Abstract
BackgroundPrisoner populations have a disproportionately high prevalence of risk factors for long-term conditions (LTCs), and movement between community and prisons is a period of potential disruption in the ongoing monitoring and management of LTCs.MethodNineteen qualitative interviews with staff, recruited by purposive sampling for professional background, were conducted to explore facilitators and barriers to screening, monitoring and medicines management for LTCs.ResultsThere is variability in prisoner behaviours regarding bringing community GP-prescribed medication to prison following arrest and detention in police custody, which affects service ability regarding seamless continuation of community prescribing actions. Systems for actively inputting clinical data into existing, nationally agreed, electronic record templates for QOF monitoring are under-developed in prisons and such activity is dependent upon individual “enthusiast(s)”.ConclusionThere is a pressing need to embed standardised QOF monitoring systems within an integrated community/prison commissioning framework, supported by connectivity between prison and community primary care records, including all activity related to QOF compliance.
Highlights
Prisoner populations have a disproportionately high prevalence of risk factors for long-term conditions (LTCs), and movement between community and prisons is a period of potential disruption in the ongoing monitoring and management of Long Term Conditions (LTC)
Since compliance with Quality Outcomes Framework (QOF) monitoring processes is voluntary in prisons, it is possible that an opportunity to improve clinical outcomes associated with LTCs is being missed. In response to such a gap in service provision, we explored the topic of the assessment and management of LTCs in four remand prisons
Participants were approached through a combination of face-to-face discussions and email correspondence, and a purposive sample was used to ensure a range of professional backgrounds were represented, including head of healthcare, lead general practitioner, advanced nurse practitioner, LTC nurse, lead pharmacist, pharmacy technician and healthcare assistants
Summary
Prisoner populations have a disproportionately high prevalence of risk factors for long-term conditions (LTCs), and movement between community and prisons is a period of potential disruption in the ongoing monitoring and management of LTCs. The risk factors for such LTCs disproportionately affects prisoner populations [3]. Compared to equivalent community populations, prisoners consult primary care doctors three times more frequently, consult other primary healthcare workers 80 times more frequently, and receive inpatient care at least 10 times more frequently [5]. They have higher mortality and morbidity rates from chronic disease due to socioeconomic determinants [6, 7]
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