Paper 02 - NHS Ayrshire and Arran.

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1.3 NHS Ayrshire & Arran has one prison within the board area. HMP Kilmarnock isprivately run by SERCO Home Affairs under contract from the SPS. Prison healthservices are currently sub-contracted by SERCO Home Affairs Prisons to SERCOHealth. This differs from the majority of other prisons within Scotland whose healthservice is provided directly by SPS.HMP Kilmarnock is contracted by the Scottish Prison Service to house 598 prisonersand currently accommodates approximately 548 male adult prisoners and has thecapacity to house a maximum of 658 prisoners. The categories of prisoners currentlywithin HMP Kilmarnock are:• Remand prisoners – prisoners who have not been granted bail while awaitingtrial• Short-term prisoners – convicted prisoners serving less than four years• Long-term prisoners - convicted prisoners serving more than four yearsYoung Offenders who are on remand may also be held in HMP Kilmarnock.Approximately 50% are residents of NHS Ayrshire & Arran with the rest of thepopulation being from other boards.1.4 A recent health needs assessment carries out within HMP Kilmarnock found thatprisoners had a range of health issues including• 40% with drug addiction issues• 32.4% with alcohol problems• 10.6 % had hepatitis C• 15.1 % sought help with mental health issues• 16.8% had asthma• 80.6% smoke1.5 Within NHS Ayrshire & Arran planning to transfer services commenced in June 2010.A Local Implementation Group (LIG) was established with 4 workstreams mirroringnational planning as follows• Models of Care• Governance• HR• ThroughcareIn addition a further workstream has been developing IT solutions.1.6 While it is clear that the legislative changes are designed to enable the prisonerpopulation to access a full range of healthcare services the advice and guidance fromthe National Programme Board for Prisoner Healthcare has been that the thereshould be continuity of service provision through a ‘business as usual’ approach inthe first instance. This is to ensure minimal disruption to prison running and reducethe risk of prison disorder associated with the transfer.NHS Ayrshire & Arran Board agreed to support the “business as usual” approach atthe NHS Ayrshire & Arran Board Meeting on 11 th May 2011 with the followingexceptions –• Removal of the existing 14 in-patients beds to mirror the rest of the SPS prisonestate2 of 6
• An electronic records system will replace the existing paper based system1.7 Future additional investment in prisoner healthcare will take place over time utilisingthe organisations clinical prioritisation process.1.8 A detailed operational plan has been developed by the Local Implementation Group(LIG) based on the “business as usual” approach specifying how the service will bedelivered post transfer. This has been submitted to the government on 28 April 2011.2. Current situation2.1 Both general and specific feedback relating to the submission by the respectivehealth board has been received from the Scottish Government in relation the detailedoperational plan. Overall the plans have been received positively and work in now ongoingto adapt initial plans reflecting the feedback received. A revised detailedoperational plan has been submitted to the Scottish Government on the 20 th of July2011.2.2 The Local Implementation Group is now working to ensure delivery of healthcareservices as described in the operational plan by the 31 st of October 2011. Whilstprogress is being made in all areas there are a number of issues that are posingsignificant risk to the success of delivery of a full service in November 2011. Theseissues being –• The provision of Pharmacy• The provision of Out of Hours Care2.3 NHS Ayrshire & Arran’s preferred option for the provision of Pharmacy to Kilmarnockprison was to opt into the national prison pharmacy contract currently held betweenSPS and Llyod’s Pharmacy. Discussions have been taking place at a national levelas to the legality of health boards with privately run prisons opting into the existingpharmacy contract. However advice received from the Central Legal Office hasstipulated that due to tendering regulations amalgamation of privately run prisons intothe existing contract is not possible.2.4 NHS Ayrshire & Arran are now currently undergoing a procurement exercise to obtaina local contract. This procurement exercise will be carried out in conjunction withNHS Lothian who also has privately run prison Addiewell within their remit. Theprocurement exercise should be completed and a contract awarded by the end ofSeptember to allow a shadow working period during October and for full takeover tobe in place on 1 st November in line with healthcare transfer.2.5 Initially detailed operational plans included details of the provision of out of hours carefor both medical and dental emergencies. Aspects of these models are however nolonger feasible given the requirement for models to work congruently with KilmarnockPrisons operational procedures. This significantly restricts the scope for provision ofOut of Hours Care. Examples of these processes are prison lockdown taking place at10pm and the limited scope for transportation of prisoners to local emergency carefacilities.2.6 Engagement will continue with Kilmarnock Prison to ensure that a robust process isdeveloped and implemented on transfer of healthcare services for emergency careprovision.3 of 6
Page 1: NHS Board Meeting10 August 2011 Pap
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Paper 02 - NHS Ayrshire and Arran.

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