Transcript Gill Scott, Macmillan Prison Project and Jackie Hall, HMP Frankland

Action for Prisoners’ Families
Families of Older Prisoners Seminar
11 July 2013
End of life care at HMP Frankland
Gill Scott, Macmillan Prison Project
Jackie Hall, HMP Frankland
Improving the Standards of Cancer Palliative and
End of Life Care in the Prison Service Project
Gill Scott Macmillan Prison Project Lead
Jackie Hall Family Liaison Officer HMP Frankland
Action for Prisoner Families Conference July 2013
Aim
• North East Palliative, End of Life Care Project
• Role of the Family Liaison Officer
• End of Life Care in Prison DVD
National Drive
High quality equitable care should be available
wherever the person may be: at home, in a care
home, in hospital, in a hospice or elsewhere.
End of Life Care Strategy (2008)
National Drive
As the prison population ages, the number of
deaths from chronic disease or simply old age is
expected to rise.
Learning from PPO Investigations End of Life Care (2013)
Natural Deaths
• January 2007 to October 2012 the PPO investigated
647 natural deaths in prison
• A disproportionate percentage of prisoners,
compared to the prison population as a whole, were
in a high security prison when they died
(19% compared to 7%).
Improving the Standards of Cancer Palliative and End
of Life Care in the Prison Service Project
North East Drive 2010-2013
• Implement prison service model for palliative and end of life
care into the North East Cluster of 7 prisons. Including
development of palliative care pathways and standards of care
to ensure equivalence
• Development of in reach services
• Confident and competent workforce
Progress
• Macmillan Adopted Prison Standards MAPS
• Prison Health and Discipline Champions
• Palliative Care Registers
• Education Adapted End of life care tools
• Policy development
• Prisoner working groups – Education, DVD, patient information
• Improving the Environment
• Chemotherapy pilot
• Macmillan National Conference End of Life Care in Prisons
• Prison palliative care teams - FLO
Family Liaison Officer Palliative Care
Frankland Model
Involving families in the end of life care process
is a key part of an end of life pathway and
should ideally happen at the earliest stage in a
prisoner’s terminal diagnosis
Learning from PPO Investigations End of Life Care 2013
Family Liaison Officer Palliative Care
Frankland Model
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Palliative Care Register
Introduction to the patient
Family point of contact
Supported visits
Multidisciplinary team
Care after death
Challenges for Families
• Communication
• Specific needs
• Children and elderly relatives
• Prison protocol
• Financial challenges
Challenges
There is evidence that death in prison is
perceived as something to be avoided, the notion
of a “good death” is counterintuitive to some
staff
Prof Sheila Payne (2010)
Challenges
• Culture and attitude
• Fear of external criticism
• Prison regime – personalised care
• Prescribing – drug issues
• Wing – prisoner and staff support
• Environment
• 24 hour care
• Access to family
• Access for outside agencies
• Staff knowledge and experience
• Competing priorities
Outcomes
• Earlier identification
• Patient centred care – improved choice
• Improved support for family/ significant other
• Appropriate communication , timely referral -ERCG
• Key worker
• Opportunities to advance care plan
• More patients dying in their preferred place of care
• Less inappropriate admissions to hospital
• Increased use of end of life care tools
• Skilled and confident workforce
• Improved partnership working
National Drive
“How we care for the dying is an indicator
of how we care for all sick and vulnerable
people. It is a measure of society as a
whole and it is a litmus test for health and
social care services”.
The End of Life Care Strategy ( 2008)
Thank you for your attention
[email protected]
[email protected]
References
• DoH (2008) End of Life Care Strategy-promoting high quality
care for all adults at the end of life. Department of Health,
London
• Prison and Probation Ombudsman Learning Lessons End of
Life Care Report (2013)
• Turner, M. (2011) Dying behind bars an evaluation of end of
life care in prisons.
Action for Prisoners’ Families
Families of Older Prisoners Seminar
11 July 2013
www.prisonersfamilies.org.uk