Chamber and committees

The National Nurse Advisor of the National Prisoner Healthcare Network will be liaising with the Scottish Executive Nurse Directors (SEND) Group in early 2017 to consider how best to respond to, and potentially address, the matters raised in the RCN Report. The report has also been viewed by NHS Prison Board Operational Leads and they now aim to consider local responses to the matters identified.

Nursing staff working in prisoner healthcare are NHS employees and as such benefit from a number of workforce approaches that support staff including the online integrated toolkit for the Knowledge and Skills Framework (eksf) and iMatter which are both intended to provide staff with an opportunity to have their views heard and acted on with the aim of enhancing their skill set and their employment experience.

In addition, the Chief Nursing Officer has launched an engagement process to develop a 2030 Nursing Vision; this is an opportunity for nurses in all settings to contribute to the discussion about what skills and experience they will need to progress their career through knowledge, education and practice.

Health boards advise that all prisoners in Scotland with sentences of less than six months retain any registration they hold with their community General Practice and are registered as temporary residents with the prison healthcare centre.

Prisoners with a sentence of six months or more are registered permanently with the prison health centre. Upon release these prisoners are required to re-register with their community General Practice to ensure continuity of care.

The process of re-registration is encouraged and assisted by prison healthcare staff and others involved in the prisoner’s liberation and throughcare planning. Guidance has been issued by Practitioner Services Division, National Services Scotland to General Practices on the re-registration of liberated prisoners.

The information requested can be found at http://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/Publications/data-tables.asp?id=1814#1814

The nine NHS Boards that have signed the memorandum of understanding, each has at least one prison within its territorial boundary. The other five Boards do not. However, going forward, if a prison is to be built within the boundary of any of these five Boards, it is expected that they would sign and implement the memorandum of understanding.

The Scottish Government notes the finding of the report 'Five Years On; Royal College of Nursing (RCN) Scotland Review of the Transfer of Prison Health Care from the Scottish Prison Service to NHS Scotland'.

The report highlights a number of important areas of improvement and innovation in health care for the prison population and welcomes the improvement in access to wider clinical expertise and clearly demonstrates the commitment of nursing staff working with people in prison. However, it is only right and proper to acknowledge that it also details a number of challenges facing Health Boards in the delivery of service for this vulnerable group.

While it remains the responsibility of individual Health Boards to provide appropriate healthcare for its population, including prisons, the Scottish Government will support Health Boards, the Prison Service and their partners, to fully implement the aspirations to reduce health inequalities, integrate prison health care into the wider NHS system without discrimination, increase continuity of care and improve sustainability.

Tackling and reducing antimicrobial resistance remains a key priority for NHS Boards in Scotland.

NHS Boards are working with the Scottish Antimicrobial Prescribing Group and National Services Scotland to reduce inappropriate use of antibiotics and ensure that antibiotic use follows national and local evidence-based polices to combat the emergence of resistant organisms.

NHS Boards are required to implement surveillance of antimicrobial use as described by the Scottish Antimicrobial Prescribing Group Local Surveillance of Antimicrobial Use guidance for both Primary and Secondary Care. In addition, NHS Boards are required to adopt and implement mandatory healthcare associated infection and antimicrobial resistance policy requirements as set out in the recent Scottish Government Director’s Letter (2015) 19 issued to all Chief Executives and distributed to the infection prevention and control disciplines within NHS Boards. The Scottish Government also funds Antimicrobial Team Pharmacists within NHS Boards who play a key role ensuring prudent prescribing and active stewardship of antibiotics.

The Controlling Antimicrobial Resistance in Scotland (CARS) expert group, chaired by Scotland's Chief Medical Officer continues to oversee Scotland's antimicrobial resistance strategy and supports delivery of the UK 5 Year AMR Strategy.

The safety and efficacy of medicines in the UK is a reserved matter and is the responsibility of the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA also has responsibility for investigating any suggestions of poor manufacturing practice by pharmaceutical companies.

The Mental Welfare Commission for Scotland submitted a final version of its review report to the Scottish Government in November 2016. The report includes a review of the existing process of investigation of homicides by people who are users of mental health services, as well as a proposal for changes to the existing system. Ministers are currently considering the report and it will be published in early 2017 as part of a consultation exercise on the proposal for changes to the current system.

I have asked Colin McConnell, Chief Executive of the Scottish Prison Service, to respond. His response is as follows:

The previous response to question S4W-22551 clearly stated SPS’s recognition that LDD was a significant issue within the prison population. The reference within current question S5W-05324 stating that “SPS does not recognise that LDDs are a significant issue” is a typographical error.

It is still the case that there is no routine screening for learning difficulties/disabilities (LDD) for those entering custody or who are part of the Scottish prison population. However, SPS has now concluded an LDD screening pilot project initiated at three prisons in partnership with Forth Valley NHS, New College Lanarkshire and Fife College.

An evaluation of the project was subsequently undertaken and the key findings of this will be considered in 2017, which will determine the way forward for SPS in this area of intervention.

I have asked Colin McConnell, Chief Executive of the Scottish Prison Service, to respond. His response is as follows:

SPS does not find acceptable the late arrival of any prisoner at, or cancellation of, any appointment, and is very conscious of the potential impact on both the prisoner and partners. The contract has in place a rigorous contract monitoring regime undertaken by a team of Escort Monitors whose role it is to keep the services under review, and challenge the contractor when a failure in meeting performance measure has arisen. Where relevant, contractual remedies such as improvement plans or direct monetary reductions are applied to failures to provide the required level of service.

The escort contract contains a varied specification and there are a number of different service requirements, with an escort to a hospital appointment, being classed as a non-core service movement. In 2016, to 31 October, 29 out of 14,603 non-core movements (which include 7,884 hospital appointments) have had a performance measure applied because of the late arrival to scheduled appointments, and 40 appointments have been cancelled. There has however been a service improvement from the period referred to and this level of service is currently being sustained.

The escort contract is currently due for renewal and SPS and partners will ensure that any lessons learned are considered and reflected in the drafting of any new contract.