ACCESS TO HIGH QUALITY HEALTHCARE FOR PRISONERS

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ACCESS TO HIGH QUALITY HEALTHCARE FOR PRISONERS

• Carole Lawrence-Parr
• Director of Strategic Development
• Dorset Primary Care Trust

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OBJECTIVES

• Quality
• Focuses on primary care
• Patient centred care
• Recognise the complexities of prison health
• Promote staff development
• Equivalence

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IN THE BEGINNING

• 6 prisons/3 Primary Care Trusts
• Developed a medical model
• Transfer of staff
• New initiatives
• - patients view
• - health promotion
• - review/increase service provision
• Communication and partnership working
• Bringing 2 cultures together

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THE COMMUNITY CONTEXT

• New General Medical Services Contract
• Quality and Outcomes Framework (QOF)
• Rewarding quality of care
• Clinical and Organisational indicators
• Structured framework
• Consistency

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MOVING TO EQUIVALANCE

• Further develop mainstreaming
• Introduce QOF
• Evidence Based model
• Quality
• Appropriate
• Timely care

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THE CHALLENGES

• Engagement
• Governors
• Partnership Board
• Clinical teams
• Data
• No clinical IT system
• No access to previous GP records
• High Turnover

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• Different health needs
• Different approach to audit
• Staff training
• QOF indicators not applicable in prisons
• High turnover

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IMPLEMENTATION

• Project developed and overseen by Prison Senior
  Management Team
• Implementation through
• Clinical Forum
• Senior Medical Officer
• Lead nurse for cluster
• Practice Managers
• Lead Nurses
• 4 prisons involved

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• 3 clinical indicators
• Care pathways developed
• Organisational indicators
• IT system installed
• Staff training
• IT
• Clinical areas
• The visit

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2006/07 and onwards

• All prisons including remand
• All indicators
• Indicators adapted and rewritten
• New indicators
• Financial incentive

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WHY BOTHER?

• We can make a difference
• Improve patient care through
• Consistent approach
• Framework for service delivery
• Staff training appropriate and transferable
• Audit outcome
• Continuous improvement