prisoners who have committed serious violent or sexual offences in relation to their risk and potential personality disorders. It then goes on to develop and provide treatment or management aimed at reducing the short and long term impact of these factors. The unit has a separate healthcare facility to that of HMP Frankland, with its own team of nursing staff (comprising registered general, mental health and learning disability nurses), its own psychiatrists and regular visits from other health professionals such as general practitioners and a dentist. It should be noted that after 19:30 hours on weekdays, and 17:00 hours at weekends, there are no Westgate nursing staff on duty, and any urgent care will be provided by the main healthcare team. In terms of care that may be required out of hours, the Westgate unit should be thought of in the same way as any other residential wing within HMP Frankland.

There are 310 female sentenced and remand prisoners. The prison also holds young offenders (females only). HMP YOI Low Newton is situated approximately four miles south west of Durham, and was purpose-built as a remand centre in 1965 with accommodation for 65 males and 11 females. Additional accommodation was provided in 1975 with a CNA (Certified Normal Accommodation) of 215. Low Newton serves the courts in the catchment area from the Scottish Borders to North Yorkshire across to North Cumbria.  


Deerbolt is a purpose built young offenders institution, which opened in 1973 built on a former army camp. It is situated on the outskirts of Barnard Castle in County Durham. Deerbolt accommodates prisoners from the North East and North West of England, Yorkshire and Humberside. Deerbolt is a male Category C training prison and caters for approximately 500 prisoners between the ages of 18-21, generally serving sentences up to four years in length.

Deerbolt has nine residential wings, including an induction wing, a large gym, healthcare centre, chapel and various educational areas spread over a 23 acre site. The prison offers a variety of purposeful activities including educational courses/qualifications and vocational courses e.g. bricklaying, painting and car mechanics. Deerbolt also participates in the Duke of Edinburgh Award Scheme.

Healthcare cover is provided on a 24 hour basis. The healthcare centre consists of a small inpatient facility (5 beds) which provides crisis care/intervention and limited post operative care. The outpatient area provides access to the primary care services. These consist of GP, surgery and dentistry, as well as specialist clinics for triage, sexual health, vaccinations, asthma, and smoking cessation. There are also optician, podiatry and physiotherapy services on a needs basis. Healthcare also has a small mental health team which provides a range of primary care services as well as crisis intervention.



The photographer and researcher, Adrian Clarke, has been commissioned to photograph and interview between 40 and 50 women who have had contact with the criminal justice system. The project will include women in custody and those who have spent time in custody but who have now been released. The interviews will deal with the following issues:

  • the impact of custody on the subjects' health;
  • the relationship between incarceration and self-harm;
  • the relationship between childhood trauma and offending behaviour;
  • the relationship between domestic violence and offending behaviour;
  • drug use and offending behaviour;
  • the impact on women's health of their separation from their children;
  • the prescription of methadone in prison and other issues surrounding drug use and prison;
  • being pregnant whilst in custody;
  • the availability or otherwise of counselling services both in and out of prison;
  • the availability of after-care following release, particularly counselling services,

as well as any other matters raised by the subjects which concern their health, offending behaviour and imprisonment.
It has not yet been decided whether the project will involve photographs and interviews of women whilst in custody or whether it will be restricted to those who have already been released.


Adrian Clarke is a qualified solicitor. For the last seven years he has worked as a photographer and researcher. His particular method has been to use photographic portraits to accompany interviews with his subjects, in effect engaging in an unusual form of user consultation. Examples of his work can be seen at He was commissioned by the County Durham DAAT in 2004 to photograph and interview a group of drug and alcohol abusers and their carers, which is why he was chosen for this work. The previous project resulted in the series "Gary's Friends", which formed a book of the same title. The work has been used by the DAAT and the Home Office to illustrate the particular issues faced by families in which there is one or more member who abuses drugs or alcohol. The project has proved to be a useful tool in informing policy and in engaging with those afflicted by similar difficulties.


We hope that the project will provide, in an unusually graphic form, a body of evidence concerning the particular difficulties faced by women in prison. It will help those charged with framing policy in this area to identify the particular circumstances that create the risk of self-harm and suicide and it will be used as a tool to help other women facing a similar situation to feel less isolated. We hope it will be used both inside and outside prison to help women examine their offending behaviour, their past lives, their drug use and what steps they can take to help themselves in the future. It will assist recovery groups, counselling services and others to focus on matters that should be addressed in order to improve women's health, reduce drug and alcohol use and reduce the risk of re-offending.

It is important to note that the focus of this project will not be on criticising the current prison regime but on what women say about their own lives. Thus far, where women have raised issues concerning the regime at HMP Low Newton they have tended to be complimentary of recent changes that have taken place, particularly in relation to the induction processes and the policies surrounding substance misuse.

'I am writing to congratulate you on your wonderful staff you have working for you at DMH.'

Patient, Catering / Porters / Domestics, Darlington Memorial Hospital