Fiona Grossick National Clinical Quality Assurance Lead, Health & Justice NHS England www.england.nhs.uk Our vision To ensure that everyone in the justice system receives high quality, cost effective health care that improves outcomes and reduces inequalities Health & Justice Commissioning, NHS England www.england.nhs.uk What we currently commission Budget of 533m for 2016/17 covering a population which has a changing turnover
Prisons 116 in England Population of 85,000 Immigration Removal Centres 11 in England Population of 3,600 Police custody, courts and Liaison & Diversion 40 police forces 1.4m go through custody suites each year Children and young people secure estate
Public health in secure and detained settings Public health of all prisons, children & young people secure estate and Immigration Removal Centres Includes substance misuse 14 Secure Children Homes (welfare and youth justice) 3 Secure Training Centres 4 Under 18 Young Offender Institutions Population 1,100 -1,200 occupancy beds
Sexual Assault Referral Centres (children and young people/adults) 43 SARCs in England Services are commissioned from a mixed market of providers including NHS Trusts but also a large percentage of independent and private sector organisations. www.england.nhs.uk 3 We are responsible for commissioning care for individuals at a particular point in their life which is solely defined by the setting they are in, not by their need or the nature of the service.
www.england.nhs.uk National Quality Assurance Lead Reducing Deaths in Custody response to the Harris Review, Assessment Care in Custody and Teamwork Review (ACCT), learning lessons from deaths in custody, clinical reviews and implementing change To improve standardisation of quality assurance for health care services commissioned across the secure and detained estate. www.england.nhs.uk Governance Structure
Internal to NHS England External to NHS England Commissioning Committee Health and Justice Clinical Reference Group Health & Justice Partnership Board Health and Justice Oversight Group
Health and Justice Partnership Forum non decision making Health and Justice Regional Portfolio Leads Health and Justice CRG Expert Panels Health and Justice CRG Task and Finish Groups NHS England Internal Assurance Health and Justice Information Management Programme Board
NHS England Immigration Removal Centres Assurance Group NHS England Temporary Estate Assurance Group PHS7A Public Health in Secure and Detained Settings Assurance Group (PHS7A) www.england.nhs.uk Sexual Assault Services Assurance Group
(PHS7A) North Regional Team meeting Partnership Assurance Midlands Regional Team meeting Police Healthcare Partnership Assurance Group South/London Regional Team meeting Prisons Health Care Board
(England). Immigration Removal Centres Partnership Assurance Group Ministerial Deaths in Custody Board Contracted Prisons Healthcare Commissioning Group Child and Young People Health and Justice Co-Commissioning Assurance Group Liaison and Diversion Board (inc
Street Triage) 6 The Role of the Clinical Reference Group for Health and Justice The CRG works in partnership with providers, medical bodies, partners, key stakeholders, patients, families and communities Recently streamlined to comprise: CRG strategic steering group; meets bi-monthly , formal agenda Bi annual whole day workshop to enable deep dives into strategic work plan areas and undertake Thematic Reviews www.england.nhs.uk
7 Health & Justice Update RESUS Guidelines publication NICE draft guidelines on physical health of adults in contact with Criminal Justice System Smoke Free Prisons roll out of smoke free prison programme DH Guidelines for the management of substance misuse Health and Justice Information Systems (HJIS 2) clinical input into development of templates www.england.nhs.uk 8
Health & Justice key priority 16/17 Supporting Reduction in avoidable Deaths in Custody Response to Harris Review , ACCT Review, suicide prevention in prisons Quality and Safety How we can manage through our partnerships www.england.nhs.uk 9 Deaths in Custody www.england.nhs.uk Deaths per 1,000 prisoners by apparent cause, 12 months ending December 2000 to 12 months ending June 2016,
England and Wales www.england.nhs.uk Death in Custody Working Group Purpose: to ensure that the learnings from deaths in custody across the secure and detained estate are identified support continuous service improvements and health outcomes for services users adopting evidence based approach. Support NHS Englands Health and Justice priority to support the reduction in avoidable deaths in custody. www.england.nhs.uk Health & Justice Deaths in custody
Harris Review Suicide and Self-Harm Project Research: Clinical Review reports analysis DH Policy Research Funds www.england.nhs.uk 13 Work to date 16/17 Clinical Review Training
Harris Review recommendations Resus Guidelines Thematic review of Self-Inflicted deaths www.england.nhs.uk Thematic Review into Self-inflicted deaths Reviewed: PPO reports PPO lessons learnt bulletins Clinical Review reports HMIP reports National reports: Independent Advisory Panel Harris Review academic literature
www.england.nhs.uk Thematic Review into Self-inflicted deaths Key areas: i. Measuring suicide and self-harm Risk stratification tool Alerts ii. Workforce Induction training iii. Medication Medicines Optimisation Programme Continuity of medication on reception into prison www.england.nhs.uk Thematic Review into Self-inflicted deaths
iv. Mental Health iv. Links with ACCT review v. NICE Guidance v. Information sharing and consent Handover Best practice Guidance vi. Learning Coroners summary report www.england.nhs.uk Current work Thematic review of pre-morbidity Prevention through early detection and case finding End of Life Care Review of Macmillan Adopted Prison Standards Community of Practice
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