HMP Doncaster

Section 2. Respect
Health services
Expected outcomes:
Prisoners are cared for by a health service that assesses and meets their health needs
while in prison and which promotes continuity of health and social care on release. The
standard of health service provided is equivalent to that which prisoners could expect to
receive elsewhere in the community.
2.42 Staff shortages had contributed to deterioration in provision of most health services. Governance
arrangements were in place but partnership working with the prison was strained and had affected
effective health care. Prisoners had reasonable access to an appropriate range of primary care
services, but triage clinics were not always delivered when expected and the management of longterm
conditions was underdeveloped. Most prisoners had negative views about health care and some
had experienced delays in receiving their medication, causing unacceptable gaps in treatment for
some serious conditions. Too many external hospital appointments were cancelled. Dental provision
was good. The integrated mental health team provided a basic service but there was a lack of
therapeutic activity, and no mental health awareness training for staff.
2.43 The Care Quality Commission (CQC) 8 did not join HM Inspectorate of Prisons on this inspection.
Governance arrangements
2.44 The Care Quality Commission did not join HM Inspectorate of Prisons on this inspection.
2.45 Health services were provided by Nottinghamshire Healthcare NHS Foundation Trust.
Quarterly partnership board meetings had recommenced in July 2015 and clinical governance
meetings were well attended. However, the working relationship between the provider and
the prison was strained; commissioners were aware of this and planned to address it. A
prisoner health needs assessment was scheduled for the end of 2015. In our survey, only
23% of prisoners were satisfied with the overall quality of health services, against the
comparator of 36% and 31% at our last inspection.
2.46 Nurses were available 24 hours a day, with three staff available at night. Health staff were
clearly identifiable, and the interactions with prisoners that we observed were professional
and caring. Despite the attempts of the experienced clinical managers to improve services
and make them effective, service delivery had been significantly affected by staff shortages,
delays in security clearance, sickness and disciplinary issues. Some of the vacancies were filled
by regular agency staff who had an induction and felt part of the team. Mandatory staff
training and access to professional development were well managed. An appropriate range of
policies, including communicable disease management and safeguarding, were used
2.47 Age-appropriate screening was available and a senior nurse had been identified for the
overall care of older prisoners. The prison had set up an area in the annexe for prisoners
with social care needs; several referrals had been made and the health care department
provided planned care for some individuals following assessment. There was access to
occupational therapy equipment and to mobility and health aids.
8 CQC is the independent regulator of health and adult social care in England. It monitors, inspects and regulates services
to make sure they meet fundamental standards of quality and safety. For information on CQC’s standards of care and the
action it takes to improve services, please visit: http://www.cqc.org.uk.
38 HMP Doncaster