Archived: HMP Lewes - Prison Healthcare Department

Updated 10 January 2020

HMP Lewes is a local category B prison located in Lewes in East Sussex. The prison holds up to 692 remanded and sentenced adult prisoners. The prison is operated by Her Majesty’s Prison and Probation Service.

Sussex Partnership NHS Foundation Trust provides primary healthcare, inpatient, pharmacy and mental health services at HMP Lewes. The trust is registered to provide the following regulated activities at this location: Treatment of disease, disorder or injury, and Diagnostic and screening procedures.

Our last joint inspection with HMIP was in January 2019. The inspection report can be found at:

https://www.justiceinspectorates.gov.uk/hmiprisons/wp-content/uploads/sites/4/2019/05/Lewes-Web-2019-1.pdf

Updated 10 January 2020

Between 21 and 23 October 2019, we carried out an announced focused inspection of healthcare services provided by Sussex Partnership NHS Foundation Trust at HMP Lewes.

Following a joint inspection with Her Majesty’s Inspectorate of Prisons (HMIP) in January 2019, we found that the quality of healthcare provided by Sussex Partnership NHS Foundation Trust at this location required improvement. We issued Requirement Notices in relation to Regulation 9: Person-centred care, Regulation 17: Good governance, and Regulation 18: Staffing, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The purpose of this focused inspection was to determine if the healthcare services provided by Sussex Partnership NHS Foundation Trust were now meeting the legal requirements of the above regulations, under Section 60 of the Health and Social Care Act 2008.

We do not currently rate services provided in prisons.

At this inspection we found that:

• The provider had made some improvements to the systems for managing patients with long-term health conditions. However, a significant backlog of patients still required improved support.
• Not all patients with an identified long-term health condition were prioritised for review when their clinical history indicated on-going need.
• Completion rates for secondary, comprehensive health assessments for newly-arrived prisoners were poor, increasing the risk that immediate health needs may not be identified or adequately addressed.
• Long-term health conditions clinics were scheduled regularly but not always effective owing to staffing, patient non-attendance and unfilled appointments.
• Patients waited too long between an initial triage and a comprehensive assessment of their needs.
• Many patients now had care plans in place, although some were generic and not sufficiently personalised to inform the patient’s on-going care.
• Patients with long-term health conditions who attended the specialist nurse’s clinic for assessment received structured and personalised support.
• The accuracy and oversight of patient registers had improved since our last inspection, although further work was needed to resolve some discrepancies.
• Staff did not consistently rebook patients who had not attended their planned appointments, which delayed care and treatment and impacted on performance reporting.
• The timeliness of mental health assessments and subsequent access to specialist interventions had improved significantly.
• There was an effective system in place to promptly process health applications.
• Patients routinely had in-possession medication risk assessments completed and recorded in their clinical record.
• The provider had improved their analysis of non-attendance at health appointments.
• The provision of formal staff supervision had improved, particularly for primary care staff.

The areas where the provider must make improvements are:

• Prioritise patients with an identified long-term health condition for review when their clinical history indicates on-going need.
• Improve the completion rate of prompt comprehensive health assessments to ensure that patients’ immediate health needs are identified and adequately addressed.
• Accurately record patient non-attendance at health appointments and consistently rebook patients to ensure that care is delivered in a timely way.

The areas where the provider should make improvements are:

• Continue to review patient registers to ensure they accurately reflect the current patient population.
• Plan dedicated long-term health conditions clinics effectively.
• Personalise care plans for all patients with long-term health conditions to inform their on-going care.
• Improve oversight of staff recording of patient attendance at appointments.