ACTION NOTE National Prisoner Healthcare Network Advisory Board Date Monday, 27 th April 2018 @ 09.30am-12.30pm Venue Healthcare Improvement Scotland, Delta House, 50 West Nile St, Glasgow, G1 2NP Present Aisha Holloway (AH) Alex McMahon (AM) Alex Pirrie (AP) Bill Fitzpatrick (BF) Grace Campbell (GC) Jane Cantrell (JC) Jillian Galloway (JG) Justin Murray (JM) Lesley Graham (LG) Michael Grassom (MG) Head of Nursing Studies, Edinburgh University Nurse Director, NHS Lothian (Chair) Location Manager, Central/Buchan HMP & Grampian Health Centre Director of Operations, Community Justice Scotland Prison Healthcare, NHS GGC Programme Director, NHS Education for Scotland Prison Healthcare, NHS Tayside Service Manager, Specialist Drug & Alcohol Service, NHS Dumfries & Galloway Associate Specialist, Public Health, NHS National Services Scotland Service Manager Justice, Social Work Scotland Orlando Heijmer-Mason (OHM) Health & Justice Collaboration, Scottish Government Pete White (PW) Philip Conaglen (PC) Rhoda MacLeod (RM) Ruth McMurdo (RMcM) Ruth Parker (RP) Tom Byrne (TB) Tracey McKigen (TMcK) Chief Executive, Positive Prison? Positive Future Consultant in Public Health Medicine, NHS Lothian Head of Sexual Services, Glasgow Health & Social Care Partnership, NHS GGC Clinical Operations Manager, HMP Kilmarnock Head of Health & Wellbeing, Scottish Prison Service National Pharmacy Advisor, National Prisoner Healthcare Network General Manager Royal Edinburgh and Associated Services, NHS Lothian
Apologies Gareth Adkins Fiona Gordon Rhona Hotchkiss Teresa Medhurst Wendy Spencer Tom Jackson Jayne Miller In attendance Claire McAuslane (CMcA) Lisa Scholin Annette Dryburgh Morag Stirling Ann Marie Rafferty Debbie Sigerson Team Leader, Healthcare Improvement Scotland Service Manager Prison Healthcare, NHS Forth Valley Governor, HMP Greenock Scottish Government Scottish Prison Service (Vice Chair) Turning Point Scotland Head of Community Justice Glasgow Service Manager Prison Healthcare, NHS GGC NPHN Administrator (Minutes) Research Fellow, World Health Organisation (WHO) Operational Advisor, Scottish Prison Service Deputy Programme Executive, Scottish Prison Service Assistant Chief Officer, Glasgow City Health & Social Care Partnership Organisational Lead, NHS Health Scotland Item Item No. 1. Welcome, opening remarks and apologies Action AM welcomed everyone to the meeting. Attendees were asked to introduce themselves. Apologies were noted. 2. Review of Minutes The Minutes were agreed as an accurate record All 3. Matters arising 1. Confirmation and extension of NPHNAB membership TB informed the group that invites had been extended to all the NHS boards but no additional members have been put forward by them. Existing members were also invited to review current representatives and invite further suitable candidates, or propose a replacement for the current member, if thought to be more appropriate. As a result of this the membership list has been amended to reflect the changes. 2. HMCIP Updated indicators for inspection of prison healthcare TB advised that standards have now been revised and it has been agreed that there will be additional supporting material produced by HIS standards and the Inspectorate team which should be available by August 2018. 3. Self certification process AM advised that a meeting with JG, RMcM and AM is planned for May and that this matter will therefore be picked up again after this point. 4. Workforce planning (to be covered as part of agenda item 4 ) 5. Update on smoke free prisons (to be covered in agenda item 11.)
