SCOTTISH HEALTHCARE
Ranald Macdonald, legal adviser to the NHS Scotland Central Legal Office, explains the upcoming transfer of prison healthcare to the health service.
access to an appropriate range of services; consistency of care – allowing variation in practice where justifiable, and taking ac- count of evidence-based national clinical guidelines and good practice; safety for prisoners, staff and the public; equity in health services: prisoners will receive the same opportunities to benefit from NHS care in keeping with services provided to the local community; promoting through- care to ensure integrated support to meet health care needs across settings; shared responsibility for multi-disciplinary func- tions; shared responsibility between the Health Boards and prisons for the identifi- cation and development of health services to prisoners on the basis of assessed need.
Provision of health services will remain the responsibility of the Health Board; pro- motion and development of best practice; transparent financial and performance monitoring and strategic planning with information sharing and documentation between the parties, and resolution of dis- putes, where possible locally, and as rap- idly as possible.
In
July 2008, Scottish ministers agreed to the transfer of responsibility for the
healthcare of state and private prisoners to the NHS. Previously such arrangements were the responsibility of the Scottish Pris- on Service.
A National Programme Board for Prison- ers’ Healthcare was appointed in March 2009 to oversee the transfer, and, in Au- gust 2010, the Scottish Parliament passed the necessary regulations to enable the change. The transfer will take place on 1 November 2011.
The process is intended to ensure equity in NHS health care. Prisoners will receive similar opportunities to benefit from NHS care as that offered to the general popu- lation, in terms of quality and the range of healthcare services according to their needs. In so doing the transfer will uphold European and International standards for the health care of prisoners.
The transfer is specifically designed to de- liver: a reduction in health inequalities;
68 | national health executive Sep/Oct 11
preservation of life and a reduction in harm; provision of a safe, secure environ- ment for the health assessment and treat- ment of prisoners; ensuring that all rel- evant information is gathered consistently, preserved, analysed and exchanged appro- priately and within both the law and ap- plicable protocols. Particular emphasis will be placed on minimising drug, alcohol and substance misuse, and seeking improve- ments in mental health and dental hygiene.
It is also intended that the process will dem- onstrate that: public services are open, con- sistent and accountable; that there is mu- tual respect for stakeholders and parties, encompassing healthcare and staff govern- ance; that there is openness in disclosure of necessary information, and reasonable no- tice of change; that there is demonstrable value for money, joint approaches to com- mon problems, and best use of available resources; that there is continuous service improvement; that there will be an assured quality of care – applying national stand- ards derived from national health or prison practice; the means to provide equity of
Those Health Boards which have prisons in their area, together with the Scottish Pris- on Service, have been working over many months with their legal advisers, the Scot- tish Government Legal Directorate and the NHS Central Legal Office, to resolve and agree the terms of the transfer, and in particular, the various contracts which will support the transfer of clinical services.
These will include the TUPE transfer of the employed SPS clinical staff to the NHS, new contracts for independent service providers - general medical practitioners, dentists, optometrists, and pharmacists, including services to both state and pri- vate prisons. It is a complex legal process to deliver but without a doubt will achieve its objective of pro- viding equity in the provision of health services for prisoners in Scotland.
Ranald Macdonald
FOR MORE INFORMATION Visit
www.clo.scot.nhs.uk
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