Transcript No Slide Title

Priorities for prison health and
social care research
Clair Chilvers
Research Director
Health and Offender Partnerships
Director
Forensic Mental Health R&D Programme
Outline
• Health and Offender Partnerships Research
Strategy
• Current and recently completed prison health
research: examples
• Best Research for Best Health
• Sources of Funding
Health and Offender
Partnerships Research Strategy:
Overview
• Process of consultation with heads of Units
• Formation of HOP Research Forum
• Priorities to be decided against policy
priorities
• Identification of sources of funding
Characteristics of the prison
& secure hospital population & disease
prevalence
• What impact does the prison environment have on
health and wellbeing? (Shaw; Taylor; Dolan)
• What are the positive impacts on health?
• What are the rates of suicide and self-harm in
subgroups? How do they compare to the general
population? What are the characteristics of prisoners
who self-harm? (Pratt; Shaw)
• Development of an epidemiological overview to inform
commissioning of secure hospital provision (Thornicroft)
Access to services
• How can prison healthcare services be organised to ensure
continuity of care, for prisoners moving through the CJS?
What role could offender managers have in facilitating care?
(Shaw)
• How can waiting times for transfer of prisoners to hospital be
reduced?
• What is the impact of health and social care services on
‘revolving door’ prisoners? (Shaw)
• What are the health and social care needs of particular
groups (women, BME groups, young offenders) and how can
they be met?
Models & organisation
of service delivery
• How can primary healthcare services be organised
to ensure equality of access? (Shaw)
• What are the most cost-effective ways of providing
hospital care for prisoners?
• What can be done to ensure the interface with
services on discharge from prison?
• What is best practice for learning disabled
offenders? (O’Brien)
Staffing and training
issues
• What are the minimum staffing and training levels
for healthcare staff? (Jenkins)
• Can changing professional roles and delegation to
non-clinical staff improve healthcare provision?
• How can recruitment be maximised?
• What are the occupational health needs of staff
working in prisons?
Cultural & organisational
issues: tension between CJS and NHS
• What is the impact of violence reduction strategies?
• What are the most effective ways of blocking drug
supply into prisons: how does treatment affect
demand (and supply)?
• Young offenders: what is the evidence base for a
tiered model of mental health care? (Shaw; Clark)
• How can the evidence base be best disseminated
throughout NOMS?
Assessment, screening
and interventions
• What is the current provision and contribution of
psychological services across NOMS?
• What individual interventions have proven
efficacious in the prevention of suicide and selfharm?
• What is the impact of the ‘listeners’ scheme on
suicide and self-harm?
• How is violence or threat of violence best managed?
(Leitner)
• Young offenders: what is the effect of the mental
health screen with follow-up plan of care?
Medico-legal, ethical &
criminological issues
• What are the links between mental disorders and
offending? (Taylor; Hodgins; Thornicroft)
• What are the pathways from local authority care to
offending, and to self-harm both in prison and the
community?
• How can escalation in offending be prevented?
Financial & resource
issues
• Development of an economic model for the DSPD
Programme: how cost effective is it?
• Economic modelling of health and social care
systems across the CJS (development of
standardised unit costs)
Current & recently completed
prison health research: examples from the
FMH R&D programme
• Evaluation of prison mental health in-reach services
(Shaw)
• Assessing needs for psychiatric treatment in
prisoners (Bebbington)
• Factors mediating the effect of the prison
environment on mental health (Taylor)
• RCT of the efficacy of SSRIs in the treatment of sexoffenders (Grubin)
• Effect of prison on the mental health of young
offenders in YOIs (Dolan)
Best Research for Best
Health
• New strategy for R&D in the NHS
• Key points:
–
–
–
–
National Institute for Health Research Faculty
Funding more transparent
Small number of Biomedical Research Centres
Programme grants to consortia of NHS
Trusts/Universities
– New regional response mode funding scheme
Research for Patient Benefit
– Focus on the NHS
Sources of funding for
Prison & Offender Research in Social Care
& Health
• NHS R&D funding streams
– Health Technology Assessment Programme
– Service Delivery and Organisation Programme
– Research for Patient Benefit response mode
schemes
– Research Capacity Development Awards
• Medical Research Council
• Wellcome Trust
• Prison charities
• Big Lottery Fund (through voluntary sector partners)