GPs working in prisons

Richard Kirk & Tim Oliver examine the challenges, needs, and opportunities in providing healthcare to individuals facing incarceration.

Working in a prison was never part of the plan. During medical school, I (Tim) considered surgery, and after graduating, I spent time working in emergency medicine, but eventually I found myself drawn to general practice. One of the things I love most about being a GP is the privilege of walking alongside people, from cradle to grave, seeing every slice of community life.

So, when I saw a locum shift advertised at my local prison, I signed up out of curiosity more than anything. I’d never even set foot in a prison before, but I’ve always appreciated the variety medicine brings. I assumed it would be a one-off.

That day turned out to be one of the most thought-provoking and memorable of my career. I encountered men who were, fundamentally, just people – people in difficult situations, some of their own making, others born of long histories of trauma, neglect, and poverty. I realised then that even a short conversation, a kind word, or simply taking the time to listen could have a significant impact. I haven’t looked back since.

Prisons are, in many ways, strange and unsettling places. At times oppressive and heavy, they can also be unexpectedly human – full of humour, vulnerability, and resilience. You meet people who have reached the absolute lowest point in their lives, those caught in a cycle of reoffending and incarceration, and others whose crimes mean they should probably never leave. The weight of hopelessness can hang in the air, and it touches not just the prisoners but the staff, too.

It’s not generally seen as an attractive workplace for healthcare professionals. In fact, the stigma associated with prison seems to extend to those of us who work within its walls. Yet the needs are immense – and so is the opportunity to make a difference.

The Bible speaks frequently about prisons. Once you’ve worked in a prison, you begin to notice how often it’s mentioned in church and the Bible. These are places of brokenness, often full of people society would rather forget. But it’s precisely these people that Jesus came to seek out.

Isaiah 53:3 describes Christ as ‘despised and rejected by mankind, a man of suffering, and familiar with pain’. It’s a description that echoes the experience of many prisoners – rejected, forgotten, and burdened with pain and shame. But God does not forget them.

In Psalm 69:33, we’re reminded: ‘The Lord hears the needy and does not despise his captive people’. And in Isaiah 61:1-3, the prophet proclaims a vision of hope and restoration: ‘freedom for the captives and release from darkness for the prisoners… a crown of beauty instead of ashes, …joy instead of mourning, …praise instead of…despair.’ These aren’t just poetic words – they offer a powerful calling to those of us working in places of despair and marginalisation. Healthcare in prisons is part of that calling. It’s a kind of ministry – though it may not always feel like one. It can be difficult and frustrating. Resources are limited, bureaucracy is constant, and the burden of mental illness, addiction, and trauma is overwhelming. But it is precisely because of those challenges that this work matters.

Jesus speaks plainly in Matthew 25:36, saying: ‘I was in prison, and you came to visit me.’ The message is clear: what we do for those whom society has cast aside, we do for him. Not just metaphorically, but in real, tangible ways. Every patient we see, every prescription, every safeguarding concern raised – it all matters.

In Mark 2:17, Jesus says, ‘It is not the healthy who need a doctor, but the sick. I have not come to call the righteous, but sinners’. It’s a statement that resonates deeply in prison healthcare. Many of our patients have lived chaotic lives, some full of harm – done to others and to themselves. But in the consulting room, they are just people. People made in the image of God. People in need of grace.

Romans 8:1 reminds us, ‘There is now no condemnation for those who are in Christ Jesus.’ And Hebrews 13:3 urges us to ‘remember those in prison as if you were together with them’. That is a radical form of solidarity – one that challenges us not just to care, but to stand alongside.

If you’re wondering what working in prison healthcare actually looks like, it’s as varied as the people we serve, requiring a wide range of backgrounds in medicine, nursing, physiotherapy, pharmacy and psychological services. The bedrock of prison healthcare, however, is primary care. Many roles are open to GPs and primary care nurses seeking part-time or full-time positions, with flexible rotas including out-of-hours work and opportunities to specialise in areas such as mental health, substance misuse, or chronic disease management.

Security concerns add to the complexity of the environment. Healthcare staff must work closely with prison officers and follow strict protocols, which can feel restrictive compared to community practice. Access to medical equipment or hospital services can sometimes be delayed, partly due to the security measures required for the patient group. You may also face a level of scrutiny that is less common in community settings.

But because of these varieties and complexities, prison medicine can be deeply rewarding and intellectually stimulating. It offers continuity of care and the chance to make a tangible impact on patients who may never have experienced consistent or compassionate medical attention. Within the same consultation, you are often acting as GP, public health lead, patient advocate, and counsellor. This could be about treating the patient’s self-harm wounds while trying to address their underlying psychological causes. It could mean liaising with the prison about improving the conditions for the patient or simply advocating for them to be allowed contact with loved ones.

Beyond the clinic room, your role often extends to service improvement, leadership, and governance – helping to build more resilient and compassionate systems for patients to exist within. This can include multidisciplinary team (MDT) meetings to discuss complex patients, audits, and significant event reviews. All have the aim of the whole team learning to improve the service on offer.

All prisons also have a chaplaincy. Christian doctors also have the opportunity to work alongside chaplaincy teams and faith-based initiatives, offering more holistic care. In a world often marked by chaos and trauma, consultations are frequently spent discussing the benefits of chaplaincy services and the supportive, safe, and confidential listening spaces they provide. Many patients also find great encouragement from the Alpha courses and church services that run throughout the week, often delivered by local churches.

If these challenges pique your interest, you might be wondering how prison medicine is organised, how to get into it, and what skills you might need.

For junior doctors, placements are sometimes possible within training rotations, and some schemes now actively encourage exposure to prison healthcare to broaden experience with underserved populations. For nurses and GP trainees, contacting the Head of Healthcare at a local prison is a good way to arrange shadowing sessions; these can often be set up as taster days within your study leave allowance. For psychiatry trainees, experience in forensic settings is required and can usually be arranged through your deanery.

For more established healthcare professionals, there are roles to suit a variety of time commitments. This could involve covering ‘reception’ duties or weekday daytime work, weekend shifts, or seeing patients who have just arrived from court or police custody. This can be an incredibly stressful time for patients, especially if it is their first experience of prison. Meeting a healthcare professional who treats them with compassion and care can fundamentally change their prison journey.

If you’re interested in healthcare for underserved populations, prison healthcare offers a unique opportunity to make a meaningful impact on the lives of these people. It requires resilience, empathy, and a commitment to providing quality care in a demanding environment. But, as Jesus constantly modelled to us, including and caring for this group of people is central to his mission to remember the least and the lost.

Perhaps prison healthcare has never crossed your mind. But we invite you to consider it. It may not be glamorous. It won’t make headlines (actually, it might!). But it may be one of the most meaningful ways you can live out your faith in practice – quietly, compassionately, and right on the frontline of inequality.