Developing Standards and Quality Indicators to Support Health Improvement in People on Probation

Aims: People on probation, considered an inclusion health group, face significant barriers to accessing healthcare including stigma and lack of appropriate services. Better data are needed to evidence this population’s needs and the quality of care that they receive to probation staff and healthcare commissioners and providers. This paper aims to describe the development of standards and quality indicators linked to objectives within a probation health and social care strategy, which can contribute to filling this evidence gap and inform wider initiatives to support improved health in people on probation. Methods: The standards and indicators were developed using a modified RAND approach. This combined a systematic scoping review and input from professionals and individuals with lived experience of probation to identify the characteristics of high-quality care and create measures of them. Findings: A set of 22 standards and 31 quality indicators were developed which could be used routinely to measure the quality of care (structures, processes and health outcomes) for people on probation – highlighting good practice and where improvements are needed (for example, to overcome barriers to access to care). Findings could inform cross-agency quality improvement initiatives to address areas where standards are not being met. Conclusions: A set of standards and indicators has been developed that can be used as a framework for quality improvement work to improve the quality of care (including health outcomes) for people on probation. Further research is needed to pilot the measures within probation and to investigate a) perceptions of their acceptability and feasibility for use within routine practice, and b) how they can inform quality improvement work by probation, public health and other professional groups to address areas where standards are not being met, and through this, improve the health of people on probation.