Monthly Archives: May 2019

HMIP Report: HMP Stocken, Jan-Feb 2019 – Health Summary

This report was on the announced inspection of HMP Stocken (22 January 2019 – 8 February), and was published 29 May 2019.

Points To Note.

The use of illicit drugs, particularly new psychoactive substances (NPS), remained a serious problem. In the survey, nearly half of prisoners said that it was easy to get drugs at the prison. The mandatory drug testing (MDT) positive rate was high, at around 26% over the previous six months, and almost exclusively for NPS.

There had been two self-inflicted deaths since the previous inspection (in July 2015). Prisons and Probation Ombudsman (PPO) recommendations were not always implemented or embedded. Levels of self-harm had increased substantially since the previous inspection and were now comparable with those at similar prisons. Over half of the 184 incidents in the previous six months had concerned just eight prisoners, which is a telling statistic.

For the same six month period, there were a total of 115 Assessment, Care in Custody and Teamwork (ACCT) case management documents had been opened, which represented an increase since the previous inspection. This was noted as being below the number HMIP inspectors usually find at similar prisons.

Several aspects of health provision had deteriorated since the previous inspection and, overall, the service required improvement. There was a lack of robust governance for several areas of health care. The management of medicines had deteriorated, in terms of poor oversight of medicines management, poor stock control and unsafe storage that needed immediate attention. Some patients requiring nursing care did not always receive the treatment they needed, which left patients at risk of their health deteriorating. Care plans were not always followed or regularly reviewed, and primary care staff did not receive regular managerial or clinical supervision. Waiting times for most primary care services were acceptable, apart from long waits to see the physiotherapist and for a routine GP appointment.

Long-term health conditions were managed effectively. However, a lack of oversight of some patients with complex nursing care needs led to poor outcomes. A social care pathway was in place but the recording of planned care was poor. Staff shortages had had an impact on the delivery of some mental health services, including delays in routine assessments, but urgent referrals were seen promptly.

The drug recovery unit provided a positive environment, with a wide range of psychosocial support available. Not all patients on opiate substitution therapy received regular and timely clinical reviews.

Healthy Prison Outcomes:

  • Safety = 3 (2)*
  • Respect = 3 (3)*
  • Purposeful Activity = 2 (4)*
  • Rehabilitation and Release Planning = 2 (3)*

Note: *Previous inspection outcomes in brackets (from July 2015)

Summary: Health, Well-Being and Social Care:

No patient consultation forums had been established and there was no embedded system to gather patient feedback for primary care services.

Mandatory training was well managed, with some opportunities for professional development. Managerial and clinical supervision was in place for mental health and psychosocial staff but there were gaps in primary care managerial supervision, and clinical supervision was not offered.

The health centre was clean and treatment rooms generally met clinical requirements, including regularly checked and calibrated equipment. However, some of the wing-based medication administration rooms did not meet Infection Prevention and Control (IPC) standards. Daily cleaning checks for clinical rooms were not consistently completed. An IPC audit completed in September 2018 had identified some deficits.

Smoking cessation support was available for those who wished to stop nicotine vaping. Two peer health orderlies had been involved in this with health services staff, but these posts had recently become vacant.

Health care applications were triaged by non-clinical staff, so inspectors could not be sure that patients needing an urgent appointment would be identified, posing a potential clinical risk. Waiting times were adequate for most primary care services, but too long for physiotherapy, dental and routine GP appointments. There were urgent appointment slots available in each GP clinic.

There was an effective system to manage the booking of external hospital appointments. There were sufficient prison officer escorts, which meant that few hospital appointments were cancelled for operational reasons.

Health care release and transfer planning arrangements were effective, when health services staff were given sufficient notice. However, there had been occasions when the transfer of a patient’s care had been arranged only after the patient had left the prison, and when prisoners on release had received only a limited supply of medicines.

45% of prisoners reported to inspectors that they had mental health problems, and 58% of these said that they had been helped with these at the prison. During the inspection, the MH team had 60 patients on their caseload, including six with severe and enduring mental health needs.

The MH team received approximately 50 referrals per month from reception, self-referral, and health services and custody staff.

The waiting time for a routine Mental Health assessment was six weeks, which was too long. The manager triaged referrals each morning, prioritising them on clinical need. The team responded to urgent referrals promptly. There was an effective weekly team meeting and good interaction with prison staff.

There was only one psychiatry session per week, which meant that some patients waited too long for a routine appointment and medication reviews.

