The ageing prison population has led to a growing number of people in prison custody in England and Wales dying of natural causes.
If their medical condition means they need treatment outside of the prison, staff have to decide whether to restrain them, either by using handcuffs or escorts chains, in order to prevent a possible escape.
These decisions affect the experience of the dying prisoner and the officers accompanying them and are frequently criticised by independent reviews after a prisoner has died.
Funded by the Economic and Social Research Council, this research has looked at how deaths from natural causes in prison impact on prison regimes, culture and relationships and what determines the responses of prison regimes and personnel to dying prisoners.
Analysing the prison service's rules relating to dying prisoners revealed contradictions in how regulations were communicated to prison staff, making it less likely that their decisions would fully comply with legal requirements.
The research also found practices that were helping some prisons make better decisions about the use of restraints.
After publishing an article about the rules of restraints on terminally ill prisoners, our researcher was consulted by the Directorate of Security, Order and Counter Terrorism to help develop the new External Hospitals Escort guide for use by prison staff.
Findings from the research are included in this operational practice guide, helping prison staff to make effective security decisions that also meet the care needs of prisoners who have treatment in a hospital outside of prison.