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

获得医疗保健，特别是从监狱转到缓刑期间，是一项长期挑战。缓刑在支持获得服务方面发挥着作用，英国国民健康服务体系目前正在试点一项RECONNECT服务，以促进对释放囚犯的持续照顾。鉴于受缓刑监督的人的健康状况与一般人群相比相对较差（见https://probhct.blogs.lincoln.ac.uk/），以及通过改善这一人群的健康状况可获得的更广泛利益（例如减少再犯、改善缓刑遵守情况、减少可避免的急症室使用），至关重要的是，尽管大流行，缓刑及其保健合作伙伴仍能继续确定和解决保健需求。包括提供旨在促进改善精神健康和减少药物滥用的社区服刑治疗要求（CSTRs）。为应对疫情，缓刑以电子邮件、Skype和上门拜访取代了办公室预约，卫生和司法机构之间的伙伴关系模式也发生了变化。这改变了在缓刑监督下的人获得医疗保健的方式。这些变化的性质和对监管对象的影响尚不完全清楚。有人担心，这一弱势群体在获得医疗保健方面的现有困难可能会进一步恶化。然而，大流行也可能导致在如何提供医疗保健方面进行有益的创新，这些创新需要加以捕捉和传播。在与几位资深缓刑工作人员、英国国家医疗服务体系和有刑事司法系统生活经验的个人进行讨论后，我们提出了一项建议，以解决这一知识差距，并为未来的政策和实践提供信息。我们将使用来自缓刑工作人员调查、与工作人员通过电子邮件或访谈进行的对话以及与服务用户的访谈的数据，以提高对Covid-19应对措施的性质和影响的理解：a)与健康相关的缓刑实践；b)在缓刑监督下寻求健康支持的生活经历；c)伙伴关系工作和获得护理的途径。除了大学和试用人员外，团队还将包括旋转门的工作人员和同行研究人员，因为这是使我们能够捕捉服务用户观点的关键。我们将与利益攸关方共同努力，以便分享调查结果，并直接告知今后如何提供服务。

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 becaptured 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 improveunderstanding 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, andc) 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.