WARNING: DISTRESSING CONTENT. As concerns grow over a spate of fatal attacks behind bars, prison doctor Dr Shahed Yousaf opens up to the Mirror about the things he wishes he could unsee, including an inmate ripping out their own bowels
Wayne Couzens is said to be cowering in his cell at HMP Frankland(Image: SWNS)
As conditions in the UK’s prisons reach boiling point, a prison doctor has opened up about some of the worst things he’s witnessed behind bars, from disembowellings to infamous patients cropping up on the front pages of staffroom newspapers.
While working in the prison system has never been for the faint of heart, a gruesome run of inmate-on-inmate attacks has frightened staff and prisoners alike, and it’s feared more bloodshed will follow. Back in October, Lostprophets singer Ian Watkins died after an assault at HMP Wakefield, with the paedophile allegedly stabbed in the neck. Two inmates have since been charged with his murder. Then, earlier this month, Soham killer Ian Huntley had his life support switched off following an attack in a workshop at HMP Frankland, where he had long been a target.
Notorious lags are reportedly now fearful that they’ll be next, with a prison insider recently telling The Sun newspaper that Wayne Couzens, who disgracefully used his position as a police officer to rape and murder Sarah Everard, is said to be cowering in his cell at HMP Frankland, “petrified” that he will suffer Huntley’s grisly fate.
Dr Shahed Yousaf has spent thirteen years working as a prison doctor(Image: Supplied)
Such stomach-churning incidents will likely come as no surprise to Dr Shahed Yousaf, who has spent thirteen years working as a prison doctor. Now the GP has warned that violent inmate-on-inmate crime will likely only continue if staffing levels remain as they are, arguing that prison officers are deserving of “more recognition and appreciation”.
Dr Yousaf, who penned the acclaimed memoir Stitched Up: Stories of Life and Death from a Prison Doctor, told the Mirror: “I wish I could unsee some of the events I have witnessed. Nothing prepares you for prison. It is a hidden world we should all know more about. I believe if we raised public awareness about the reality of prison life, prison reform would be higher on the political agenda. It is far from a holiday camp.”
After qualifying as a GP in 2012, Dr Yousaf started off working with the homeless community, before quickly moving into prisons, much to the anxiety of his family and friends, who he tries to shield from the absolute worst of what he has to deal with day to day.
The doctor tries to shield his family from the absolute worst of what he has to deal with day to day(Image: Supplied)
While managing all the usual conditions he would have handled as a community GP, including chronic diseases, acute illnesses and general emergencies, Dr Yousaf has noted that certain conditions are overrepresented behind bars, including mental health issues and substance misuse. Then of course, there’s the violence.
Dr Yousaf told us, “I am always surprised by people’s inhumanity to others. The level of violence is extreme. I have treated patients with boot prints on their faces and broken skulls. Sugar-watering also features in my nightmares, where a kettle of water is boiled with sugar to form a molten syrup that is thrown as a weapon. This can lead to a full-thickness burn and is excruciatingly painful. Often, the worst injuries I have witnessed have been self-inflicted.
“People have cut open their bowels and pulled out their intestines. They have cut themselves to ribbons and inserted foreign objects into their septic wounds. Another relatively common example of bodily harm is people swallowing foreign objects such as batteries, broken glass, thumbtacks, stationery, and cutlery. This can lead them to perforating their bowels, they have to go to the hospital for emergency surgery, and when they come back to prison, they open their stitches and continue to self-harm. I use this as an example when people who have never experienced prison tell me that it is a holiday camp.”
The doctor is keen to show people that prison is not ‘a holiday camp’(Image: Supplied)
With these prison attacks, there is a hierarchy, which has become particularly apparent in recent times. Dr Yousaf highlighted that those locked up for crimes of a sexual or sensitive nature, known as Vulnerable Prisoners or VPs, are at greater risk of attack from those in the mainstream population. Noting that there has been a “spate” of such incidents, the doctor detailed: “There is an unofficial hierarchy of criminality which prisoners sort themselves into, with VPs being at the bottom. There is a sense of pride amongst some prisoners for attacking a VP.”
