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What is the challenge your project is going to address and how does it connect to your chosen theme?

Escorting patients from prison to outpatients’ appointments, is challenging and expensive (approx £260 per episode) with negative impacts on patients, health and justice systems. Cost and limited availability of prison officers to escort patients means attending outpatient appointments are allocated according to urgency. Deprioritised appointments are cancelled which has psychological and physical health impacts for patients and an impact on resources, time and personnel across the health and justice systems. Jan-Jul 2019 203 appointments were deprioritised/cancelled across our 5 prisons.

Our patients tell us that attending an appointment in handcuffs and discussing health issues in the presence of prison officers is stressful and demeaning.

Research evidence is limited, but does suggest digital alternatives to outpatient appointments can add value in terms of cost savings, timely address of health needs and removing the challenges, security and escape risks associated with transfer.

What does your project aim to achieve?

The aim is to test whether CVP Cloud rooms provide a safe, viable alternative to traditional outpatient appointments for patients in prison. Based on limited literature and our experience the anticipated benefits/improvement and added value of this project include:

For Health and Justice systems/personnel

·         Cost savings to the NHS service provider – specifically related to escort and transport

·         Reduced time and resource demands of persistent cancellation

·         Reduced risks of understaffing and associated incidents in the prisons

·         Removed challenges of transporting and accommodating patients in outpatient settings

·         Reduced security/escape risk

For patients:

·         Reduction in the number of appointments cancelled

·         More timely receipt of healthcare

·         Better health outcomes for patients

·         Continuity of care enabled by interaction between specialist and prison healthcare

·         Dignity and confidentiality for patient preserved

How will the project be delivered?

The MoJ is testing CVP Cloud rooms for prisoners attending court hearings and agree this may offer an alternative (solution to issues related) to outpatient’s appointments for patients in prison. We will work with the MoJ to test this. This will be underpinned by a risk log, with specific attention to IT security/safety/unexpected issues or impacts/challenges.

The test sites will be HMP Leyhill and HMP Erlestoke and the corresponding outpatient consultants in NBT.  Governors at both prisons and consultants at NBT are keen to engage. The Head of Healthcare at HMP Leyhill met with patients to gather their views on this proposal. It was well received, described by patients as logical and particularly positive for those who feel embarrassed or have anxieties around attending outside appointments. There has already been interest from our prison healthcare staff who have identified where this technology could also make time, personnel, cost and resource savings for inter/intra prison services

What and how is your project going to share learning throughout?

This project will generate learning for both Health and the Justice systems around alternatives to current provision of outpatient appointments and it is anticipated that there will be transferable learning appropriate to the development of inter/intra prison services and facilitating staff engagement at for example, coroners court. The evaluation and learning will inform improvement in HMP Leyhill and HMP Erlestoke and where appropriate will be scaled up and rolled out across our other 3 prisons and with other providers of prison healthcare. The partnership with the MOJ will support dissemination of the learning across the Justice system.

We will share our learning through our local networks and contacts, through the Q community at events and through the evaluation SIG. We work closely with the WEAHSN and will promote the work we do through their networks and conferences.

How you can contribute

  • This will require a robust evaluation and would benefit from the expertise of the Q community, and in particular the Evaluation SIG.

Plan timeline

1 Jul 2019 Consult with patients (proposal/current experience/concerns)
1 Jul 2019 Develop proposal. Engage patients, HMP healthcare, NBT, MoJ
1 Jul 2019 Test 'room' access /IT with MoJ from NHS system (NBT/BCH)
1 Jul 2019 Working with key stakeholders to set up test sites
31 Aug 2019 Continue to develop partnerships with MoJ and NBT
1 Nov 2019 Develop evaluation plan and tools
1 Nov 2019 Set up phase starts - site set up in HMPs/NBT testing IT etc
10 Nov 2019 Develop training session
8 Dec 2019 Deliver 8x training sessions
31 Jan 2020 Finalise site set up at HMPs/NBT and set up phase concludes
2 Feb 2020 Test phase begins
8 Feb 2020 Final evaluation drafted by end Oct
8 Feb 2020 Start of monthly tracking of data/evaluation/risk register

Comments

  1. I think that data collection will be important for the evaluation. Have you given this aspect of you project some consideration? I'm sure that results will be positive as it's such a good idea.

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