Source · Select Committees · Justice Committee
Recommendation 29
29
Deferred
Paragraph: 153
Require MoJ, HMPPS, NHSE/I to set out work improving prison healthcare and accessibility.
Recommendation
It is concerning that issues relating to healthcare continue to be a contributing factor to deaths in custody. The MoJ, HMPPS and NHSE/I should set out what work they are doing to: • improve communications between staff across all disciplines in prisons; • improve the response to medical emergencies; and • improve drug management processes. We welcome both the Women’s Review, and the National Mental Health Needs Analysis, which will provide a greater understanding of physical and mental health needs, existing service provision and gaps in service provision. We were concerned to hear that demand for services may be greater than the available provision and that waiting lists are growing, in part due to the pandemic. NHSE/I should also set out the work it is doing (aside from both reviews), to reduce existing waiting lists, and increase service accessibility.
Government response summary AI-generated
The government accepted the recommendation but focused its response on improvements in data collection for learning difficulties, educational attainment (exploring gender breakdown in Autumn 2022), and care experience (publishing guidance in Oct 2022 and a research project until Jan 2023), rather than addressing the requested improvements in staff communications, medical emergency response, drug management, or efforts to reduce healthcare waiting lists.
Summary of the government's response below — read the verbatim text to verify.
Paragraph Reference:
153
Government Response
Deferred
HM Government · verbatim extract
Deferred
We accept this recommendation. A joint HMPPS/NHSE Information Sharing Task & Finish group has produced a delivery plan identifying a number of products to improve practice and confidence amongst prison, probation, and health staff to share information effectively and appropriately. Delivery will be spread across 2022–2023 and will target different staff groups. Consideration is also being given to how Information Sharing is captured within the Adult Health, Care and Wellbeing curriculum. We continue to work hard with health partners to improve our response to medical emergencies. We recently amended our Prison Service Instruction to make clear that the HMPPS codes ‘Red’ and ‘Blue’ are for use within the prison only and should not be used when communicating with ambulance service staff. The revised instruction requires the member of staff using the medical emergency code to provide relevant information about the condition of the prisoner to the control room staff, to enable them to share this with the ambulance service for use in the triage process. Alongside the revised instruction, we provided Governors with a poster for display in prison control rooms to provide clarity on the information required by ambulance services and a supply of pocket cards for staff, providing an instant reminder of the information that they must communicate to the control room in a medical emergency. Governors continue to work with health partners to test and refine local contingency plans for the management of medical emergencies. We have created and rolled out a contingency plan for unexpected birth within all women’s prisons. On the 20 September 2021, the MoJ published a new policy on Pregnancy, Mother and Baby Units and Maternal Separation from Children up to the Age of Two in Women’s Prison. It makes clear that an ambulance must be called in the event of an unexpected labour or birth, and issues guidance on identifying signs of labour and procedures in the event of an unexpected delivery of a baby in a prison. As part of the drugs strategy, the Government has committed to investing an additional £900m across 3-years in the combating drugs mission - £780m of this will create a world- class treatment and recovery system–the largest single increase in treatment and recovery investment in England. In addition to this investment NHS England has committed to have an additional £21m over 3 years as part of the restore and recovery and NHS England have set five priority areas. Work is currently underway with regions to establish expected tangible benefits from the additional funding allocations. Benefits profiling to support the outcomes of the additional £21M funding is currently underway for 2022–23 delivery. This will continue to be managed through the annual funding cycle. The five priority areas of focus are: (1) Supporting the increase in Continuity of Care and prison leaver Substance Misuse pathways with community Substance Misuse providers and RECONNECT services (2) Increasing early days screening and assessments of substance misuse harms and pathways of care (3) Targeted support for complex individuals and intensive intervention care planning (including TBI, ADHD, Physical harm, Mental Health risk including self-harm and suicide, perinatal and maternity) (4) Increased focus on substance misuse, treatment models supporting health inequalities including NHS England’s Core 20PLUS5 cohort and considerations around ethnicity, religion, belief and all protected characteristics. (5) Understanding innovative intervention and treatment options (including digital solutions)–to support psychosocial therapy and incentivise substance free living. The Substance Misuse service specification is currently being refreshed and includes specific reference to dual diagnosis and the wider neurodiverse population ahead of consultation. The specification highlights the importance of integrated working with mental health services and the need to take a holistic approach to healthcare assessment and deliver. The refreshed specification will support the delivery of the five priorities to ensure these priorities are embedded in future service models. Work is on-going to support HMPPS/ MoJ in the establishment of Drug Recovery Wings–learning from this work will also feed into the refreshed service specification
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