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Investigates 1999/2000 health promotion activities in prisons in England and Wales and documents the range and quality of health promotion occurring in prisons, against which future activity might be measured. Finds that health promotion is under‐resourced and the concept and practice poorly understood. Health needs assessment tended to be analysis of and for health‐care services and, except in a minority of cases, did not include consultation with staff, prisoners or their families. Where responsibility was shared and the work based on multi‐disciplinary approaches, it seems more likely to have been reported accurately as health promotion activity. The official policy of a healthy settings/whole prison approach was not understood by many and its application was limited. The findings have informed the development of a new health promotion strategy for the prison service in England and Wales.

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