Prison Health Research Network Conference Manchester 20 th October 2006

1. Prison Health Research NetworkConference Manchester 20th October 2006 Education for Prison Dentists Helen Falcon Director of Postgraduate Dental Education, Oxford PGMDE Vice Chair COPDEND

2. Identified wide range of issues relating to prison dental care- • Action Plans • Focus on facilities, waiting lists and workforce • Clinical governance issues • Funding (Capital and Revenue) for SHAs and prisons

3. Educational Needs Assessment • Focus group • DH lead (Tony Jenner) • Consultant in dental public health (John Beal) • Prison dentists • Postgraduate dental dean (Helen Falcon) • Costed proposal to DH for educational events and development of educational framework for prison dentists

4. Prison Dentists’ Educational Needs -What the Focus Group said • How the prison health system works • Substance misuse • Detoxification programmes • Blood borne viruses • Mental health – impact on dental care • Oral health promotion • Clinical governance in the prison setting • Minor oral surgery • Sharing good practice

5. Educational Events planned • 2 part seminar events repeated in Leeds and London (Watford) • First part November/December • Follow up February 07 • 24 hour residential format • Conference and accommodation costs funded • GDP loss of earnings allowance funded • Travel to be claimed from PCT/Prison

6. How many prison dentists? • Letter to • all English prison governors, healthcare managers, dentists (120+ prisons) • UK Consultants in Dental Public Health • Application form sent to all prison dentists • 75 applications from dentists received, 66 with questionnaire responses (not all complete) • 16 applications from dental nurses received, 12 with questionnaire responses

7. Dentists responses • 37 GDPs • 28 Salaried Dentists • 1 consultant

8. How the prison health system works Never received any training 45 Received some training 17 None required 3 No response 1

9. How the prison health system works “Thrown in at the deep end 11 years ago as prison desperate and had to find out everything for myself” “More training needed on legal rights of prisoners in relation to dental treatment and responsibilities of prison dental surgeon” “I learnt more from a recent TV programme about Drake Hall than from any training” “Have asked for induction but told this would be after security clearance which has taken a year. Training still not available”

10. Substance misuse Never received any training 44 Received some training 20 None required 1 No response 1

11. Substance misuse “Would really appreciate training on above! Would v much appreciate info on types of drug abuse, effects orally and systemically-feel v naïve on this topic when dealing with inmates” “Received some training- little as an undergraduate” “I know a little …from reading journals” “Have completed the certificate in management of substance mis-users from Royal College of General Practitioners London”

12. Detoxification programmes Never received any training 55 Received some training 9 None required 0 No response 2

13. Detoxification programmes “You hear a lot about detox but not much else – you almost feel an annex to the whole subject and not part of it” “Prisoners often talk to me about the courses they are on” “Know only a small amount from own study” “Worked in a drug treatment centre as dentist and part of multi disciplinary team”

14. Blood borne viruses Never received any training 20 Received some training 41 None required 3 No response 2

15. Blood borne viruses “Refresher would be useful, also relevant for my nurse” “Very relevant topic which I would appreciate learning from prison perspective” “Very important……..never taught or informed about it in the prison setting” “Medical personnel other than dental surgeons need educating as to how these viruses can affect the surgeons themselves”

16. Mental health – impact on dental care Never received any training 52 Received some training 13 None required 0 No response 1

17. Mental health – impact on dental care “Pharmacology regime review helpful” “I feel this is a vital part of providing care for people in prison and am finding it very difficult to get any relevant and practical training in mental health” “Mental health unit is adjacent to the surgery – what goes on in there is a mystery” “Feel v naïve and clueless when dealing with mental health- no background learning on the subject”

18. Oral health promotion Never received any training 29 Received some training 31 None required 4 No response 2

19. Oral health promotion “I already undertake this, would be useful for my nurse” “Have had training though not prison related “Not specific to prisons” “…but have great difficulty implementing it” “Dental surgeons understand their importance in oral health promotion, the rest of the medical team need educating to understand our potential”

20. Clinical governance in the prison setting Never received any training 40 Received some training 23 None required 2 No response 1

21. Clinical governance in the prison setting • Attended several lectures but too busy with clinical work on patients to find much time for this subject • From PCT as part of requirements of GDC registration. Not specifically for prison • Keen to implement • Belong to a peer review group

22. Minor oral surgery Never received any training 11 Received some training 45 None required 8 No response 2

23. Minor oral surgery “This is what I do all day” “Would welcome info on surgical policies and referrals- nobody seems to know” “Oral Surgery SHO in past- biopsy refresher (would be) helpful” “Stronger links need to be forged between prison dental surgeries and OMFS Depts” “A good practical training would be useful 1 (clinical) attachment 25 years ago!”

24. Improving care by sharing good practice Never received any training 42 Received some training 21 None required 1 No response 2

25. Improving care by sharing good practice “Really no time for this under present conditions in the prison I work in. I have a clinical waiting list of over 4 months” “Minor appraisals – verbally met by manager, personal development plans independent of prison setting” “Received some training within PCT”

26. Sustainability • Working with Faculty of General Dental Practitioners to establish a framework for prison dentistry • Using “Dentists with a Special interest” model, building on existing frameworks and others in preparation • Representative working group • Potential uses? Portfolio approach to work based learning, DwSI contracts, induction programmes, training and education leading to accreditation

27. Sustainability Role of Prison Health Research Network? Acknowledgements Department of Health Annette Rushmere Faculty of General Dental Practitioners, RCS England