HMP Doncaster

Section 2. Respect
2.58 GP appointments were available four days a week, and routine appointments were within an
acceptable timescale. There was no planned GP cover on Thursdays, at weekends or in the
evenings to see new arrivals. Four non-medical prescribers mainly worked during the day;
they routinely covered only one evening and Saturday mornings, which contributed to delays
in new arrivals receiving their medication. Prisoners made health appointments by paper
applications handed to health care staff or through the electronic kiosks (see paragraph 2.7).
2.59 Out-of-hours emergency GP cover was provided to the same level as in the community. The
emergency care practitioner service was available for advice and treatment, and had
sometimes attended to suture wounds.
2.60 The primary care team offered nurse-led clinics, including a specialist pain clinic, minor
ailments and daily triage, although delivery of the triage service had been inconsistent due to
staffing problems. There were limited nurse-led long-term condition clinics, although there
were plans to give staff appropriate training. There were assessment templates reflecting
national clinical guidance but care plans had insufficient detail. Entries in patient records on
SystmOne (the electronic clinical information system) were of a reasonable standard and
regularly audited to ensure a consistent approach.
2.61 An appropriate range of primary care services was available, including physiotherapy, with
acceptable waiting times. A consultant provided a weekly sexual health clinic, and an on-site
X-ray service was available three days a week.
2.62 Prisoner access to external hospital appointments had deteriorated since our last inspection.
This had followed a reduction from four to three in daily allocated slots, an increase in
incidents necessitating emergency care, and lack of custody escort staff. This had led to
prisoners waiting too long for necessary treatment, which was unacceptable.
Recommendations
2.63 Prisoners with lifelong conditions should receive regular reviews from
appropriately trained and supervised staff that generate an evidence-based care
plan.
2.64 There should be adequate escort arrangements for prisoners to attend hospital
appointments, and the health care department and the prison should monitor
external hospital appointments jointly and robustly.
Pharmacy
2.65 Pharmacist-led clinics for prisoner clinical and medicine use reviews were available. The
pharmacist reviewed clinical audits and prescribing data, and attended the bimonthly offender
health drugs and therapeutics committee meetings.
2.66 Medicines were supplied from Well pharmacy as patient-named items with appropriate
labelling and a dispensing audit trail. Emergency stock was adequate and usage was audited.
Medicine was administered up to three times a day at appropriate times. Officers did not
always manage medication queues well, which affected confidentiality and increased the risk
of diversion.
2.67 Medication was supervised for the patient's first month, when they attended a risk
assessment clinic. The medicines in-possession policy was not robustly followed or
documented, and there were inaccuracies in the in-possession status recorded in the
40 HMP Doncaster