National Prisoner Healthcare Network Annual Report 2016

Transcription

1 National Prisoner Healthcare Network Annual Report 2016 November 2016 National Prisoner Healthcare Network

2 Contents Welcome from our Chair 2-3 About us 4 What we do 4 Who we are and where to find us 4-5 Why an Annual Report? 5 Our Partners 6 Going Global 7 Inspections 7-8 Community Justice in Scotland 8 9 Significant events in the last year 9 10 Our successes and achievements in the last year What s next? Appendix

3 Welcome from our Chair I would like to welcome you to the first annual report from the National Prisoner Healthcare Network (NPHN). This has been written for all of our stakeholders and those of you who work in and have an interest in prisoner healthcare. We have used this annual report to advise you of the work that has been developed in the last year and to give you a sense of our future plans. Over the last year we have had a number of successes and driven a number of improvements through our standing groups and workstreams which have assisted in taking prisoner healthcare forward. Our achievements have been as a result of multiagency collaboration from across Scotland and also reflect the opportunity we have had this year to extend our partnerships with international and UK national colleagues. We hope that we can continue to develop links with these partners and to learn from their experiences. We want to hear your thoughts too and to invite you to join groups and workstreams that will help to further develop healthcare for prisoners. We hope that by enhancing healthcare support in prisons and through the development of better throughcare arrangements after release and liberation we can contribute directly to the aim of reducing reoffending and ultimately to the overall health of the Scottish nation. Who are we? The National Prisoner Healthcare Network is a collaboration of key stakeholders, principally the National Health Service, the Scottish Prison Service and other agencies and bodies who are collectively driving improvements in prisoner healthcare. The Network is led by an Advisory Board that is accountable to the NHS Chief Executives, the membership of which is drawn from NHS Boards, Scottish Prison Service, local authorities, third sector organisations and Scottish Government. The role of the Advisory Board and associated groups, in part, is to meet Scottish Government s goal of reducing health inequalities. By improving the health outcomes of those in prisons and by ensuring better healthcare support for prisoners after their liberation we will impact on the wider community. Quoting from the terms of reference the purpose of the Advisory Board is; To achieve better health outcomes by performing the following; To advise NHS, SPS, Scottish Government on Prisoner Healthcare To collaborate with justice and health agencies and third sector To influence and respond to Government Policy To commission workstreams in relation to offender health To provide expert advice and opinion as required To improve outcomes in prisoner healthcare To provide leadership To improve throughcare 2

4 To enable the workplan for the Network to be achieved we have an administrative office based in Delta House in Glasgow and are supported by professional leads who guide and facilitate workstreams and standing groups. Our Thanks The Network Advisory Board would like to thank all of the Health Board Prison Leads, Health care Managers and colleagues in NHS Boards and in the Scottish Prison Service for their commitment and contribution to prisoner healthcare in the last year. We would like to give a special thanks to practitioners working in prison services delivering care. We would also like to thank the long list of agencies and bodies that we worked with throughout the year who have assisted us in driving prisoner healthcare forward. Although they are too numerous to mention in full special thanks are given to HMCIP and the HIS Scrutiny Team working with them to improve and sustain standards of healthcare, to third sector colleagues for their contribution to key workstreams and to colleagues in other Networks and in Scottish Government with whom we work closely. Andreana Adamson Chair of the National Prisoner Healthcare Network & NHS Director Health and Justice 3

5 About us A brief history for those who may be unfamiliar with the Network is that we were created in 2011 when responsibility for prisoner healthcare transferred to the NHS. We have evolved and now continue, after restructuring, with endorsement from NHS Chief Executives and Scottish Government, to guide and support workstreams with the aim of enhancing healthcare provision to prisoners and ultimately reducing their offending behaviour. The strategic and political framework for the Network is Scottish Government Health Strategy including The Healthcare Quality Strategy for NHSScotland, the 20:20 Vision and Health and Social Care Integration. We also ensure prisoner healthcare provision satisfies legislation such as the Mental Health (Care and Treatment) (Scotland) Act 2003 and the Equality Act 2010 and we ensure key initiatives such as The Report of the Ministerial Group on Offender Reintegration are acted upon. More widely we keep Scotland in tune with developments in international prisoner healthcare through our influence of and response to the 5 Nations Health and Justice Collaboration. The aim of the 5 Nations Health and Justice Collaboration is to; To provide a forum for sharing of best practice and mutual learning for health and justice partners in the countries of the United Kingdom & the Republic of Ireland to improve our collective capability in understanding and meeting the healthcare needs of people in prison To ensure we represent Scotland well in this national forum we have established a Scottish Co-ordinating Group who contribute to the agenda and ensure that any best practice is shared. What we do The NPHN workplan is a working document that is constantly evolving when new areas are identified as important for the Network to consider. Most of the work of the Network is taken forward by short life workstreams with membership from all bodies involved in the Network. As each of the workstreams nears completion of their work reports are circulated widely for everyone to give comment before a final draft is passed to the Advisory Board for approval. You can see progress of workstreams and read about the final reports and recommendations of those who have most recently completed their work by visiting our website. Our web address is; It would be good to hear what you think. Who we are and where to find us? The Network is a collective of representatives from organisations and bodies across Scotland, principally these are NHS Board Leads based in each of the NHS Boards, 4

