Inspection airs concerns over healthcare provision at jail

10 October 2018, 06:45

Man in Jail

An inspection report has raised "serious concerns" over aspects of the provision of healthcare at a prison.

HM Inspectorate of Prisons for Scotland (HMIPS) rated the performance in this area at HMP Perth as "poor" in its latest publication.

Breaches of confidentiality, the apparent ineffectiveness of the smoking cessation service and problems maintaining a suitable workforce were among the issues raised by inspectors.

The HMIPS revealed it immediately escalated its concerns to the prison's healthcare provider, NHS Tayside, and local Scottish Prison Service (SPS) managers setting out action to be taken.

Nevertheless, inspectors said the findings should not overshadow the wider conclusions of the report, which found HMP Perth "did many things to a high standard and should be commended".

The jail holds male inmates on short and long sentences, as well as those on remand, and there were 663 prisoners under its roof at the time of the inspection in May.

On health and wellbeing within the prison, the report found the time taken to give out medications had a "significantly negative impact" on prison life, such as by delaying prisoners in getting to work or education.

The healthcare team also described having "many challenges in maintaining a consistent and stable workforce", the report noted.

It added it found "a number of concerning instances where patient confidentiality was breached" and inspectors raised concerns about the process for managing clinical records within the prison.

Inspectors further aired fears about the effectiveness of services to quit smoking at the jail.

"Only two out of 138 patients registered with the smoking cessation service in 2017 were smoke-free at 12 weeks, which was a concern," the document said.

It added that while waiting times were generally acceptable, patients had a four week wait for a GP appointment and to see the mental health team.

The report also went on: "During the staff discussions, staff highlighted some concerns including the strain on prison staff due to an increase in the numbers of prisoners being under the influence of substances."

Inspectors asked NHS Tayside to make sure that appropriate care had been put in place. It was also asked to provide an action plan to address the issues highlighted.

HMIPS said it is "reassured" appropriate steps are being taken by the SPS and NHS Tayside to respond to the concerns and it vowed to return to the prison for further inspections before the end of the year and in late 2019.

In their report, inspectors praised the dedication of the prison's throughcare support officers and the establishment of a club for men to talk about their health and wellbeing issues.

They continued: "Despite the issues with medications and some of the healthcare provision, HMP Perth was an establishment that did many things to a high standard.

"Relationships throughout the prison were positive and respectful and contributed to the sense of safety and good order that was evident during the inspection."

Perth and Kinross Health and Social Care Partnership, involving NHS Tayside and the local council, hosts prisoner healthcare services on behalf of the health board.

It said the problem of the time taken to administer medication has already been addressed and that all the issues identified are being progressed through an improvement plan.

Chief officer for the partnership, Robert Packham, said: "We accept all the recommendations in the inspection report and will continue to work to improve healthcare services at HMP Perth.

"The healthcare team works hard every day, to deliver person-centred, safe and effective care. I am pleased the inspectors highlighted our important working relationship with Scottish Prison Service staff.

"We will learn from the more critical aspects of the report and the observations and feedback from the inspectors is helpful in showing where improvements can be made.

"During a follow-up visit to HMP Perth in June, the inspectors were assured that good progress had already been made since their last visit. We will continue to closely monitor progress against our improvement actions."