Social value case study: Vaccinations in Peterborough Prison

 

The Off The Grid (OTG) project delivers targeted vaccination programmes to underserved and vulnerable populations.

Beginning at Peterborough Prison in March 2025, the initiative addressed a critical gap in healthcare provision, with no vaccinations delivered since the prison opened in 2005. Through collaboration with prison healthcare staff and an outreach-based model, the project has successfully improved vaccine uptake, reduced health inequalities, and strengthened trust among prisoners. The programme has since expanded to Littlehey Prison, demonstrating scalability and wider public health impact.

The challenge

Prison populations are at significantly higher risk of infectious diseases due to overcrowding, close living conditions, and increased prevalence of underlying health conditions. At Peterborough Prison, no vaccination programme had been implemented since its opening in 2005, creating a serious public health concern. Additional challenges included identifying appropriate contacts for collaboration, navigating security clearance processes, and engaging a population that may initially distrust healthcare interventions or decline vaccination.

Project description

The OTG project began work at Peterborough Prison in March 2025 following a six-week clearance process for staff. Collaboration with Chronic Diseases Nurse Sharon Bubb enabled the programme to launch effectively. Clinics were structured to prioritise pregnant women and babies, followed by older and vulnerable individuals, and then the wider prison population.

Vaccinations were initially delivered in clinic settings; however, the approach evolved to include outreach onto prison wings. This opportunistic model allowed vaccination of individuals unable or unwilling to attend clinics, significantly increasing uptake. Educational leaflets were also provided to those declining vaccination to support informed decision-making. The team conducts monthly visits, with dedicated sessions for women and babies and separate sessions for the male population.

Outcomes and impact

• 645 vaccinations delivered at Peterborough Prison.
• Vaccines administered include BCG for babies, pregnancy-related vaccines, older adult vaccines, and routine childhood immunisations.
• Increased vaccine uptake over time due to improved trust and engagement.
• Reduced number of refusals, with many individuals later accepting vaccination after reviewing information.
• Improved access to healthcare services equivalent to those available in the community.
• Expansion of the programme to Littlehey Prison, where 399 vaccinations have been delivered to date, with ongoing twice-monthly clinics. 

Lessons learned

• Building trust is essential to improving vaccine uptake in hard-to-reach populations.
• Providing clear, accessible information supports informed decision-making and can reduce initial refusals.
• Flexibility in delivery models, such as outreach on prison wings, significantly improves access and coverage.
• Strong collaboration with on-site healthcare staff is critical for successful implementation and sustainability.

Next Steps

• Strengthen collaboration with prison healthcare leadership to ensure continuity following staffing changes.
• Secure ongoing clinical support to maintain and expand vaccination delivery.
• Explore opportunities to access additional prison units, including the S1 unit.
• Continue and expand delivery at Littlehey Prison and assess potential rollout to other prison settings. 

Contact details

Off the Grid lead, Kathy Law, kathy.law1@nhs.net