This is a very important document, particularly for commissioners, prison health professionals, and prison workers because it is trying to overcome the vicious circle that faces offenders when they leave prison, which is finding housing and employment while maintaining their health and re-integrating back into society. Alcohol, drug misuse, other addictions, and mental health issues are all problems that offenders are at risk of and that require high quality healthcare. Because several organisations are involved with the welfare of prisoners, this agreement has been drawn up between the major parties to ensure that a robust co-commissioning strategy is in place.

Coverage

The agreement covers health care for all remand and sentenced prisoners in all National Offender Management Service commissioned institutions, including:

• Primary care
• Planned secondary care
• Community care services
• Public health (including infection control and substance misuse services)

The document describes not only all the clinical levels of service that are available to prisoners, such as dentistry, pharmacy, mental health services, end of life care, stoma care, physiotherapy, immunisation, screening, and podiatry, but also non-clinical, such as IT infrastructure, clinical governance, human resources, and funding. The agreement describes the roles and responsibilities of all the organisations involved in commissioning health care services for prisoners. It also describes the expected outcomes, principles and priorities of their joint working activities. Outcomes include:

1. Prisoners receiving equitable services in line with the general population.
2. Improving health and wellbeing, overcoming health inequalities, and helping protect prisoners from re-offending.
3. Prisoners experiencing better health and wellbeing, through better health checks, treatment for addictions and/or mental health problems, and management of long-term conditions, such as diabetes.
4. Seamless health and social care delivery as prisoners are re-introduced to society.

Priorities

Twelve priorities are listed and the organisations involved, namely the National Offender Management Service, NHS England, and Public Health England, are committed to meet these priorities by April 2014:

1. Core service specifications to support commissioning
2. Information and intelligence sharing
3. Improving continuity of care
4. Reviewing the commissioning arrangements for healthcare services in private finance initiative prisons
5. Review and clarify responsibility for future funding
6. Test substance misuse services as part of the Transforming Rehabilitation Strategy
7. Reducing smoking and supporting smoke free prisons
8. Managing prescribing and abuse of prescription medications
9. Reviewing multi-agency approaches to managing serious risk of harm
10. Integrating health and social care in prisons
11. Improving the detection and management of tuberculosis among prisoners before or as soon as they enter the prison system
12. Delivery of an ‘opt out’ blood-borne viruses testing programme.

Commentary

Although this agreement is between the National Offender Management Service, NHS England, and Public Health England, it involves everyone delivering care services to prisoners and former offenders. It is useful because not only does it describe in detail what is expected, but it also shows the governance structure from national to local level, so that everyone can understand what their role is. The list of priorities above, are described in far greater detail in the agreement, and commissioners need to think about what implications this might have on local services. How many prison services are in your area? Are you in touch with the other service providers delivering care to and rehabilitating offenders? There is not much time for these priorities to be met, so it is important to be thinking about what you can do at a local level.

Link

National partnership agreement between: the National Offender Management Service, NHS England and Public Health England for the co-commissioning and delivery of healthcare services in prisons in England (PDF)
Ministry of Justice
October 2013