Checking for bad blood vessels in prisons

A new health initiative in south London prisons is checking men for life-threatening swellings in the blood vessel running from their hearts.

Healthcare teams from Guy’s and St Thomas’ have begun visiting Brixton, Belmarsh and Thameside prisons to carry out abdominal aortic aneurysm (AAA) screening sessions.

AAA is a swelling of the aorta, the main blood vessel that leads away from the heart to the rest of the body through the abdomen. The abdominal aorta is usually around 2cm wide but the wall can swell into an aneurysm of 5cm or even larger. If it then bursts it causes massive internal bleeding and is usually fatal - 80 out of 100 people die when an aneurysm bursts.

The condition is most common in older men and the NHS invites all men for AAA screening in the year they turn 65. Research suggests that the national screening programme, which is funded by NHS England, reduces the rate of premature death from AAA by up to 50%.

Transporting and escorting inmates to standard screening venues outside prisons is challenging and time-consuming, so Guy’s and St Thomas’ has instead begun bringing the service directly to local prisons to improve access to AAA checks for people in prison.

Mark Tyrrell, consultant vascular surgeon at Guy’s and St Thomas’, says: “People in prison have the right to receive healthcare and we’re pleased to be able to provide this screening service. Our proactive new approach to AAA screening in prisons means we are far more likely to find swelling at an early stage so that it can be treated promptly.

“Bringing the screening to people in prison gives us a much better chance of preventing a burst blood vessel. As well as being potentially life-saving for them, this is also a more efficient use of health service resources. If someone isn’t screened and their blood vessel goes on to swell and burst, that would lead to them coming into hospital and having emergency surgery, which is hugely expensive.”

AAA does not usually produce any noticeable symptoms and the condition is identified through an ultrasound scan. The scan of the abdomen, similar to that offered to pregnant women, usually lasts less than 10 minutes and enables the aorta to be checked for swelling. 

Karen Kemp works at HMP Belmarsh for Oxleas NHS Foundation Trust, which provides the prison’s healthcare services. She says: “It’s fantastic that we can mirror in prison what is offered in the community. The team carrying out the screening are efficient and professional – the people in prison who received the screening were very impressed and so were the staff.”