TRANSFER OF RESPONSIBILITY FOR PRIMARY HEALTHCARE SERVICES IN PRISON

1. TRANSFER OF RESPONSIBILITY FOR PRIMARY HEALTHCARE SERVICES IN PRISON DR MINI MISHRA DIRECTORATE FOR HEALTH AND SOCIAL CARE INTEGRATION 4 MAY 2011

2. BACKGROUND • Ministers established the Prison Healthcare Advisory Board (PHAB) in 2007, to explore the feasibility of transfer of responsibility for primary healthcare services in Scottish prisons from the Scottish Prison Service (SPS) to Health Boards (HB) • Ministers approved the transfer in principle, in July 2008, following the PHAB report’s recommendation that the transfer was feasible • The National Programme Board for Prisoners’ Healthcare was established in early 2009, to provide national leadership, and oversee the planning, preparation and implementation of this transfer • The underpinning primary legislative changes to the Prisons (Scotland) Act 1989, and the Criminal Justice and Licensing (Scotland) Act 2010 in August 2010 • Several workstreams of the Programme Board were established to take forward the complex work involved in the transfer

3. THE AGREED RESPONSIBILITIES OF SPS/PRISONS AND HEALTH BOARDS Health Boards will be responsible for: • Contracts and contracted services, associated with the delivery and support of enhanced primary health care to prisoners/patients • Community public health, health protection and health improvement services • Mental health services similar to those dealt with by primary care in the community, and includes involvement in SPS Suicide Risk processes • Ancillary services to support clinical activities • The management, training and support of directly employed health care staff, including support functions • Ensuring appropriate skill mix of professional staff, assistants and administrative staff • Infrastructure related to healthcare services – IT, clinical assets • All health care related complaints • Clinical performance management and monitoring, and prison liaison

4. THE SCOTTISH PRISON SERVICE AND INDIVIDUAL PRISONS WILL BE RESPONSIBLE FOR: • Security and good order within health centres e.g. security services within the health centre • Escorting and hospital bed watch functions, for security purposes, both within and outwith the establishment • Facilities management and cleaning services within the health centre • Structural maintenance of the health centre • Infrastructure to support the operation of the health centre • All non clinical complaints • Training for the purposes of working effectively and safely within the prison setting

5. NATIONAL WORKSTREAMS • Model of Care – The first phase looked at the services to be delivered, and responsibilities between Health Boards and SPS/prisons proposed via an MOU. The second phase is considering the national support and coordination functions. • HR – Developed supporting implementation guidance for Health Boards and is in the final stages of identifying HR-related costs to Health Boards • Finance – The first phase achieved agreement about the spend by SPS on primary healthcare prisons. The second phase recommended the historical allocation of the funding to Health Boards, to be reviewed in future years. Outstanding costs currently being considered include those related to the 2 Private Prisons – Kilmarnock and Addiewell • Throughcare – National standards for the throughcare process are being developed, building on existing good practice models. The group will also address the integration with other workstreams such as IM&T, Clinical Governance and Anticipatory Care

6. NATIONAL WORKSTREAMS • Contracts – Considering all national and local contracts, and assets currently held by SPS, for the delivery of primary healthcare services. SPS is also progressing the contract variation for the private prisons • Performance Management – Responsible for identifying appropriate national quality measures for Health Boards, the collection of appropriate data consistently across all prisons, and application of relevant health output measures post transfer • Legislation – This Scottish Government workstream is considering and attempting to address all the appropriate changes required to devolved and reserved legislation • Governance – Addressing areas such as Information Sharing, Prisoner Complaints, Clinical Governance, Memorandum of Understanding, and liaison with various inspection arrangements covering prisons such as the HIMP Inspector and NHS QIS

7. NATIONAL WORKSTREAMS • IM&T – Business case has been finalised for GPASS replacement within prisons • Information Governance – A Short Life Working Group has been set up under the governance workstream to develop a National Information Sharing Protocol for use between SPS, public and private prisons and Health Boards, related to healthcare and operational issues; and to recommend to the Programme Board about the ownership, use, storage of current paper healthcare records.

8. LOCAL IMPLEMENTATION GROUP (LIG) • Every Health Board has LIGs, or is linked to a LIG • LIGs have generally mirrored the national working arrangements • LIGs submitted their detailed operational plans on 29th October 2010 • Final plans were expected by 28 April 2011 • The enhanced primary care services include – medical, nursing, dental, optometry, pharmacy, primary care mental health, addictions, and other such as podiatry, sexual health, etc.

9. PROGRAMME TIMELINE • All national workstreams to close April – June 2011 • Final assurances of readiness by Health Boards, prisons, SPS and others May – September 2011 • Transfer – 1 November 2011