Ishmail Kubilay

The Prison Ombudsman obtained a clinic review which helpfully made a number of recommendations concerning healthcare not only at the Mount but also nationally. The national recommendations which had implications nationally were:- A review of end of life care in prisons should be undertaken to produce guidance for healthcare commissioning organizations to ensure that there are appropriate pathways and resources for end of life care for prisoners in category C prisons. National guidance should be agreed and developed to facilitate the assessment of the social care and needs of prisoners and provide care to meet the needs_ was informed by both the NHS England (East Anglia) and the Mount Prison that these recommendations have been implemented locally as far as possible but draw these t0 your attention just in case there are implications for other areas of the country that may not have implemented these recommendations would be grateful for your confirmation that these have been considered for national implementation. However, in the discussion at the Inquest relating to palliative care it was clear that good links have now been established within Hertfordshire but this raised a further discussion at the Inquest relating to pain management: heard evidence both from the Healthcare Manager at the Mount and also from who was the Director of Nursing and Quality at East Anglia for NHS England who has the responsibility for the medical services in prison undertaking clinical reviews where deaths occur in prisons that outside support for medical teams in hospital in relation to pain management would be useful: was informed that many of those who are in custody suffer from pain usually in their backs and that pain relief can sometimes be difficult to manage as in the community: This is why patients are often referred to specialist pain management clinics when you know the cause of the pain: Medication for pain relief in prisons also has it own problems_ heard for instance at this Inquest that dihydrocodeine which was prescribed for Mr Kubilay was to be administered on daily basis under supervision in view of its opiate qualities impression from the Healthcare Manager and from the NHS England (East Anglia) was that they would both welcome the establishment of similar links that are now being established with palliative care and social care and would also be available in relation to pain management. am wondering whether this could be considered and recommendations made for the provision of such links Cont'd/3 The got maybe with pain management specialists accessing prisons as am aware that outside appointments have implications for prison management personnel and assessments of risk. am t0 you on this issue because it was not covered in the clinical review of the prison and probation ombudsman but it was clear from hearing the evidence that this was something felt should draw your attention to. appreciate your interest in this matter and look fonward to hearing from you in due course_ The require a response within 58 days, which calculate is 28th November 2013. Please do not hesitate to contact me if you have any difficulty in complying with this date as would be happy to extend the time with reasons_ Many thanks for your anticipated assistance in this matter: Yours sincerely Edward G Thomas Senior Coioner writing rules good