Royal Devon University Healthcare NHS Foundation Trust, working in partnership with the South West Probation Service and One Northern Devon, is delivering a health and justice pilot in Ilfracombe that aims to address health inequalities experienced by people on probation.

The initiative is part of a national NHS and Ministry of Justice pilot taking place in four areas, including Ilfracombe, Cambridge, Middlesbrough, and Hammersmith.

People in contact with the criminal justice system face significant health inequalities. They are far more likely to have poor physical or mental health or addiction issues, which increases the likelihood of reoffending.

When people are on probation they can face additional barriers to healthcare, such as registering with a GP, keeping on top of long-term conditions, or accessing mental health and substance use support.

The pilot is addressing unmet physical and mental health needs among people on probation by bringing practical healthcare support directly into the contact points people have with the probation service.

This personalised approach can prevent ill health, which aligns with the 10 Year Health Plan’s neighbourhood health model and the ambition to move towards prevention rather than treatment.

With funding from NHS England, the pilot is initially focusing on a small cohort of people currently on probation in Ilfracombe, with a test and learn approach before exploring a wider roll-out.

The Royal Devon and the South West Probation Service are jointly leading the pilot over six months, which ends in March 2026.

Chris Tidman, Deputy Chief Executive of Royal Devon, said: “People on probation can face multiple barriers to getting the right help at the right time. This pilot is about meeting people where they are, using probation contact points as an opportunity to spot issues earlier, connect people to services faster, and coordinate support around the whole person.

“It’s also going to be an invaluable test of community-based integrated working that will inform development of our Neighbourhood Health Service.”

Louise Arscott, Head of Probation Delivery Unit at South West Probation Service, said: “Probation appointments are a key touchpoint, but too often health needs sit in the background until they become a crisis. By working side-by-side with NHS colleagues, we can help remove barriers, improve engagement, and support people to stabilise their health and wellbeing—an important part of rehabilitation and building safer communities.”

What the Ilfracombe pilot is doing

The pilot is testing an integrated approach that combines:

• Probation delivery within Ilfracombe instead of Barnstaple, helping reduce travel and access barriers and strengthening links with local health and community services.
• Structured health checks (including checks such as blood pressure, BMI and key risk markers), alongside support to improve continuity of medication and vaccination status, with prompt referral into relevant services where needed.
• A multi-agency plan and “Team Around the Person” approach, so people can get coordinated support rather than being passed between services. People will have a holistic needs assessment that looks at health and wider needs linked to rehabilitation (for example housing, substance use, mental health and other pressures that can increase the risk of crisis and reoffending).
• Better identification and coordination, including consistent NHS number capture and testing the feasibility of linking information across health and justice systems to support safer, more joined-up care.

Building evidence for what works

Alongside supporting individuals, the project is designed to generate learning about health needs and service use among people on probation, and to test practical ways of working that could inform future neighbourhood multi-disciplinary team (MDT) approaches and wider health–justice collaboration.

The evaluation will combine quantitative and qualitative methods to assess feasibility, impact, and system learning, with findings intended to help shape scalable models of health–justice partnership working.
 
Quick facts

• The Ilfracombe health and justice pilot runs from 1 October 2025 to 31 March 2026 and is funded by £40,000 from NHS England.
• The pilot is being delivered through partnership working between the Royal Devon University Healthcare NHS Foundation Trust, the South West Probation Service, One Northern Devon and One Ilfracombe, aligning with neighbourhood health approaches and inclusion health priorities.
• People in contact with the criminal justice system are recognised as an inclusion health group within Core20PLUS5, and can experience higher levels of unmet need, poorer continuity of care, and barriers to accessing preventative services.
• Devon has hotspots of urban deprivation with the highest overall levels in Ilfracombe. Devon’s Joint Strategic Needs Assessment recognised that across Devon, people living in the poorer neighbourhoods tend to, on average, die between 5 and 7 years earlier that people living in more affluent neighbourhoods. However, the difference in life expectancy is even more stark in certain areas such as Central Ilfracombe where people tend to, on average, die 15 years earlier.