6 senior representatives from the Scottish Prison Service and colleagues working in a number of third sector organisations involved in support to and rehabilitation of offenders. In addition, the Network is supported by a team of professional leads and an administrative officer who are based within the offices of Healthcare Improvement Scotland working in the Delta House office in Glasgow and Gyle Square in Edinburgh. This team and the Network Advisory Board are led by the NHS Director, Health and Justice who is located in St Andrew s House in Edinburgh. Our contact details Andreana Adamson NHS Director Health and Justice John Porter National Prisons Nurse Advisor Tom Byrne National Prisons Pharmacy Advisor Claire Hastie Prisoner Healthcare Administrator St Andrews House Edinburgh Based in Delta House, Glasgow Based in Delta House Glasgow Based in Delta House Glasgow ext 8592 Why an Annual Report? We have produced this annual report for wide circulation to tell you what we having been doing over the last year in prisoner healthcare and to explain our future plans. We have used the report to support the information available through our website and in our more regular flash reports. We want to give you a summary of the year and to update you on projects and initiatives over the last year and the impact these have had. We have also referred to changes in policy, strategy and legislation that often drives the agenda for prisoner healthcare and for the Network. Finally, the report gives us an opportunity to describe to you planned activity for the coming year that you may find interesting. 5

7 Our partners The strength of the Network is the number and variety of key partnerships that exist and the value these bring to our work. Some of these key partners are; Healthcare Improvement Scotland, HMCIP, Mental Welfare Commission for Scotland, NHS Special Health Boards, Scottish Government, Other Networks, most closely the Forensic Network and the Police Custody Network, Third Sector organisations including the Wise Group and the Robertson Trust, The 5 Nations Health and Justice Collaboration, World Health Organisation Health in Prisons Project ( WHO HiPP). 6

8 Going Global Recognising that prisoner healthcare is a matter of global concern we know we can learn from our colleagues across the world, quoting from the World Health Organisation publication : Good Governance for Prison Health in the 21st century; Prisoners mostly come from socially disadvantaged segments of the community and carry a higher burden of ill health and diseases compared with people in the general population. data/assets/pdf_file/0017/231506/good-governancefor-prison-health-in-the-21st-century.pdf?ua=1 We actively participate in regular meetings of the 5 Nations Health and Justice Collaboration and in addition this year we were approached by international colleagues from China whom we hosted as visitors in This visit was to enable them to learn about the way in which healthcare in prisons is delivered in Scotland. We were also invited to visit China and the Chair of the Network was pleased to accept this invitation on behalf of the Network. As part of the 5 Nations Health and Justice Collaboration we also contribute to and engage with partners in the WHO Health in Prisons Project ( WHO HiPP) which is a national project addressing key matters of health in prisons. In addition to this we have been asked to participate in research from across Europe that is looking at different methods of healthcare delivery to prisoners and evaluating the most effective methods. News of the outcomes of this research will be provided to stakeholders as the study develops and in the next annual report. Inspections HMIPS are supported in their inspections of prisons for all matters relating to healthcare by Healthcare Improvement Scotland. They employ a lead inspector specifically to lead on prisoner healthcare inspections. HMIPS inspect and monitor against a set of published standards launched in March 2015, these can be found at; 7

