Action required to build palliative care capacity in prisons: A descriptive qualitative study

BACKGROUND: Globally, people in prison are increasingly older, more culturally diverse and have a growing need for palliative and end-of-life care. Yet, they have limited access to equitable primary and specialist healthcare or culturally safe care. Strengthening prisons capacity to deliver palliative care is critical to improving care for this underserved population. AIM: To understand correctional and justice health professionals' and specialist palliative care clinicians' perceptions of the actions required to strengthen palliative care for people in prison. DESIGN: A descriptive qualitative study underpinned by a constructivist paradigm. The semi-structured interview data were analysed using a hybrid inductive-deductive reflexive thematic analysis approach informed by the WHO Capacity-Building Framework. SETTING/PARTICIPANTS: Purposive and snowballing sampling were used to recruit participants from Australian prisons. Eligible participants included correctional staff (e.g. prison executives, managers and officers), prison volunteers, justice health professionals (e.g. nurses, doctors and allied health) and specialist palliative care clinicians providing palliative care to people in prison. RESULTS: = 17) participants were interviewed. Five themes describing the capacity-building actions required at the individual, organisational and systems levels were identified, including: (3) Embedding culturally safe palliative care for Aboriginal and Torres Strait Islander people in prison requires intentional capacity-building. (5) Building the prison workforce's palliative care capabilities is challenging but is required to build confidence. CONCLUSION: Strategic capacity-building action focussed on prison governance, formalising internal and external partnerships, cultural leadership and tailored workforce development is required to support the delivery of equitable palliative care for people in prison that is evidence-based and culturally safe.