Working together inside and out

Jake explores how we can ensure people in prison receive the same healthcare as those outside.

Dr Jake Hard, chair of the Royal College of GPs Secure Environments Group

I have experience of providing care both in, and outside of the prison walls. I know only too well what difficulties the restrictive environment can impose on delivering healthcare.

People in contact with the criminal justice system often have complex needs. They have a high chance of experiencing physical and mental health problems, exhibiting alcohol and substance dependency, and they are at an increased risk of self-harm.

With this long list of needs comes a large team of healthcare professionals required to support the person. This is why good communication between everyone involved is vital.

When someone arrives at a prison they undergo an initial health assessment. This allows us to identify their needs and tailor their care. We also rely on getting consent from the person to access their medical records. This documentation can give us real insight into what their ongoing healthcare needs are.

In order to establish a sustained level of support, care plans are shared with staff working in and outside of the prison. This should ensure that every member of staff supporting a person in prison is aware of the medication they are on. It also promotes timely access to these prescribed drugs, which is important when avoiding deterioration in the person’s physical and mental health.

Being in prison makes someone become part of a captive audience. It can provide an opportunity to identify missed medical problems – for example with confidential HIV tests and tuberculosis screening. This is beneficial because it allows us to address any unmet needs. It also means we can provide the individual with advice that could improve their wellbeing.

I am pleased that the recommendations within the new NICE guidance aim to maintain a good level of care that not only supports the person throughout their time in prison, but also follows them upon their release into the community.

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