Introduction

In our Manifesto for the new government, we issued a series of recommendations on how to best support the growing older cohort within prisons and ensure that there is tailored support to meet their specific needs. In this guest blog, Recoop elaborates on these recommendations, drawing on their experience supporting older people in prison and evidence submitted to the Independent Review of the Prison System to set out the case for reform and the changes that should be prioritised.

The prison population is ageing. The system must catch up 

Many Clinks members will recognise the situation. A service exists, but an older person cannot reach it. A social care need is evident, but nobody is clear who owns the referral. A prisoner begins withdrawing or forgetting things and the change is interpreted as difficult behaviour. Release approaches, but suitable accommodation, healthcare and support have still not been secured. 

These are not isolated operational problems. They are signs of a prison system that has not kept pace with the changing population it holds. At 31 March 2026, 16,370 people in prison were aged 50 or over, and government projections suggest that this will rise to around 18,600 by September 2029. More people are entering prison later in life or growing old while serving long sentences, yet much of the prison estate and its operating model remain designed around a younger and more able-bodied population.

Recoop has worked alongside older people in prison for more than 15 years. 

Our recent evidence to the Independent Review of the Prison System drew together frontline practice, prisoner voice, operational case studies, independent evaluation and national research. Our central conclusion was that ageing is not a marginal or specialist issue. It exposes wider weaknesses in prison design, assessment, commissioning, workforce capability and release planning.

Clinks' manifesto calls for a national strategy for older people in prison, bringing together appropriate accommodation, health and social care, and release planning. We strongly support that recommendation. Drawing on Recoop’s frontline experience and our evidence to the Independent Review of the Prison System, we believe such a strategy also needs to confront some fundamental questions about how an ageing prison population should be assessed, accommodated and supported and, in some cases, whether prison remains the most appropriate environment.

Identifying changing needs before they become crises 

Assessment of age-related needs should not be a one-off exercise at reception. In a recent Recoop consultation with 63 older people at one prison, 82.5 per cent reported a long-term illness, disability or infirmity, but only six reported having a local authority care plan. This was evidence from one establishment, rather than a national study, but it illustrates the potential gap between visible need and formal support. 

Every prison needs a consistent pathway for assessing frailty, cognition, mobility, falls risk, sensory loss, nutrition, continence, mental wellbeing and ability to manage daily life. Reviews should take place regularly and after events such as serious illness, hospital admission, transfer or recall. Crucially, assessment must result in practical change. Identifying a mobility problem means little if the person remains on an upper landing, cannot use the shower or is unable to reach healthcare and activities.

Making risk assessment reflect the person as they are now

We support a fast-track review of people over 50 who are experiencing significant health conditions or accelerating frailty. This should inform a dynamic register which brings together relevant information about health, care, functional ability, security, sentence progression and release planning. It must be an active decision-making tool, rather than another administrative record.

Risk is not fixed throughout a long sentence. Age, cognition, physical capability and opportunity to offend or abscond can change considerably. These factors should be considered alongside the original offence, behaviour, safeguarding concerns and continuing public-protection requirements. A more dynamic approach would support better placement and parole decisions, helping to ensure that people are held in the lowest security and most appropriate environment consistent with public safety.

Creating a geriatric parole process

Compassionate release currently applies to very few people. Government figures cited in our evidence show that only seven people were released on grounds of ill health in 2023 and six in 2024. This leaves a group of people with significant frailty, disability or complex care needs who do not meet the existing threshold. Some may have experienced a considerable reduction in risk, yet there is no dedicated mechanism for considering whether continued imprisonment remains necessary and proportionate. 

A geriatric parole process should not provide automatic release at a particular age. It should enable an individual assessment of current risk, health, functional ability, time served, victim considerations and the availability of appropriate care and supervision. Public protection must remain central, but proportionality also requires the system to respond when a person’s circumstances and capabilities have substantially changed.

Joining up justice, health and social care

Clinks members frequently work across the boundaries between prisons, healthcare, local authorities, housing and community services. They see how easily people can disappear into the gaps between them. Although legal and commissioning responsibilities may be defined, the experience of the individual is too often one of fragmented services, repeated assessments and unclear ownership.

For people with complex needs, government should establish a single accountable commissioning pathway with authority to coordinate justice, health and social care responsibilities and funding. Suitable placements and care packages should be agreed before transfer or release, rather than negotiated when a crisis has already developed.

Temporary release could also be used more effectively to support the transition into care. Where appropriate, it could allow someone to visit a placement, complete an assessment, become familiar with the environment and begin building relationships with those who will support them.

Voluntary organisations could provide supported community navigation where this is properly commissioned, helping people practise essential journeys and identify barriers while there is still time to resolve them.

The voluntary sector brings trust, continuity, specialist knowledge and strong local relationships. It should be involved in designing and delivering these pathways, but it cannot be expected to carry statutory responsibility or repair fragmented systems through short-term and insecure funding.

Developing secure and specialist care options

For some people with profound frailty, dementia, serious illness or end-of-life needs, the question is not simply how conventional prisons can be adapted. It is whether prison remains the most appropriate environment. For an older person with significant health or care needs, release planning cannot begin at the prison gate. Health, social care, accommodation and community support need to be coordinated well in advance, with clear accountability for continuity after release.

Recoop has therefore called for a continuum of provision which could include specialist prison units, secure care, existing forensic provision, age-responsive Approved Premises and supported community accommodation.

A statutory and non-statutory working group should develop and test these options, bringing together the Ministry of Justice, HMPPS, NHS bodies, local authorities, care providers, voluntary organisations and people with lived experience. Decisions must be based on current risk, legal status and functional need, rather than age alone. Any secure care pilot should evaluate public protection, quality of care, hospital use, staffing, family contact, prison capacity, progression and whole-system cost. The purpose is not to weaken public protection. It is to match security and care more intelligently to the person.

Giving staff the knowledge and confidence to respond

Prison staff and voluntary sector workers are often the first people to notice changes in mobility, cognition, appetite, mood, self-care or behaviour. Mandatory training should cover ageing, frailty, dementia, sensory loss, cognitive change and reasonable adjustments. Staff are not expected to become clinicians, but they should understand when apparent non-compliance, withdrawal, forgetfulness or irritability may indicate deteriorating health or an unmet care need.

The voluntary sector has an important role in developing this training, bringing lived experience into workforce learning and showing what age-responsive practice looks like. That expertise should be recognised and properly resourced, with clear routes for staff and voluntary organisations to escalate concerns when they identify deterioration or unmet need. 

Clinks members hold a considerable body of knowledge about what happens when systems work and what happens when they fail. This manifesto can bring that knowledge together and turn it into a clear demand for reform. The challenge is no longer to prove that the prison population is ageing or that older people have different needs. The evidence has been available for many years.

The choice now is whether we continue responding after people have deteriorated, or build prevention, accessibility, appropriate care and continuity into the prison system from the outset. Getting this right for older people would create a more decent, proportionate and effective system for everyone.