Health and care in the criminal justice system

Page last updated: 5 May 2022
Organisations we regulate

We monitor, inspect and regulate health and social care in the criminal justice and immigration detention systems (or 'health and justice') to make sure people who use services in secure settings receive the same quality of care as the rest of the population.

Most healthcare services in secure settings must register with us just like any other care service. There are some exemptions for services that are provided under arrangements with government departments.

The services we inspect range from health services that form part of youth offending teams to prison healthcare. We work in partnership with other inspectorates and use different frameworks to inspect different types of service.

Services we inspect

Adult prisons

These range from Category A (high security) to D (open prisons) for men; and closed and open prisons for women. Some have a YOI provision for young men aged between 18 and 21. There are 106 adult prisons in England; 12 of these house women.

Immigration removal centres

IRCs hold people detained under the Immigration Act. This includes people:

  • claiming asylum
  • awaiting a decision on their right to enter the UK
  • refused permission to enter and awaiting removal
  • overstayed or failed to comply with visa terms
  • without appropriate documentation.

There are seven IRCs in England.

Police custody facilities

These provide healthcare to make sure all detainees are:

  • assessed for health needs and vulnerabilities
  • provided with treatment as appropriate
  • offered brief interventions and health promotion
  • signposted to community services.

Secure children’s homes

These provide placements for boys and girls aged 10 to 17 who are assessed as being vulnerable or at risk. Some placements provide secure accommodation for children serving a custodial sentence. The rest are for children placed under Welfare Orders by the courts on the application of local children’s services. There are 13 secure children’s homes open in England.

Secure training centres

STCs hold young offenders, usually over the age of 14. There are three STCs in England, one for boys only, and two are mixed.

Sexual assault referral centres

SARCs provide medical, practical and emotional support services to victims and survivors of rape and serious sexual assault. They support adults and children.

Young offender institutions

YOIs are run according to many of the same rules and policies as prisons. There are seven YOIs holding young men in England and Wales. Some hold young offenders from 15 to 18; others take those aged 18 to 21.

Youth offending teams

YOTs are statutory community bodies managing and supporting young offenders aged under 18. They include representatives from health, education, police, probation, substance misuse and social services.

See our joint inspection reports.

How we work with other inspectorates

Adult prisons, immigration removal centres and young offender institutions

These inspections are led by HMI Prisons, who inspect and report on conditions and treatment. CQC is responsible for monitoring, inspecting and regulating health and social care providers.

Police custody facilities

We work with HMI Constabulary and Fire & Rescue Services (HMICFRS) and HMI Prisons to inspect services provided in police custody. Find out about Police custody facilities - joint inspections.

Secure children’s homes

The 13 SCHs are inspected twice a year by Ofsted. CQC joins one of these inspections for each location. See the inspection framework for secure children's homes.

Secure training centres

England's three STCs are inspected annually. These inspections are led by Ofsted and include representatives of HMI Prisons and CQC. There are plans to introduce secure schools in place of STCs, and we are involved in developing a future inspection plan for these. Find out about:

Sexual assualt referral centres

We are carrying out a full inspection programme of SARCs.

Youth offending teams

We inspect YOTs according to risk, carrying out five full joint inspections a year in England alongside a programme of single agency inspections by HMI Probation. Joint inspections are led by HMI Probation and each inspection team includes representatives from CQC, Ofsted, HMI Constabulary and HMI Prisons.

See the YOT inspection framework.

Guidance for providers

How we inspect and regulate services in:

  • adult prisons
  • immigration removal centres
  • young offender institutions

Health and social care in prisons and young offender institutions, and health care in immigration removal centres: provider handbook

Inspection reports

We publish reports jointly with other inspectorates.

See secure settings

See also

Our memoranda of understanding with HMI Prisons and HMI Probation

Sexual assault referral centres

Thematic reports on National Archives website

External links


HMI Constabulary and Fire & Rescue Services (HMICFRS)

HMI Prisons

HMI Probation

Independent advisory panel on deaths in custody: online resource for people working in different custodial sectors, to share good practice and learn how to prevent and reduce the number of deaths in custody.