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Health Needs Assessment of a Prison Population

Health Needs Assessment of a Prison Population. Dr Lincoln Sargeant Clinical Lecturer, University of Cambridge SpR Public Health, South East Essex PCT. Health Needs Assessment.

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Health Needs Assessment of a Prison Population

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  1. Health Needs Assessment of a Prison Population Dr Lincoln Sargeant Clinical Lecturer, University of Cambridge SpR Public Health, South East Essex PCT

  2. Health Needs Assessment • Provide information in order to plan, negotiate and change services for the better and to improve health in other ways • To build a picture of current services- the baseline • To help ensure equity and efficiency in service provision • Involves stakeholders

  3. Methods (1) • Epidemiological needs assessment • Attempts objective assessment of health care needs, reviews effectiveness and cost-effectiveness of services and assesses existing services • Main outcome is to identify any mismatch between needs and service provision

  4. Methods (2) • Corporate needs assessment • Attempts to represent the perceived needs of all relevant stakeholders • Service users • Service providers • Service commissioners • Other • Attempts to represent national, regional and local priorities

  5. Methods (3) • Comparative needs assessment • Attempts to reflect current practice elsewhere • Choice of comparators important • Epidemiological and corporate needs assessments may focus on the ideal and may not be feasible

  6. HMP Bullwood Hall • Re-roled in May 2006 • Used to be a prison and Youth Offender Institution for women • Now category C male prison with capacity of 184 • Houses prisoners within last 2 years of sentence • No health needs assessment since re-role

  7. Key findings: epidemiological • Based on review of 155 inmate medical records (90% of prison population) • Expected prevalence and incidence based on research estimates in the “Toolkit for health care needs assessment in prisons” developed by the University of Birmingham

  8. Severe mental illness • Functional psychosis • 10% remand, 7% sentenced • Any neurotic disorder in past week (including depression) • 59% remand, 40% sentenced

  9. Key findings: corporate • Three focus groups with prisoners • Focus group with health care staff • Questionnaires for prison officers • Interviews with health care managers and other stakeholders

  10. Comparative • No similar prisons had completed needs assessments • This prison population is atypical because of screening for low risk

  11. Using results of HNA • Information to PCT and Prison management • Development of service specification for prison health care system • Establishing baseline for audit against prison health performance indicators • Comparator for similar prison populations

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