Paramedics working in a prison-based healthcare setting: an exploratory mixed methods study

BACKGROUND: Prison healthcare departments recently started recruiting paramedics to assist in dealing with a rise in medical emergencies largely attributed to an aging prison population and an increase in novel psychoactive substance misuse. There has been little research investigating the paramedic role in this setting. This study aims to explore the strengths and limitations of employing paramedics within the prison healthcare setting from the perspectives of non-paramedic colleagues. METHODS: An exploratory mixed methods study was conducted in a UK category B remand prison, focusing on the opinions and observations of current healthcare and custodial staff. Paper questionnaires were completed by 32 members of staff and semi-structured interviews were conducted with two participants. RESULTS: Seven global themes were identified within the qualitative data: management of medical responses; effect of a specialist role; effect on ambulance escorts; contribution to professionalism within the department; effect on the role of other healthcare staff; prisoner interaction with paramedics; and difficulties encountered in role implementation. Of the 32 participants, 31 believe paramedics have had an overall positive effect on the provision of healthcare, with a variety of reasons explored. CONCLUSION: In a small exploratory study, it is suggested that paramedics possess the relevant skills and training to offer a meaningful contribution to the provision of prison healthcare; however, further research is required to explore the full scope of their contribution in this setting.