4. NPHN Workplan update TB advised that the NPHN workplan and Board leads workplan have now been combined into one document. The group were issued with an up to date version and TB talked them through it. Corporate & Strategic: 1. Network Advisory Board: To continue to meet as normal until the review of the Prison Health & Social Care Programme Board is complete when a decision will be made re the long term role and remit of the network. 2. Board Leads: To continue to meet. Future extended role envisioned. 3. Health Care Managers Group: recently revived. There is a meeting scheduled to take place later today (27 th April 2018). RMcM is the new chair. 4. Clinical Strategy for Prisons: JG advised that future actions would be dependent on the outcome of the review by Prison Health & Social Care Programme Board. 5. Health Communication Governance: TB proposed that this issue needs to be revisited to better clarify the process between SPS and the NHS. OHM offered to circulate a note, after the meeting, providing a general outline of all the workstreams that the Programme Board intend to undertake to help the group better identify who the appropriate contacts would be. OHM 6. Workforce Planning: AM highlighted that recruitment and retention in the prison healthcare sector is variable and advised that the Scottish Executive Nurse Directors (SEND) are keen to pick up this issue at their next meeting. Mark Richards and AM will sponsor a session at SEND dedicated to devising a strategy to support recruitment retention and development of prison healthcare workforce. AM will bring the output of these discussions to the Advisory Board. The Advisory Board will then produce a paper to go to the NHS Chief Executive Officers September meeting informing of the proposals to address workforce planning issues. AM then highlighted synergies that existed between prison healthcare, police custody and forensic healthcare services and questioned how they could be linked to share best practices. OHM informed the group that he would be meeting with Shirley Rodger and CNO to better understand the challenges of prison healthcare recruitment. In addition a strand of excellence in care will be devoted to developing the prison healthcare workforce. The group acknowledged the need for a workforce planning tool for prison healthcare to be developed. JG suggested that in the interim people should adapt existing workforce planning tools and combine with professional judgement to inform decision making. AM asked for nominations for a new chair for a refreshed workforce planning group to be sent to TB/CMcA at NPHN. AM will take workforce planning tool issue to SEND. JG proposed that the prison healthcare and police custody groups be merged into one larger working group. LG to establish who chairs the police custody healthcare group and approach them. ALL AM LG
Best Practice: 1. Expert Advisory Group for Medicines: TB updated the group on the current work being undertaken, in particular Nicotine Replacement Therapies in relation to smoke free prisons and the potential reclassification of Gabapentin and Pregabalin. 2. Prison Pharmacy Group: TB advised that he chairs this group and gave a brief summary of work currently being carried out, including the review of the prison pharmacy contract and the retendering process. 3. Mental Health: TB advised that he had contacted Lyndsay Thomson for an update on progress with the mental health report. This will follow. OHM added that the mental health workforce provision of mental healthcare in prisons is one of the themes that the Prison Health & Social Care Programme Board are going to look at as part of Action 15 of the mental health strategy. There was discussion around the difficulties implementing the Action and he advised that the Prison Health & Social Care Programme Board have asked for some recommendations on how best to manage it. The group acknowledged the difficulties in recruitment and development. OHM advised that there are plans for eight hundred mental health practitioners to be recruited over the next four years, some of whom will be dedicated to prisons. OHM requested recommendations from the Advisory Board as to how best address the challenges. RP reminded the group that the mental health report contained a recommendation to undertake a health needs assessment for mental health which has not been done. The group agreed that this should be given consideration but that funding would be a challenge. 4. Substance Misuse Implementation Plan: LG informed the group that currently there is substance misuse guidance for prisons which the NPHN published in 2016. She further advised that SG are developing a drug and alcohol treatment strategy which should include prisons. It appears that at this stage there are no plans to consult with the NPHN in relation to prisons requirements. AM asked LG to draft a letter to SG to enquire what considerations are being made in relation to prisoner healthcare. OHM advised that a draft strategy is being completed within the month to then go in front of Ministers for discussion. The group agreed that the letter should therefore be arranged and sent asap. 5. Brain Injury: TB advised group that HIS are undertaking a review of neurological standards which will ensure that requirements of prisons healthcare and police custody healthcare are included. TB has arranged for LG and Tom McMillan to input into this. LG advised that at a recent meeting of the Five Nations Health & Justice Collaboration interest was expressed in setting up a task and finish group in relation to brain injuries. It is yet to be established what the task is. LG to go back and seek clarification on what is expected/required. AM AM/LG LG 6. Psychological Therapies: To be absorbed into the mental health workstream now.
