Background The number of prisoners over 50 years old has nearly trebled in the past 15 years, leading to an inevitable increase in natural deaths in prisons. The number of expected deaths has more than doubled (Prisons and Probation Ombudsman, 2017). The Dying Well in Custody Charter Self Assessment Tool was launched in March 2018 to promote good practice in palliative and end of life care in prisons (Community of Practice for Prisons Steering Group, 2018). It includes eight ambition statements, each with quality statements and evidence guides and is backed by NHS England Ambitions for Palliative and End of Life Care Partnership (Community of Practice for Prisons Steering Group, 2018).

HMP Littlehey is a Category C prison. With approximately 1220 residents, it is one of England’s largest older age prisons: 35.5% aged over 50 years and 6.6% over 70. The prison has no 24 hour healthcare but has developed close links with its local palliative care team and hospice.

Aims To promote quality palliative care for prisoners by piloting the Dying Well in Custody Charter and sharing the experience.

Methods A multi-disciplinary group of a nurse, a governor and a palliative medicine consultant used the Self Assessment Tool to review current work.

Results The tool enabled a review of current practice and establishment of standards including:

• Identification of patients using the SPICT for All tool (University of Edinburgh, 2018)

• All patients enabled to do Advance Care Planning

• All patients having a Family Liaison Officer and keyworker

• Establishment of Palliative Care MDT

• Controlled Drugs available via locked box in cell subject to risk assessment

• Timely application for compassionate release

• Timely assessment by specialist palliative care

• Healthcare input into risk assessments on restraint.

Conclusions The Self Assessment Tool is a helpful way to evidence existing good practice. It may also be useful where change is required, or palliative care is infrequent in demonstrating the standards expected in the prison service and which can be achieved.