Healthcare provision in prisons: emergency care response — HSSIB

HM Prison and Probation Service is grateful for this feedback on the medical emergency response cards that we provide for our staff. In partnership with the Association of Ambulance Chief Executives we have reviewed the design of the medical emergency response cards. We will now arrange for revised cards to be printed and distributed. We will do this alongside the introduction of new guidance for control room staff which will equip them to ask staff at the scene for the information that they require to respond to the triage questions that are asked by ambulance service call handlers. This will be supported by the provision of revised posters for control rooms to provide a visual reminder of the triage questions. We will introduce a regular audit check to ensure that these posters remain visible to control room staff. We will also be exploring whether and how we can include an assessment of the effectiveness of the response to medical emergencies in future safety audits. We recently issued a new training video on ‘Responding to emergency situations’ designed to help staff to understand what they need to do in a medical emergency, including when they find a prisoner who has ligatured. The video shows a member of staff calling a code blue and following up by giving the control room relevant information about the condition of the prisoner and explains that this information is required so that ambulance control can arrange the appropriate response. The video has been viewed over 2,000 times on the HMPPS intranet and is also available on the ‘My Learning’ platform which can be accessed by staff from partner organisations and contracted prisons. Actions planned to deliver safety recommendation: Review design of medical emergency response cards. By: Completed. Print and distribute revised cards. By: 31 March 2025. Issue guidance to control room staff. By: 31 January 2025. Print and distribute revised posters. By 31 March 2025. Introduce audit check on control room posters. By: 31 March 2025. Explore the inclusion of the response to medical emergencies in future safety audits. By: 31 March 2025. Response received on 3 December 2024. -------------------------------------------------- May 2026: HSSIB has been notified by HM Prison and Probation Service that all actions have been completed.

HM Prison and Probation Service is committed to equipping staff to respond appropriately when they encounter a medical emergency. All new Foundation Prison Officers are now required to complete Emergency First Aid at Work as part of the Foundation Course. We recently issued a new training video on ‘Responding to emergency situations’ designed to help staff to understand what they need to do in a medical emergency, including when they find a prisoner who has ligatured. The video has been viewed over 2,000 times on the HMPPS intranet and is also available on the ‘My Learning’ platform which can be accessed by staff from partner organisations and contracted prisons. We have worked with St John Ambulance to produce five training films for staff who are first on scene. These are available on the ‘My Learning’ platform, which can also be accessed by staff from partner organisations and contracted prisons. The films have been sent to Governors and Directors who have been informed that it would be advantageous for all Prison Officers and other front line staff to view them and for them to be used to supplement annual refresher training for emergency first aiders. We are committed to updating the films to include the same content as the redesigned medical emergency response cards, which identifies to staff the information they will need to share with the control room about the condition of the prisoner. Actions planned to deliver safety recommendation: Launch first on scene training films. By: Completed. Update the films to include the content from the redesigned medical emergency response cards. By: 31 March 2025. Response received on 3 December 2024. --------------------------------------------------- May 2026: HSSIB has been notified by HM Prison and Probation Service that all actions have been completed.

HM Prison and Probation Service is very aware of the communication challenge presented by medical emergencies in prisons, where mobile phones are not available to facilitate direct contact between staff at the scene and ambulance control. We have considered including the facilitation of direct communication to ambulance control amongst the requirements for our reprocurement of prison radios. However, our reprocurement is initially focused on support for the existing hardware and infrastructure, and is unlikely to deliver new radios to prisons until 2029, so this is not an option that could facilitate improvements in the short or medium term. Moreover the project team has not been able to identify a suitable system that would facilitate direct communication with ambulance control, and it has therefore been decided that this will not be within the scope of the project. We will conduct a review to consider how to improve communication between the incident scene and ambulance control within the confines of the current policy and technology. The review will include workshops involving operational staff and partners, including the Association of Ambulance Chief Executives. Actions planned to deliver safety recommendation: Consider prison radios as an option for direct communication to ambulance control. By: Completed. Arrange workshops involving operational staff and partners. By: 31 March 2025. Complete review of communications between incident scene and ambulance control. By: 30 June 2025. Response received on 3 December 2024. --------------------------------------------------- May 2026: HSSIB has been notified by HM Prison and Probation Service that all actions have been completed.

Since receiving the HSSIB report, representatives from the Association of Ambulance Chief Executives (AACE) have worked in close co-operation with counterparts in His Majesty’s Prisons and Probation Service (HMPPS) to agree actions to address all four of the safety recommendations outlined in the report. Specifically in relation to this action assigned to us we have agreed through our National Directors of Operations Group (NDOG) that ambulance service Operations Directors (or Chief Operating Officers) will be the lead point of contact for regional communications with prisons. We have agreed with HMPPS that Prison Group Directors (PGDs) are the appropriate regional counterpart and we will be mapping prison regions onto ambulance regions and establishing connections between Operations Directors and PGDs. At a national level we will formalise the existing relationships between HMPPS and AACE to offer a national channel for regional colleagues to escalate issues and conversely for national issues to be cascaded to regional teams. We expect that these arrangements will build on existing local relationships that may exist between individual prisons and individual ambulance services and that the overlaying of regional and national channels will strengthen those relationships and encourage greater consistency. We will document these arrangements in a brief, simple partnership agreement and cascade to colleagues in the prisons and ambulance environment in order to improve communications at all levels Actions planned to deliver safety recommendation: Agree regional and national points of contact for ambulance services. By: November 2024. Other dependencies identified: Corresponding agreement of HMPPS points of contact. Additional comments: Complete. Agree regional and national points of contact for HMPPS. By: November 2024. Other dependencies identified: Internal approval required. Develop simple partnership agreement. By: January 2025. Other dependencies identified: Internal approval required from AACE and HMPPS. Cascade partnership agreement. By: February 2025. Response received on 27 November 2024.