23% of prisoners reported an alcohol problem, and 33% a drug problem, on arrival; of these, 61% and 63%, respectively, advised inspectors that they had been helped with this while at the prison.

The Inclusion team, although stretched because of staff absence, was actively engaged with 279 prisoners (33% of the population). Eighty-one prisoners (10% of the population) were prescribed methadone, which was the only opiate substitution therapy available at the time of the inspection and limited patient treatment options. A third were on reducing doses. The prison did not receive any prisoners on buprenorphine (a heroin substitute), which needed to be reviewed.

The CQC issued 3 Requirement Notices against Regulation Standards.

Recommendations: Health, Well-Being and Social Care:

  • Effective and robust (clinical) governance structures should be in place, to ensure that all aspects of health delivery meet the needs of prisoners and are safe, including effective oversight of patient care and the immediate implementation of robust and secure medicines management arrangements.
  • Local partnership board meetings should occur more frequently, to provide strategic oversight and effective governance of the service.
  • Screening, immunisation and vaccinations should be offered and implemented in a timely fashion.
  • Specialist sexual health services should be available within the prison, to ensure privacy and dignity.
  • There should be clinical oversight of the appointment system, to ensure that patients are appropriately booked into clinics.
  • Waiting times for some primary care services, including physiotherapy, the GP and dental services, should not exceed clinically acceptable waiting times in the community.
  • Prisoners should have timely access to mental health services, including routine mental health assessments.
  • Prisoners needing treatment for their condition in hospital under the Mental Health Act should be transferred within the timescales established by the Department of Health.
  • Wider options for clinical treatment should be available, in line with national clinical guidance.
  • Joint clinical and psychosocial reviews should be timely, to support effective management and care of prisoners on opiate substitution therapy.
  • Medicines should be prescribed and administered at clinically appropriate times, to ensure optimal treatment.
  • Medication administration should be supervised effectively by prison staff, to ensure confidentiality and compliance, and reduce the risk of bullying and diversion.
  • The medicines management quorate should ensure that medicines storage and oversight are in line with legal and professional standards, and deficits should be immediately resolved.

Good Practice: Health, Well-Being and Social Care:

None identified.

CQC Requirement Notices Issued:

  • Regulation 9 – Person-centred care
  • Regulation 12 – Safe care & treatment
  • Regulation 17 – Good governance

Links/Resources:

Press Release

Full Report

Strep A Guidance For Prisons

On 14th May 2019, the Government published some information and guidance around Group A Streptococcal Disease (GAS). Amongst prisoners, officers and healthcare staff, this is more commonly referred to as Strep A. This guidance was jointly created by Public Health England (PHE) and HM Prison and Probation Service (HMPPS).

What is Strep A?

Strep A is a type of bacteria often found in the throat and on the skin. The most invasive GAS (iGas) infections happen when the bacteria get past the skin and other bodily defence. The less common, but more severe cases on the invasive disease could be life threatening.

Over the past 18-24 months this bacteria has caused infection with ever increasing frequency amongst the prison population and across the wider prison estate. Local prisons are the most at risk of infections, given the correlation with those who are part of the homeless community (also a high risk area) and those active within the drug sub-culture being the most common.

Strep A – Signs And Symptoms.

Signs and symptoms of invasive group A streptococcal disease include:

  • High fever
  • Severe muscle aches
  • Localised muscle tenderness
  • Redness at the site of a wound

Where any of these symptoms develop, seek medical advice immediately. If anyone you know develops these symptoms, they should also seek medical advice immediately.

Actions To Minimise Risk.

  • Prisoners should be encouraged to maintain clean cells.
  • Prisoners should have opportunities for clothing to be washed at the right temperature and dried fully.
  • Prisoner bedding should be regularly changed and washed. This should be more frequent for those who have wounds.
  • Prisoners should have opportunities to wash and shower at least daily.
  • Prisoners should be reminded of the importance of good hand hygiene – washing hands after using the toilet and before the eating or preparing of food.
  • For those prisoners who have infected wounds, the guidance is that they should not use the gym, until they have had 48 hours of antibiotics and/or the wound is covered or healed.

The concerns will rise where the this guidance is not adhered to, and the disease is allowed too become more prevalent as a consequence of denial, ignorance or complacency. In all reality, it is likely to a combination of all of these factors.

The full guidance is found here.

Photo by Brian Patrick Tagalog on Unsplash.

HMIP Report: HMP Guys Marsh, Jan 2019 – Health Summary

Overview.