9 In the current annual cycle of inspections these have been used in HMP Glenochil and will now be used in all establishments going forward. In addition to the individual reports, made available to local teams after each inspection visit, an overview of significant matters raised and best practice identified is undertaken by the Professional Nurse Advisor within the Network for the purposes of shared learning. Network professional leads also provide valuable input into the healthcare inspection reports to guide inspectors through the complexities of the prison environment. Reflecting the importance placed on the healthcare aspect of the inspection process HMCIP David Strang is quoted from their annual report (2014/15) as saying; Health care always plays a major part of an inspection programme. There have been some excellent examples of support for vulnerable prisoners, particularly in need of mental health care or drug and alcohol support. Prisoners transition to the community has been improved in cases where there were good systems for passing information to the GP practices in the community. Community Justice in Scotland Since the inception of the National Prison Healthcare Network (NPHN), close ties have been forged to community justice, and in particular to Community Justice Authorities (CJAs). This working relationship has functioned to support policy and planning in the health and wellbeing community, centred on a public health approach to justice. Work and guidance developed through the NPHN have provided a resource for community justice policy makers, planning and strategy officers, commissioners and funders. Similarly, input from the work of the CJAs has contributed to a broadening perspective on health care and health improvement developments across justice settings. New legislation, the Community Justice (Scotland) Act 2016 received Royal assent on 21 March The legislation disestablishes the Community Justice Authorities, places the responsibility for local strategic planning and monitoring of community justice services on statutory community justice partners, and establishes a new national body (Community Justice Scotland) to provide leadership; promote innovation, learning and development; provide assurance to Ministers on the delivery of outcomes; and to provide improvement support where it is required. The statutory community justice partners are:- Health Boards, Integration Joint Boards for Health & Social Care, Local Authorities, Police, Scottish Fire and Rescue Service, Skills Development Scotland, the Scottish Courts and Tribunal Services, and Scottish Ministers (in practice this refers to the SPS and Crown Office and Procurator Fiscal Service). The statutory partners must work together to prepare a community justice outcomes improvement plan (CJOIP) for their local authority area. The first CJOIP is due to be completed by March Partners will be jointly responsible for the plan s development and implementation. 8

10 This work will be informed by guidance materials, an outcomes performance and improvement framework, and a national strategy for community justice, which will complement and consolidate each other within the new model. Drafts of these documents are available at the Community Justice Redesign Knowledge Hub site (linked below) The national strategy provides a vision for community justice in Scotland. It will help partners to prioritise key areas which they will address in partnership, through an approach which is both outcomes-focused and evidence-based. In this way, the strategy will facilitate and drive improvement. The strategy addresses health and wellbeing concerns, and includes a recommendation that community justice partners, led by NHS Boards should ensure that Every contact in the community justice pathway should be considered a health improvement opportunity. Partners should work in collaboration to ensure that individuals have access to essential health services, substance use, and specialist mental health services from point of arrest onwards and to ensure continuity of care following a community/custodial sentence or remand. For further information linked to Community Justice Redesign, see the Knowledge Hub (and register to access supporting materials) - Significant events in the last year We have described below some of the events in the last year that have been significant for the Network ; 1. Second Annual National Prisoner Healthcare Conference in October 2015 The Network hosted the second annual conference at the Beardmore Hotel in Glasgow in October of last year. The keynote address was given by the Public Health Minister Maureen Watt MSP who said that; We know the profile of those in contact with our criminal justice system come predominately from communities which experience poor physical, mental and social health. We also know that a disproportionately high number of those who spend time in our prisons have never worked, have been in care or dropped out of school with few or no qualifications. As a group, those in prison frequently suffer from multiple and complex short and long term health issues, including both physical and mental health problems, learning difficulties, substance misuse and increased risk of early death. Efforts to improve the health and wellbeing of those in our prisons represent an excellent opportunity to provide care and support for some of our most vulnerable and difficult to serve individuals. 9

11 The Minister s speech set the tone and context for the conference and enabled the delegates to discuss future opportunities and challenges for the Network in the coming year. The outputs from these discussions have fed into the workplan and have led to the creation of new workstreams. 2. NHS Prison Board Leads Operational Group Event 12 th and 13 th April 2016 This event was planned to provide the NHS Board Leads with an opportunity to consider how best to guide future developments in prisoner healthcare. This was in recognition that as a collective body they are strongly placed both to shape prisoner healthcare within their own Boards and to identify opportunities for development, across Scotland. In addition to the core membership of the NHS Board Lead group, Clinical Directors and Associate Medical Directors from NHS Boards were invited to the event. During the event an NHS Board Leads workplan was formed and key themes and areas for future activity identified. The key areas and potential workstreams identified by the group included: Prison Healthcare Estate Clinical IT including electronic prescribing and links to other healthcare systems Clinical Strategy for Prisons Complaints Health Governance Prisoner Sickness Self Certification Process Route for the delivery of Public Health Initiatives Social Care Workforce Planning Third Sector Involvement To support the above activity it was agreed that the working groups formed to take these forward would include involvement from Clinical and Medical Directors in each of the territorial NHS Boards. It is hoped that a key outcome of the creation of an NHS Board Lead workplan will be enhanced, dedicated and committed leadership from NHS Boards. 10

