1 / 26

PRISON PRIMARY HEALTH CARE SURVEY

PRISON PRIMARY HEALTH CARE SURVEY. Charles Cornford, Bonnie Sibbald, Katie Buchanan, James Mason, Lenny Baer, Helen Thornton-Jones, Mark Williamson. Introduction. Concerns about the standard of primary care services in prisons Debates about the ‘normalisation’ of care provision

sal
Download Presentation

PRISON PRIMARY HEALTH CARE SURVEY

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. PRISON PRIMARY HEALTH CARE SURVEY Charles Cornford, Bonnie Sibbald, Katie Buchanan, James Mason, Lenny Baer, Helen Thornton-Jones, Mark Williamson

  2. Introduction • Concerns about the standard of primary care services in prisons • Debates about the ‘normalisation’ of care provision • Chronic disease management current NHS priority

  3. Background • Known problems • The particular patient group • Prison setting • High turnover • Opportunities • Cervical smear uptake • Diabetes • Hepatitis C

  4. Aims • To describe the organisation of primary health care services in prisons • To describe the organisation of health care services for common chronic illnesses (diabetes, IHD, hepatitis, asthma) • To make comparisons between different types of prison

  5. Method • Survey of all prisons England and Wales • Questionnaire design • Posted to governors and returned to the DH • Reminders: one postal, several telephone • Data input into SSPS • Statistical analysis (descriptive and multivariate)

  6. Response • Questionnaire sent to 138 prisons • 124 Prisons responded of which 2 too late to be included • Response rate 122 from 138 (87%)

  7. Section 1: Organisation

  8. 70 am 60 pm/evening total 50 40 Percent (%) 30 20 10 0 0 1 2 3 4 5 6 7 8 9 10 11 12 >12 Number of surgeries per week Organisation1. How many morning surgeries are offered each week? 2. How many afternoon/evenings surgeries are offered each week?

  9. Organisation3. What is the booking interval for routine appointments? 70% (n=119) 66% 60% 50% 40% Percent (%) 30% 26% 20% 10% 4% 3% 1% 0% 5 7 10 15 variable minutes

  10. Organisation10. Is the prison ‘paper light’ (clinical information is entered directly onto computer)? yes no 9% 91% If yes, does this apply to-

  11. Yes No 1. Is there a system in place to ensure that a prisoner’s general practice medical records are transferred from the community to your healthcare facility? If No, are you planning to introduce such a system in the next year? 2. If a prisoner is transferred from your prison to another, do you have a system in place to ensure that your medical records for that prisoner are forwarded? If No, are you planning to introduce such a system in the next year? 3. If a prisoner is transferred to your prison from another prison, does that prison send you the prisoner’s medical records? If No, would this be helpful? 0% 20% 40% 60% 80% 100% Percent (%)

  12. Vacances Other staff Staff vacancies Number of prisons 0 10 20 30 40 50 60 70 80 90

  13. Section 2: Chronic Diseases

  14. Chronic diseasesDoes the prison have a register of patients with…? 100% 13 no 19 38 yes 80% 49 60% Percent (%) 109 102 40% 82 72 20% 0% Diabetes IHD Asthma Hepatitis

  15. Chronic diseases1. If yes, is the register electronic? 100% no yes 80% 64 49 77 60 60% Percent (%) 40% 20% 36 23 34 23 0% Diabetes IHD Asthma Hepatitis

  16. Chronic diseases3. Does the prison have a recall system for …? 100% no 31 36 yes 43 80% 73 60% Percent (%) 40% 89 78 77 20% 47 0% Diabetes IHD Asthma Hepatitis

  17. Chronic diseases6.Does the prison provide sessions held by a specialist nurse trained in the care of …? 100% no yes 45 80% 54 60 60% 98 Percent (%) 40% 73 61 60 20% 20 0% Diabetes IHD Asthma Hepatitis

  18. If yes, who provides the talk therapy? 60 yes no Sole 50 68% 32% Combined 40 30 Percent (%) 20 10 0 Counsellor Psychologist Unknown CPN Other no yes 23% 77% Chronic diseases1. Does the prison provide ‘talk therapies’ (e.g. cognitive behaviour therapy) for patients with anxiety or depression? 2. Does the prison provide self help material for prisoners with anxiety and depression?

  19. Exploratory Analysis

  20. Stratifying variables for exploratory analysis • Category of prison: Cat A/B if category A/B prisoners present • Women’s prison: If prisons identified themselves as such (15) • Large prison: >500 • Level of health care support: GP sessions/week/prisoner. High level if >0.02

  21. Relationship between stratifying variables Correlations GP sessions /week Category A Women's Prison /prisoner or B prison prison popn >500 > 0.02 Category A or B prison Pearson Correlation 1 -.234 ** .249 ** .185 Sig. (2-tailed) .009 .008 .058 N 122 122 113 105 Women's prison Pearson Correlation -.234 ** 1 -.324 ** .373 ** Sig. (2-tailed) .009 .000 .000 N 122 122 113 105 Prison popn. >500 Pearson Correlation .249 ** -.324 ** 1 -.287 ** Sig. (2-tailed) .008 .000 .005 N 113 113 113 96 GP sessions /week Pearson Correlation .185 .373 ** -.287 ** 1 /prisoner > 0.02 Sig. (2-tailed) .058 .000 .005 N 105 105 96 105 **. Correlation is significant at the 0.01 level (2-tailed).

  22. OrganisationSpecialist services

  23. OrganisationSpecialist services

  24. Main findings • Low use of IT • Significant problems with recruitment/retention • Gaps in delivery of services for chronic diseases • Category A/B prisons are more likely to have a range of services

  25. Discussion • What is expected, what is unexpected? • The association of category of prisoner and provision of services: is it justifiable? • What needs investigating further?

  26. The End

More Related