Agenda item

11:45

A presentation will be given by representatives from NHS England on Representatives from NHS England on healthcare in prisons and Immigation Removal Centres (IRC) in the county. A report is also attached entitled ‘Health & Justice Commissioning for Oxfordshire Prisons and IRC in Oxford (JHO9).

The Chairman welcomed Sue Staddon, Head of Health & Justice Commissioning, NHS England South. She was accompanied by the following representatives:

Nikki Luffingham, Deputy Director of Health & Justice Operations and Delivery, NHS England

Victoria Kurrein, Regional Service Manager, Thames Valley Prisons Cluster, IRC & SARCs – Care UK

The Committee had before them a report (JHO9) entitled ‘Health & Justice Commissioning in Oxfordshire Prisons & Immigration Removal Centres (IRC) in Oxford.’ Sue Staddon gave a presentation on healthcare in custody in Oxfordshire. At the end of the presentation the meeting was opened out to questions from members of the Committee.

A member asked whether smoking had been banned generally in prisons to bring them in line with the ban on smoking in public places, in light of concerns raised about passive smoking. Sue Staddon responded that there had been a move to implement a non-smoking policy in prisons, but there had been concerns expressed by staff with regard to how it would impact on some priority prisoners.

A member asked what the flashpoints were in terms of assessment for vulnerable prisoners released back into the general population, for example, older prisoners, and prisoners with a learning disability. It was explained that the County Council commissioned and was responsible for the social care of prisoners. Victoria Kurrein stated that it was a challenge to get prisoners assessed for their physical needs. However, on their release, they would have been assessed prior to their release.

In response to a question asking who was responsible for the scrutiny of NHS England delivery, it was explained that this was undertaken by Public Health England, the Home Office and the Ministry of Justice. A national Board regulated the Partnership Board of South and London. There were regular contact meetings with providers to look at performance, key performance indicators and Health Justice performance indicators. A national Quality workstream in NHS England paid regular quality visits. Inspections were undertaken by HMI of Prisons, and Care Quality Commission inspectors who worked with the Independent Monitoring Board (IMB).

A member asked what constituted success in judging how much health care to give a person, particularly to those in Bullingdon prison, and what constraints were there in commissioning care and support for people with a mental health condition, for example. Sue Staddon responded that people in prisons were entitled to exactly the same health care as a people outside of the service would receive. For example, there was strong scrutiny given in the event of a death of a prisoner. A probation report was commissioned, as was a clinical review. The aim was to reduce deaths whilst in prison and good health outcomes were looked for. She also stated that it was about keeping offenders safe but the reality was to try to provide the best environment possible within the constraints. Moreover, the specification was set nationally and was very strong in its emphasis on the same measurement of primary and secondary care for prisoners. She added that some care such as mental health care and cancer care had a higher focus, as often, needs were greater in the prison environment (for example, offenders were more likely to smoke and there was a higher incidence of mental health problems). More work was required on, for example, IAPT Psychology intervention, as it was a national requirement that offenders now had the same right to treatment. She stressed that the service recognised the importance of implementing new services and understood that the provider would be held strongly to account if this did not take place.

Sue Staddon confirmed that offenders had the same rights to health screening – all who were eligible received screening on arrival – and there were key performance indicators in place for it. She also confirmed that the 18 week waiting time for surgery also applied to offenders and facilities available to them on discharge were the same.

When asked about how much support was given to offenders suffering from autism and mental health conditions, Sue Staddon stated that a primary and secondary care mental healthcare service had been commissioned and the prison and health care providers worked hard to provide a fairly stable environment for them. She added that a piece of research had indicated that at least 70% of offenders had some form of mental health issues whilst in prison.

Sue Staddon was also asked how the transition from prison to release was managed. She explained that currently the medical IT system for prisons was closed, however, every attempt was made to contact GPs. Community teams were responsible for the transition (for those who were on probation). Locally every appointment was kept where possible, and those who were not registered with a GP would be registered on release. Victoria Kurrein added that a release plan was made into the community service to ensure a degree of transition.

When asked about how drug misuse was handled and what care was given, members heard that the responsibility for the use of illegal substances was with the Ministry of Justice who provided a substance misuse service, which included clinical and psycho-social assistance. Health needs assessments were undertaken and support via focus groups was given. Providers were required to ensure that friends and family tests were undertaken and there was a satisfactory survey completed once a year, when feedback was sought.

A member asked if health screenings were also undertaken at the IRC coupled with screenings for signs of torture. It was explained that a 2 hour screening was given on the day of entry and a second one 24 hours later. All were advised that they could declare any issues relating to torture if they wished and a report under Rule 35 completed if appropriate. Referral was then made to the Home Office if suitable to be detained.

The Chairman thanked all for attending.

She ascertained that Healthwatch Oxfordshire had highlighted this as an area for future review.

The Committee AGREED to request the following:

(a)  copies of the latest annual or monthly reports which gave an indication of performance in Oxfordshire compared with other localities; and

(b)  information on causes of deaths in custody.