12 Our Successes and achievements in the last year This table is a short summary of some of our achievements in the last year highlighting, major reports that have been distributed widely and groups that have been established all with the aim of driving improvement in prisoner healthcare. ACHIEVEMENTS Work completed Who for Status More About Workstreams - Throughcare Mental Health Brain Injury Substance Misuse NHS Boards, SPS and other key stakeholders Final Reports have been circulated or are awaiting signoff Can be found on the Network website; Work in progress Who for Status More About New Psychoactive Substances (NPS) The workstream are finalising their recommendations Details of the final report of the workstream will be made available on the website National Events 2 nd Annual NPHN Conference in October 2015 For all of the key stakeholders in prisoner healthcare in Scotland Actions have been identified for inclusion in the NPHN workplan and through discussion about the challenges and opportunities within prisoner healthcare. Can be found on the NPHN website and through discussion with local NHS Board Leads This visit resulted in an invitation to China that was accepted by the 11

13 Delegation from China and follow up visit to China in December 2015 Raised the profile of Scotland as a leading nation in prisoner healthcare NHS Director Health and Justice. The visit to China raised awareness of other countries and their approach to prisoner healthcare Information from these visits was shared with the NPHN Advisory Board and further detail can be sourced from members of that group NHS Board Leads Event April 2016 For All NHS Board Leads and Clinical Director colleagues and members of the Advisory Board To take forward actions from the NPHN workplan and develop a workplan specific to the role of the Board Leads A Boards Leads Workplan and associated workstreams have been established Scotland hosted the 5 Nations Health and Justice collaboration in April 2015 This group has been formed to share best practice and learning across the five nations in the UK and Ireland. Hosting of the quarterly meetings is shared between the nations with Scotland hosting in April Scotland has a governance group that ensures all items for discussion and any information shared about Scotland is commonly agreed. Membership of the group attends the 5 Nations collaboration meetings to represent Scotland. Information from these meetings can be sought from members of the governance group who can be accessed through the Network offices at Delta House. Other Developments NPHN Website The website has been created to enable anyone interested and involved in prisoner healthcare to source information on progress that is being made by the Advisory Board, our standing groups and our short life workstreams The Website is constantly updated to ensure that information on events, progress on work being developed and completed and information about our key partners is available to you The web address is 12

14 What s next? Changing landscape We are constantly evolving and also need to be in tune with changing legislation, government policy and external influences. We have commenced new workstreams to ensure we respond to such changes and developments. Recent additions have been, Male Young Offenders and Psychological Interventions. New Healthcare challenges Similarly we respond to new challenges such as the impact of New Psychoactive Substances (NPS), which have been an increasing challenge for healthcare and operational staff within prisons. The workplan has been and continues to be developed to ensure such matters are addressed by the Network. Management Data/Clinical IT Systems Currently the clinical GP IT system Vision, in place within all 15 prison NHS health centres, is not producing dependable management data that will inform the health outcomes of prisoners. Reasons for this include the lack of prescribing capability that is necessary for the prison environment. Full clinical data is not always entered onto the system resulting in incomplete outcome and performance health reports. A new NPHN Outcome and Performance Management workstream is in place to oversee the challenges and offer recommendations required to secure solutions to these constraints. Research We are members of the UK 5 Nations Health and Justice Collaboration with representation to this group drawn from across Scotland from the Network, NHS, SPS and Public Health. This collaboration is currently considering the potential to develop a UK Research Special Interest Group. The benefits of such a group for Scotland would be through collaboration to have a platform for published research that would have a greater impact on the wider prison healthcare community. The group would provide a greater focus and weight to be given to research studies that we may wish to pursue. In addition over time the group may also be able to consider developments in audit and evaluation that would be beneficial across a range of activity. These discussions are at the very early stages albeit an exciting prospect and any further developments will be advised through dissemination of notes of meetings and through the NPHN website. Opportunities We have exciting times ahead of us, the health agenda in Scotland and changes such as Health and Social Care integration create a real opportunity for the Network to make a difference. There is strong commitment to prisoner healthcare from the Advisory Board and importantly from the NHS Prison Board Leads and healthcare managers who are instrumental in leading and taking forward prisoner healthcare within their own Boards 13

15 Sustainability We have made excellent progress in the last year and prisoner healthcare is now firmly embedded within the NHS. The Network is fully endorsed by NHS Chief Executives and Scottish Government and we have clear goals for the future. We look forward to you being part of this journey. 14

16 Appendix 1 Our sources Links to some of the key documents referred to in this report are quoted here for your reference. The Network website: The Healthcare Quality Strategy for NHSScotland: Scottish Government 20:20 Vision: Health and Social Care Integration: Her Majesty s Chief Inspectorate of Prisons for Scotland: 15