A significant new health initiative in England is set to embed dedicated healthcare support within the Probation Service, offering targeted assistance to approximately 4,000 people under statutory supervision. This pilot programme, a collaboration between NHS England and the Probation Service, directly confronts the profound health inequalities prevalent among individuals involved in the criminal justice system. Its primary goal is to address untreated physical and mental health issues, which are recognised as key drivers of reoffending.
The scheme involves NHS clinicians and nurses being co-located in probation offices in four initial areas: Cambridge, Middlesbrough, Ilfracombe, and Hammersmith. These health professionals will participate in statutory supervision appointments, enabling them to directly refer individuals into appropriate care pathways for mental health, addiction, and chronic conditions. Essential support services will also be provided, including GP registration, facilitating cancer screening invitations, and making referrals into secondary care.
The programme is underpinned by compelling evidence that individuals under probation supervision experience significantly poorer health outcomes compared to the general population. A 2025 report by the Chief Medical Officer for England highlighted that this population faces high rates of smoking (around half), widespread drug or alcohol dependence, and a majority struggle with poor mental health. They are also less likely to access routine cancer screening.
Offenders frequently fall through the gaps in mainstream health services, often due to chaotic lifestyles, a lack of GP registration, or difficulty navigating the NHS. This leads to a pattern where health issues escalate, forcing many to rely on high-cost urgent and emergency care.
With over 240,000 adults under probation supervision in England and Wales, a population roughly three times larger than the prison population, probation offices represent a critical point of contact for effective health engagement. The scheme is designed to intervene earlier, aiming to reduce reliance on A&E and crisis services. NHS England's Strategy Unit has identified probationers as a priority inclusion health group due to compounding risk factors like homelessness and socioeconomic disadvantage.
Framed by probation and health leaders as a dual benefit for public health and public safety, the initiative has been welcomed by the government. Prisons, Probation, and Reducing Reoffending Minister James Timpson called it a “game-changer” that can identify warning signs early and refer people into the right services, addressing the underlying causes of criminal behaviour, thereby cutting both missed appointments and reoffending risk. The novel intersection of criminal justice and healthcare puts holistic health support at the heart of rehabilitation, recognising that untreated health issues are often root causes of reoffending and high-cost emergency care use.
While third-sector organisations like the Prison Reform Trust cautiously endorsed the pilot, noting that many offending behaviours are driven by untreated health issues, they urged planners to ensure equal attention is given to those on community sentences and individuals leaving custody. The pilot aligns with England’s National Partnership Agreement for Health and Social Care, which mandates continuity of care for those in the criminal justice system. However, its success hinges on adequate staffing, training, and robust data sharing between the NHS and the Probation Service. Experts note that many probation practitioners currently lack formal training in responding to mental health needs, underscoring the necessity of integrated professional development during the rollout.
