Guidance

Voices of women: engagement discussion guide

Published 26 October 2026

Applies to England

1. About this discussion guide

This engagement discussion guide supports the Health and Social Care Needs Assessment (HSCNA) for women in prison.

The questions are organised by the 15 categories within the HSCNA toolkit and are intended to support engagement with women in prison. They can be used as prompts during interviews, focus groups or other engagement activities to gather feedback on women’s experiences of health and social care services.

The questions are not intended to be used as a formal survey and do not need to be asked verbatim. They should be adapted as appropriate to the local context and the needs of the women taking part. The insights gathered should be considered alongside other evidence sources used as part of the HSCNA.

2. Voices of women

The HSCNA has 2 components:

1. assessing evidence across the 15 toolkit categories
2. gathering feedback from women in prison, referred to as the ‘voices of women’

This feedback is essential to help us shape and deliver effective services. Women’s lived experiences provide valuable insights into the challenges they face in custody. These insights can help identify gaps in current services and highlight areas where additional support may be needed.

By including women’s voices in the HSCNA, we can inform policy development, service planning and the design of interventions. This helps healthcare and social care services in women’s prisons become more responsive, equitable and person-centred.

In turn, services are better placed to meet the complex health, social and rehabilitation needs of women in prison, helping to improve outcomes and support rehabilitation.

To ensure discussions are sensitive and trauma-informed, they should be facilitated by professionals with substantial experience supporting women in secure settings. These practitioners are skilled at creating safe and trusting environments where women feel comfortable sharing their experiences.

3. Feedback and Engagement

A structured approach should be in place to capture, review and respond to feedback from women. Clear mechanisms should support the collection of feedback and ensure participants are informed how their contributions have been considered and used.

Women’s views should directly inform recommendations through ongoing and meaningful engagement. Organisations should have clear accountability arrangements in place to ensure feedback is acted upon and informs service improvement.

Designated roles, such as a patient engagement lead or quality manager, should oversee this process and ensure that insights gathered from women are translated into tangible actions and improvements.

4. Service user questions

4.1 Category 1 – Resident Demographics

1. How do you feel the size and turnover of the prison affects your access to healthcare or support?

2. Do you feel your individual needs (including any protected characteristics) are recognised and considered?

3. How does the prison regime (movement, unlock times) affect your ability to attend healthcare appointments?

4. Do you have suggestions for small changes (“quick wins”) that would improve access to services?

4.2 Category 2 – Healthcare Overview

1. Do you feel you know what healthcare services are available and how to access them?

2. How satisfied are you with the healthcare services you’ve received here?

3. Have you experienced difficulties accessing clinics (GP, nurse, dentist, physiotherapy, etc.)?

4. How would you improve the way healthcare services are organised or run?

4.3 Category 3 – Physical Health (LTCs)

1. If you have a long-term condition, do you feel it is managed well here?

2. Are your appointments, tests and follow-ups arranged within a reasonable time?

3. Do you feel confident that you can raise concerns about your health and be listened to?

4. If you missed or declined an appointment, what were the reasons?

4.4 Category 4 – Mental Health Needs

1. Do you feel comfortable asking for help with your mental health?

2. Were you able to access mental health support when you needed it?

3. Do you feel respected and listened to during mental health assessments or interventions?

4. What would help improve mental health support in this prison?

4.5 Category 5 – Women’s Health

1. Do you feel your reproductive health needs were understood and taken seriously?

2. Were you given clear information about contraception, pregnancy, menopause or other issues?

3. If you had sexual health screening or treatment, did you feel safe and respected?

4. Do you feel confident your results and personal information are treated confidentially?

4.6 Category 6 – Substance Use Disorder / Treatment

1. Do you feel supported in managing your substance use needs while in prison?

2. Did you trust the staff providing support (clinical or psychosocial)?

3. Were mutual aid groups (AA, NA, etc.) available and easy to attend?

4. Is there anything that prevents you from accessing substance misuse services?

4.7 Category 7 – Communicable Diseases & Vaccinations

1. Were you offered testing (HIV, Hep B/C, TB, etc.) in a clear and respectful way?

2. Did you feel able to give informed consent for testing or vaccinations?

3. Were results or treatment options clearly explained to you?

4. Did you feel supported to stay safe and healthy during outbreaks?

4.8 Category 8 – National Screening & NHS Checks

1. Were you given enough information to understand the screening tests offered to you?

2. If you declined screening, what were the reasons (e.g., fear, lack of info, timing)?

3. How easy was it to attend screening appointments?

4. How could the screening process be made more comfortable or accessible for you?

4.9 Category 9 – Self-harm, Self-inflicted Deaths, Other Deaths in Custody

1. If you felt at risk of self-harm, did you feel able to ask for help?

2. Did you feel supported by staff during or after a self-harm incident?

3. Did the ACCT or support processes feel helpful and respectful?

4. What would make you feel safer or better supported here?

4.10 Category 10 – Wellbeing & Health Promotion

1. Do you have access to activities and support that help with your wellbeing (e.g., exercise, education)?

2. Do you feel staff understand and support your individual needs (e.g., mental health, trauma, parenting)?

3. Have you been able to get involved in any health promotion or engagement activities?

4. What would improve your wellbeing while in prison?

4.11 Category 11 – Social Care Needs

1. Do you feel your support needs (mobility, communication, daily living) were identified early?

2. Were you involved in decisions about your care and support?

3. Did you understand how to request social care help if needed?

4. Did you feel the support you received was appropriate and accessible?

4.12 Category 12 – Midwifery / Mother & Baby Unit

1. If you were pregnant or recently gave birth, did you feel well supported?

2. Did you receive timely access to midwives, antenatal care or specialist services?

3. How were you treated by prison and healthcare staff when attending maternity appointments outside the prison?

4. What improvements would have helped you feel safer or better supported during pregnancy?

4.13 Category 13 – Medicines Management

1. Do you receive your medication in a way that works for you (timely, safe, private)?

2. Have you ever had difficulties collecting or taking your medication?

3. Do you understand the purpose of your medication and how to use it?

4. How could the medication process be improved?

4.14 Category 14 – Dentistry Services & Oral Health

1. How easy was it to get a dental appointment when you needed one, were reminders sent? Did they miss appointments due to prison related operational issues?

2. Did dental staff explain your treatment clearly and treat you with respect?

3. Were your individual needs accommodated (e.g., anxiety, disability, trauma)?

4. Do you have the oral health products you need (toothpaste, brushes, denture products)?

5. Did they feel that they had the information needed and the dental suite was a clean environment?