Ambulance service demand from prisons: a service evaluation.

Abstract

Introduction: People in prison experience substantial health inequalities, including higher prevalence of physical and mental health conditions, substance misuse and mortality. Despite this, ambulance service activity involving the prison population is poorly understood. The aim of this service evaluation was to understand the nature and volume of emergency ambulance calls from prisons in the Yorkshire and Humber region.

Methods: This service evaluation used retrospective data from Yorkshire Ambulance Service (YAS) dispatch records for emergency calls for adults (≥18 years) from 13 regional prisons between 1 April 2021 and 31 March 2022. Call details included the call reason, the patient disposition (defined as the plan after assessment and/or treatment, categorised as transported or not transported) and call timings. Publicly available Ministry of Justice statistics on prison populations were also consulted for context. Descriptive analyses were performed using counts, proportions, means, medians and confidence intervals. Conveyance rates (the percentage of calls attended by a YAS vehicle that resulted in patient transport) were calculated and compared to conveyance rates from incidents attended by YAS as a whole.

Results: YAS received 1263 calls from prisons, with at least one ambulance dispatched to 1025. These calls accounted for 0.14% of total incidents attended by YAS. Of these, 730 incidents resulted in conveyance, representing a 71.2% conveyance rate, which was approximately one-third higher than the regional average. However, the clinical acuity of patients did not consistently justify this. Considerable variation in call frequency was observed between prisons.

Conclusion: Calls to the ambulance service from prisons represent a small proportion of overall YAS workload. Initial call triage placed a greater proportion of calls from prisons in the highest priority category, and both attendance and conveyance rates were higher from prisons compared to the general population.