HMP Guys Marsh was found to be a safer prison and the overall impression from the inspection team was of a calmer, more settled institution. Putting this into perspective, HMIP also noted that the levels of violence as being higher than that of similar prisons.

This inspection of Guys Marsh evidenced tangible progress for the first time in many years, and the Health service was described as being very good overall.

Some notable statistics from the prison for the six period prior to the inspection were that 202 prisoners had required medical intervention due to suspected new psychoactive substance use in the previous six months. 27% of prisoners had tested positive in random mandatory drug tests.

Additionally, there had been 211 reported incidents of self-harm, and at the time of the inspection, only 70 men (18%) were on the mental health team caseload. There had been five deaths since the previous inspection, one of which had been self-inflicted and three that appeared to have a connection to the use of new psychoactive substances (NPS).

Date of publication: 21 May 2019
Report type: Prison and YOI inspections
Location: HMP Guys Marsh

Healthy Prison Outcomes:

  • Safety = 2 (1)*
  • Respect = 3 (2)*
  • Purposeful Activity = 2 (2)*
  • Rehabilitation and Release Planning = 3 (1)*

Note: *Previous inspection (Dec 2016) outcomes in brackets.

Summary: Health, Well-Being and Social Care:

Staffing levels were good and the team told us they felt supported. The health care team was well trained and further relevant training opportunities were available. Clinical supervision was available to all staff and recent supervisor training for primary care staff had prompted further development, which was good.

Staff were well trained in emergency response. Senior prison officers had recently undertaken the custody officer intermediate life support training and were well supported by health care staff.

Health care services were well embedded with the developing a rehabilitative culture project. Health care staff had supported well-being initiatives as part of this work.

Health information was available across the prison, and health promotion material was widely displayed. We noted innovative, imaginative initiatives which included a mental health and well-being calendar and identification of monthly health promotion themes.

A release and well-being coordinator had recently been employed, which was a good initiative. The role included oversight of peer workers, further development of health promotion and provision of pre-release support.

An initial health care screen was undertaken and appropriate referrals made. Rates of attendance for a timely secondary health screen were very poor. An initiative to address low uptake had recently been implemented but it was too early to assess its impact.

Telemedicine had been used to support provision on site. Patients were also offered the opportunity to register with Socrates, the health care smart phone software application.

There was a high level of mental health need. In our survey, 57% of men said they had a mental health problem against the comparator of 43% and 58% said they had been helped with their mental health.

A daily MH duty worker screened referrals, responded to urgent cases and participated in ACCT reviews when appropriate. Standard templates were used to support mental health triage and reviews.

Opiate substitution treatment was administered from a dedicated treatment room on Saxon/Gwent units, and other controlled drugs were administered from the health care department.

All other administered medicines were available three times a day from two medicine administration points in the health care centre, one of which was in the health care waiting area. This resulted in medicines being administered among prisoners waiting for appointments. When we raised this, the appointments were rescheduled and the problem of prisoners crowding around the hatch was resolved. Supervision of medicines queues by prison officers had improved since our last inspection, with the allocation to health care of a dedicated prison officer.

Recommendations: Health, Well-Being and Social Care:

  • Health care services should be informed by an up-to-date health needs analysis.
  • All prisoners should receive secondary health screening within seven days of arrival at the prison.
  • All patients should receive advance notification of their health care appointment.
  • Patients requiring mental health inpatient care should be transferred without delay. (repeated recommendation)
  • The clinical management of substance dependent prisoners should be strengthened by consistent specialist nurse input.
  • All prisoners should have lockable cabinets in which to store their prescribed medicines. (repeated recommendation)
  • Staff training and competency assessments relating to medicines administration should be reviewed to help ensure all staff administering medicines maintain their competency.
  • The governance of in-possession risk assessments should be reviewed to ensure that the assessments reflect the current risks for the prisoner.

Good Practice: Health, well-being and social care:

  • The care of prisoners who were self-isolating ensured that current and emerging health needs were quickly identified and managed.

CQC Requirement Notices Issued:

None

Links/Resources:

Press Release

Full Report Here

HMIP Inspection Report Health Summary – HMP Lewes, Jan 2019

Date of publication: 14 May 2019
Report type: Prison and YOI inspections
Location: Lewes

Background and Context.

