Prisoners are used to being in the dock, but this time it's prison health staff having their knuckles rapped.

An analysis of 120 Prison and Probation Ombudsman reports by Offender Health (OH) identifies several policies that, if implemented, could make a “significant, positive difference” to the healthcare delivered in prisons.

In mental health there is little evidence to suggest that the Care Programme Approach for people with serious mental illness is being used. A series of deaths from natural causes highlights a need for improvements in chronic disease management and the reports show a need for people with substance misuse problems to be effectively identified, treated and monitored, particularly in the first 72 hours.

Despite all new policies concerned with improving healthcare applying to prisons, they are not always included in local PCT/prison action plans. Reports show that, although waiting time targets apply to people in prisons, there are frequent delays in referrals to secondary care.

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BACKGROUND

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• Care provision fails prisoners

• Bill Emery of ORR: A regulator who plays it safe

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In a letter to all PCT prison health leads and governing governors from OH, a partnership between the Department of Health and Ministry of Justice, PCTs are reminded to include the prison setting in policy implementation, modernisation programmes and performance monitoring.

A lack of appropriate medical and nursing skills and training are frequently highlighted. Reports indicate that poor clinical professional performance in the prison may go unrecognised or not be properly addressed, raising issues of accountability in individual clinical care on a daily basis.

Differences in the aims and cultures of the NHS and the Prison Service at local level may compromise working relationships on the ground and an integrated approach to prisoner care, reports show.

CCTV to nab non-washers

If we really are at risk of sleepwalking into a surveillance society, at least it will be a clean one. That's if the call for CCTV cameras on wards to monitor handwashing is heeded.

It's the only way to reduce MRSA, says Peter Goss, co-director of Patient Concern, reports Nursing Standard (May 28). “We have not got a hope until CCTV is installed and staff are fired and patients are banned for non-compliance.” Banning patients from hospitals, whatever next?

Life-size cardboard cut-outs of nurses with movement-activated voiceboxes could be the answer. Hospitals across the East Midlands have put them at ward entrances to remind patients, visitors and staff to clean their hands.

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