Abstract
Aims and methodTo consider the link between responsible commissioner and delayed prison transfers. All hospital transfers from one London prison in 2006 were audited and reviewed by the prisoner's borough of origin.ResultsOverall, 80 prisoners were transferred from the audited prison to a National Health Service (NHS) facility in 2006: 26% had to wait for more than 1 month for assessment by the receiving hospital unit and 24% had to wait longer than 3 months to be transferred. These 80 individuals were the responsibility of 16 different primary care trusts. Of the delayed transfer cases (n=19), the services commissioned by three primary care trusts were responsible for the delays.Clinical implicationsThere are significant differences in performance between different primary care trusts related to hospital transfers of prisoners, with most hospitals able to admit urgent cases within 3 months. This suggests that a postcode lottery operates for prisoners requiring hospital transfer. Data from prison services may be useful in monitoring and improving the performance of local NHS services.
Highlights
Overall, 80 prisoners were transferred from the audited prison to a National Health Service (NHS) facility in 2006: 26% had to wait for more than 1 month for assessment by the receiving hospital unit and 24% had to wait longer than 3 months to be transferred
All those transferred from the prison to an NHS mental health facility during that period were included
In 2006, 80 prisoners were transferred from the audited prison to hospital under the Mental Health Act, almost exclusively because of severe mental illness
Summary
In 2006, 80 prisoners were transferred from the audited prison to hospital under the Mental Health Act, almost exclusively because of severe mental illness. We have included in our analysis patients transferred to both NHS and independent sector units Prisoners who need such transfer for hospital treatment under the Mental Health Act are the responsibility of their borough of origin, determined by their home address, their general practitioner’s address, or where their (alleged) offence was committed.[12] This required the prison mental health in-reach team to liaise with services commissioned by 16 different primary care trusts: 8 in Inner London, 3 in Greater London, and 5 from other parts of England. Current practice is that the receiving hospital arranges its own assessment of the prisoner: 39 individuals (49%) were assessed in this manner within 2 weeks of being referred, (25%) were assessed within 2-4 weeks, and (26%) waited longer than 1 month for such an assessment Of these 80 prisoners, 70% were the responsibility of the services commissioned by four Inner London primary care trusts and we considered their performance in more depth (Table 2). With the exception of one case (the responsibility of a Greater London primary care trust), the services commissioned by all the other primary care trusts were able to transfer their patients within 3 months of referral
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