HMP Lewes is a medium sized Cat B male Local/resettlement prison. The last inspection was in January 2016. Since then there have been 5 self inflicted deaths and reported incidents of self harm have increased 300%.
On the positive side, 78% of prisoners told the HMIP Inspectors that staff treated them with respect. This finding in itself attracted the notable remark of this statistic being an “unusually high figure for this type of prison.”
A recognition surely of the challenges faced within the local/resettlement prisons across the estate?

Healthy Prison Outcomes:

  • Safety = 2 (2)*
  • Respect = 2 (3)*
  • Purposeful Activity = 1 (2)*
  • Rehabilitation & Release Planning = 2 (3)*
Note: *(Previous inspection outcomes in brackets)

Summary – Health, well-being and social care:

Many prisoners were very negative about the health services, with two-thirds of prisoners in the survey responding that the overall quality was quite or very bad. Services had deteriorated since the previous inspection, most notably mental health services and the provision of nurse-led primary care.

Over half of prisoners said they had mental health problems. Waiting lists were lengthy and the under-resourced integrated mental health team could not meet the level of need.

The range of primary care services was limited and the oversight of prisoners with long-term conditions was poor. The application process for health appointments was very poorly managed. Inspectors found 143 outstanding applications, presenting significant risks to prisoner care.

Managers did not have accurate data on waiting times.

The inpatient unit continued to provide good quality care for some of the most seriously ill patients. However, it still lacked a therapeutic regime and some of the cells were in poor condition. There were five prisoners receiving funded social care packages, and they received good quality care.

In relation to Substance Misuse services, The Forward Trust provided good clinical and psychosocial services for prisoners requiring substance use treatment.
Prison officers did not always manage medication queues effectively, which continued to compromise confidentiality and increased the opportunity for medication diversion.

Dental care was good but some aspects of governance needed immediate attention, particularly the maintenance of fixed equipment.

The CQC issued 3 Requirement Notices against Regulation Standards.

Recommendations – Health, well-being and social care:

  • Health governance structures should be robust enough to identify and effectively address key risks and concerns, and should ensure that prisoners have prompt access to all health services.
  • All health care staff should receive regular clinical and managerial supervision, and be up to date with mandatory training.
  • All health care should be delivered in a clinically appropriate setting that meets infection control standards.
  • There should be a prison-wide strategy and approach to support health promotion and well-being activities.
  • Waiting times for patients should be regularly monitored to ensure prompt access to care.
  • Applications for health care appointments should be reviewed and actioned without delay.
  • The reasons for prisoner non-attendance at health care appointments should always be recorded and reviewed.
  • Prisoners with long-term health conditions should receive regular reviews by trained staff, informed by an evidence-based care plan.
  • External hospital appointments should not be cancelled. (Repeated recommendation)
  • The prison should work with key stakeholders to produce an updated memorandum of understanding and information-sharing agreement for social care provision.
  • Prisoners referred to the service should be reviewed and assessed promptly, and offered a suitable range of mental health interventions within agreed timescales.
  • There should be a regular substance use strategic meeting to support the implementation and development of the strategy.
  • In-possession medication should be prescribed, reviewed and administered by health care professionals adhering to an up-to-date policy and risk assessment that reflects the range of medications prescribed, up-to-date prescribing guidelines, robust risk assessment of patient and medication, and appropriate storage of such medicines/doses. (Repeated recommendation)
  • Custody officers should manage queues during medication collection times to maintain confidentiality and minimise potential bullying and diversion of supplies (Repeated recommendation)
  • Prisoners should have access to routine dental appointments within six weeks.
  • All dental equipment, including the x-ray machine, should be regularly serviced and certified.
  • The provider should maintain an up-to-date file to document local arrangements for radiation protection.

Good Practice – Health, well-being and social care:

None Identified.

CQC Requirement Notices Issued:

  • Regulation 9 – Person-centred care
  • Regulation 17 – Good governance
  • Regulation 18 – Staffing

Links/Resources:

Press Release

Full Report

Hepatitis C Report – Prisons In England 2019

In this latest report (published on 9 April 2019), Hepatitis C in England 2019, Public Health England summarises the current data and the impact of action plans in England to drive down mortality from Hepatitis C Virus (HCV) and to reduce the number of new infections. Also included is an outline the actions required to make further progress. It is clear that progress is being made, but there is still much to do.

This post provides a summary of the key points relative to the levels of activity ongoing through the prison estate in England.