7. Clinical management of NPS: Draft guidance is with the Scottish Ambulance Service for consideration by the clinical advisory group. Once approved by this group, the next step will be to agree individual processes for implementation in prisons, police custody and forensic health settings. 8. Screening Services for Prison: Jennifer Champion will speak to the group on this under agenda item 10. 9. Transfer of Health Records: TB advised that this is being taken forward by the NPHN Board Leads Operational Group. PSD are devising a process to transfer paper records to Docman and will store the paper records while patients are in prison. Training/Development: 1. NES Education & Training sub-group: To be revived. There is a healthcare manager s meeting later on today where this will be discussed. Also, TB advised that he had been approached by David Cunningham, an associate director for GP practice from NES, who informed him that they had produced a Practice Based Small Group Learning package which he thought might be useful to prisoner healthcare too. This is to be looked at. JC advised that NES has a mental health group and a forensics group. She suggested that now might be an opportunity to link up some of the workstreams with a view to refreshing the workplan. JC suggested that a refresh meeting be held to discuss this before the next NPHNAB in August. TB and JC to arrange separately. TB/JC Third Sector: 1. Third Sector TB advised that he is now pursuing this matter and has recently been invited to link in with the WISE group. He is to attend a meeting with them very shortly. He further advised that the new senior programme manager for the NPHN has now been appointed and will soon be in a position to assist. The group discussed how they would engage with the third sector and agreed that further work was required in this respect. 5. 1. Minutes of the Programme Board 2. Review 3. Workstreams the ask from the Programme Board OHM talked the group through the above three items and gave an overview of the four planned workstreams. He also advised the group that as part of the Clinical IT workstream there will be an additional project on Telehealth not mentioned in the minutes. The Prison Health & Social Care Programme Board are keen to investigate the potential opportunities in using Telehealth. RP informed the group that SPS are visiting all prison healthcare centres to better understand how they can support the delivery of healthcare and this will include Telehealth strategy. 6. Scope of the network review OHM advised this is currently ongoing and proposed that this be revisited at a later date once there is output from the Prison Health & Social Care Programme Board.
7. Health & Social care in Prisons Prison Risk register Paper provided for information purposes. TMcK raised the issue of care for older, frail patients in prison. In HMP Edinburgh concerns have been voiced about the care agencies ability to care for these patients properly. She advised the group that solutions are being looked into in order to put a new system in place in the prison to provide a better service. An exchange of ideas around this issue ensued. OHM added that Scottish Govt is seeking to link in with prisoner healthcare much more effectively and asked that if anyone believed there was a policy area that needed more/better engagement that they let him know. 8. Overview of the aims and objectives of the Prison Research Conference held on the 4th June AH spoke to the group and advised that some research on prison healthcare had started but was in the very early stages. Focus is currently on building relationships with stakeholders. She talked the group through the planned approach and offered assistance with research to those who would like it. AH will keep the group updated with progress. ALL AH 9. World Health Organisation overview of current work in prisons Lisa Scholin advised the group that she works for WHO as a consultant on the Health & Prison programme. She updated the group on the work on prison healthcare being undertaken, more information on which can be found on the WHO website. She gave a brief overview of the conference to be held on 4 th June and of the prisoner healthcare conference hosted by WHO in Lisbon in December. 10. Health Screening NPHN workstream Jennifer Champion explained to the group the reasons behind the production of her screening report and highlighted some of the recommendations around risk and best practice made in it. She also asked for comments from the group in terms of whether they could support these. 11. CCU overview SPS perspective A presentation was given by Annette Dryburgh & Caroline Johnston of the Scottish Prison Service. CCU overview IJB perspective A presentation was given by Anne-Marie Rafferty of the Glasgow Health & Social Care Partnership. 12. SPS Smoke Free Prisons Project update A presentation was given by Debbie Sigerson, aided by RP, in the absence of the invited speaker, Linda Dorward. Debbie updated the group on the activities of the Strategic Advisory Group for Smoke Free Prisons and the NHS Stakeholders Group in the absence of Linda Dorward. Debbie will provide a progress briefing that details work undertaken to date and the milestones still to be achieved to successfully implement Smoke Free Prisons for circulation to NHS Board Leads. NHS Board representatives enquired about additional funding to support demand for increased prescribing and interventions costs. DS reported that she was not aware of any new funding being available.
13. AOCB 1. DAISy AM led the group in a discussion about the requirements for NHS Boards to record activities in relation to drug and alcohol addictions management through the DAISy system. NHS Board representatives expressed some concerns regarding the preparedness of Boards to adopt and implement this system within the timelines required and believed that additional time may be required to facilitate training. The group will keep a watching brief on developments. 2. AM advised the group that this would be RP s last meeting as she is retiring. He and the group wished her well in her retirement. 14. Date of next meeting 2 nd August 2018, 9.30-12.30, Meeting Room 6A, Healthcare Improvement Scotland, Delta House, 50 West Nile Street, Glasgow, G1 2NP Name Claire McAuslane Tel 0131 623 4293 Email claire.mcauslane@nhs.net Team inbox hcis.nphn@nhs.net