For confidentiality reasons, Dr Yousaf often finds himself alone, without an officer, when dealing with patients, and has to use de-escalation techniques when dealing with aggressive or threatening patients. On occasion, the GP has had “to push the panic button or leave the room very quickly” out of fear for his personal safety.
He tells the Mirror how, on one occasion, a patient ran down a corridor “to head-butt me,” but luckily, prison officers were able to step in to protect him.
Threats are a regular occurrence for the team, especially when an inmate is denied a request.
Ian Huntley was recently slain by a fellow inmate (Image: Geoff Robinson/Shutterstock)
“I try to explain that we have extra guidance in prisons to prescribe safely,” said Dr Yousaf. “It is always uncomfortable to say no to a patient, in the community or in prisons. The NHS has a Zero Tolerance approach to abuse. I have a poster that says as much on my wall, which I look at wistfully when someone is shouting and venting at me.”
Benchmarking introduced in response to austerity has resulted in the loss of some 10,000 prison officers, and 15 years on, the strain is still very much felt. The Mirror previously heard from lawyer Rachel Fletcher, whose low-risk client was kept in their cell for more than 20 hours a day, as there simply weren’t enough officers on hand to watch him. It’s little wonder that prisoners and staff alike are fearing for their safety after a spate of brutal attacks.
The rate of inmate-on-inmate assaults in men’s prisons soared by 11 per cent in 2024 compared to the previous year, while facilities are operating at 99 per cent capacity – a toxic combination.
Paedophile Ian Watkins died in prison back in October(Image: SOUTH WALES POLICE/AFP via Getty)
The number of assaults on members of staff also rose by 13 per cent in this same time period. Pledging a new £40 million investment, the Government stated at the time, “This is the first time a direct link has been drawn between increased violence behind bars and the capacity crisis inherited by the Government that put the public at risk.”
With his 2022 book, Dr Yousaf hoped to drive home the harrowing reality of what those working and living in prisons have to deal with every single day, a world away from common gripes over inmates having an easy time of it, usually espoused by those without the doctor’s extensive experience. During his work with the homeless, Dr Yousaf was horrified to see the number of vulnerable individuals committing petty crimes, such as shoplifting, during the wintertime, in a desperate attempt to get off the freezing streets. But on the inside, a whole different sort of nightmare awaits.
Naturally, many of the patients Dr Yousaf treats will have featured on the news, but he does his absolute best to avoid such grim reports, for the sake of his own mental well-being, preferring to focus on the positive when his working day is done. Not knowing the potential horrors the person sat before him has committed allows him to deal with appointments just as he would with any other patient, and that’s the way he prefers it.
The UK prison system is facing a crisis(Image: PA)
Dr Yousaf told us: “I have never met a famous or high-profile person, outside of prison. I’ve met plenty of infamous and high-profile people in prison. I prefer not to find out why the patient before me is in prison. This could interfere with my ability to care for them without prejudice, which is my duty as a prison GP. This is difficult when they are on the front page of newspapers in the coffee room or on the news. Notorious criminals are sometimes disappointed when I do not recognise them.”In November 2025, the Justice Committee warned that prisons were in a “state of disrepair” with many inmates locked in their cells for 22 hours or more each day. Concerns raised included staffing levels, high turnover, poor recruitment processes, and limited professional development, all of which are said to have contributed to an environment which stunts rehabilitation and contributes towards reoffending.
Dr Yousaf said, “Prison officers see themselves as the forgotten fourth emergency service, and I believe they need more recognition and appreciation. We only seem to hear about prison officers when there is a bad apple who has abused their position or become involved in an inappropriate relationship. This narrative does a massive disservice to the countless prison officers who put their lives at risk on a daily basis. They keep us all, and the public, safe from the worst members of our society.”
A Ministry of Justice spokesperson previously told the Mirror: “This Government inherited a prison system in crisis, overcrowded and with significant staffing shortages. We are recruiting more officers and deploying them where they’re most needed, as well as investing £40 million in new security measures to clamp down on the contraband that fuels violence behind bars.”