Latest modelled estimates suggest that around 143,000 people in England were living with chronic HCV infection in 2015. Prevalence is estimated to have fallen in recent years, and was predicted to decline to 113,000 in 2018 with the advent of new treatments. HCV affects a larger proportion of people in prison and other detention centres than the wider population, principally as a result of the relatively higher levels of injecting drug use that are observed among this population.

Partnership Working – HMPPS, NHSE and PHE.

Since 2013/14, PHE in partnership with NHS England and Her Majesty’s Prison and Probation Service (HMPPS) have overseen the rollout of BBV testing in adult prisons on an ‘opt-out’ basis. A significant milestone was reached in April 2018, when after more than 4 years of implementation, the programme was successfully rolled out across the entire adult prison estate.

Testing and Diagnosis.

Opt-out bloodborne virus (BBV) testing is now fully implemented across the prison estate, and among new receptions to English prisons, levels of testing have risen from 5% in 2010/11 to 19% in 2017/18. In the 2017/18 financial year, Health and Justice Indicators of Performance (HJIP) testing data suggest that, after excluding previously confirmed cases, 75% of new receptions and transfers were offered HCV testing, 26% were tested, 11% of those tested were found anti-HCV positive but less than half (46%) went on to have HCV Ribonucleic acid (RNA) testing. About 40% of those testing positive for HCV RNA received specialist referrals for their HCV infection.


Overall, these data suggest an increasing awareness of HCV in prisons with significant increases in testing, including Dried blood spot (DBS) testing. Whilst testing volumes remain sub-optimal, work is ongoing to move from the implementation of BBV testing to improving the quality of the offer and uptake of testing within prisons.

HJIP Metrics.

Prison Health Performance and Quality Indicators and HJIPs have shown a rise in HCV tests performed, from 5.3% in 2010/11 to 19.4% in 2017/18. It is likely that the recent increase in testing of people in prisons is due to the introduction of BBV opt-out testing, which was agreed in October 2013 by PHE, NHS England and HMPPS and is now fully implemented across the prison estate. While this increase in testing is welcomed, current levels are still below the lower BBV testing threshold proposed by NHS England (50-74%), and well below the target threshold of at least 75% uptake.

Performance in relation to the BBV opt-out testing programme is measured at the prison level by NHS England through the collection of data via HJIPs. These metrics include specific reports on:

  • the number of BBV tests offered within 72 hours of reception,
  • the number of tests undertaken,
  • the number of people newly diagnosed,
  • the number of patients referred for specialist treatment following diagnosis,
  • the number who received treatment.

These data are used by NHS England commissioners to performance manage healthcare providers in prisons and are important for identifying potential attrition points in the testing pathway.

In the 2017/18 financial year, HJIP testing data suggest that, after excluding previously confirmed cases, 75% of new receptions and transfers were offered HCV testing and of these 26% were tested. Of those tested, 11% were positive and 46% of these went on to have HCV RNA testing.

The image with this post illustrates the Hepatitis C testing cascade in the English prison estate (112 prisons).

World Hepatitis Day is held on 28 July 2019.

Read the full report Here

HMIP Report Health Summary – HMP Garth – Jan 2019

Date of publication 09 May 2019
Report type Prison and YOI inspections
Location HMP Garth

Report on an announced inspection of HMP Garth (17 December 2018 – 18 January 2019)

Main Points: Health, well-being and social care.

Several aspects of health care had improved since the previous inspection, but patients still waited too long for hospital appointments. Governance structures and partnership working were reasonable. Staffing levels had improved, but there were still vacancies. However, in some areas they were offset by regular agency staff and an active recruitment programme. Supervision in the health care waiting room was poor, leaving some prisoners at risk from others. The management of long-term conditions had improved and patients now received regular reviews and a good level of care. Waiting times for some primary care services, including dentistry, were still too long, exacerbated by high non-attendance rates. The integrated mental health team mostly delivered an appropriate range of services. Substance misuse services were reasonably good, prescribing was safe and reviews took place regularly. A good range of psychosocial support was also available. The ethos of the substance misuse therapeutic community was undermined by a lack of dedicated prison officers and some prisoners’ use of illicit drugs. Medicines were managed reasonably well and medicines administration had improved since our previous inspection, but governance and oversight needed to be enhanced.

Recommendations: Health, well-being and social care.

  • 5.2 The availability of illicit drugs and associated debt, violence and victimisation should be reduced significantly. (S44)
  • 5.3 Prisoners should be able to access all hospital and primary care services within community- equivalent waiting times. (S45)
  • 5.17 All health and substance use service providers should contribute to a single patient record to ensure relevant information is shared effectively. (2.56)
  • 5.18 All prisoners should be able to wait in a suitable waiting room that provides a respectful and safe environment. (2.57)
  • 5.19 Discipline staff should provide the health care department with adequate support so that a safe environment is maintained. (2.58)
  • 5.20 There should be a ‘whole-prison’ strategy to promoting health and well-being. (2.61)
  • 5.21 An updated memorandum of understanding between all key stakeholders and regular meetings to monitor the provision should be in place to ensure that prisoners receive a good level of social care. (2.71)
  • 5.22 All discipline officers should receive mental health awareness training, to enable them to recognise and support prisoners with mental health problems. (2.79, repeated recommendation 2.81)
  • 5.23 Transfers to hospital under the Mental Health Act should take place within the Department of Health’s established guidelines. (2.80)
  • 5.24 Appropriate options for clinical treatment should be available in line with national clinical guidance. (2.88)
  • 5.25 The TC should have an operating policy and appropriately trained dedicated officers should support the ethos of the unit. (2.89)
  • 5.26 Medicine administration rounds should be supported in all areas by adequate officer supervision. (2.94)
  • 5.27 Robust governance arrangements should be embedded and involve key stakeholders to ensure oversight of medicine management and prescribing practice is effective. (2.95)

Good Practice: Health, well-being and social care.

None.

Full Report Here

HMIP Report Health Summary – HMP Swaleside – Dec 2018

Date of publication 08 May 2019
Report type Prison and YOI inspections
Location HMP Swaleside

Report on an unannounced inspection of HMP Swaleside (3-13 December 2018)

Main Points: Health, well-being and social care.

Health services had improved and were reasonably good but a few areas were still concerning. The chronic staffing shortages had started to reduce. Prisoners could access an appropriate range of primary care services and visiting specialists. Waiting times for primary care services were reasonable but too many prisoners did not attend their appointments. The in-patient unit provided good care for patients with very complex needs. A lack of escorts led to the cancellation of too many hospital appointments, long delays and risks to prisoners’ health. The social care referral pathway was not sufficiently well promoted. Mental health services were good but waiting times for counselling were too long – at up to 32 weeks in some cases. The emotional well-being mentors scheme was excellent, and an example of good practice. Substance misuse services were reasonably good, with flexible prescribing and a range of psychosocial support. Inconsistent supervision of medicine queues by custody staff compromised confidentiality and increased the risk of medicines being diverted. Some tradable medicines, such as dihydrocodeine (an opiate-based painkiller), were prescribed in-possession. In-possession risk assessments were too infrequent. Some prisoners waited up to 11 months for a dentist appointment, which was very poor.

Recommendations: Health, well-being and social care.

  • 5.23 Prison officers should ensure that health service areas, including queues for medication, are safely and effectively managed. (2.57)
  • 5.24 Professional telephone interpreting services should always be used for confidential consultations when a prisoner does not speak good English. Information should be available in a range of languages. (2.62)
  • 5.25 The number of missed appointments should be reduced further, to ensure that patients receive prompt treatment within effective use of clinical resources. (2.72)
  • 5.26 Arrangements for prisoners convicted of a sexual offence attending health care appointments should be safe and respectful. (2.73)
  • 5.27 There should be sufficient escort staff available to ensure that prisoners’ treatment at outside hospitals is not delayed. (2.74)
  • 5.28 Patients on the in-patient unit should have access to a range of therapeutic activities to support their well-being and recovery. (2.75)
  • 5.29 The referral pathway should ensure that all prisoners with social care needs are identified and supported. (2.77)
  • 5.30 Prisoners should have timely access to counselling services. (2.87)
  • 5.31 The in-possession policy should be followed, to ensure that the prescribing of medicines is suitable for patient treatment in a secure environment, overseen by the medicines management committee. (2.102)
  • 5.32 All medication that cannot be held in possession should be administered at times that ensure clinical efficacy. (2.103)
  • 5.33 Risk assessments for in-possession medicines should be regularly reviewed and updated when a prisoner’s circumstances change. (2.104)
  • 5.34 Prisoners requiring routine dental appointments should receive them within six weeks. (2.106)

Good Practice: Health, well-being and social care.

  • 5.53 The ‘Well-being for all’ action group promoted health activities and provided relevant guidance. (2.63)
  • 5.54 The emotional well-being mentors scheme encouraged better understanding and awareness of mental health issues. (2.88)

Full Report Here

%d bloggers like this: