PRISON PHARMACY
bEhInD cloSED DoorS
WhEn It comES to ‘nIchE’ marKEtS In pharmacY, thErE can bE no grEatEr nIchE than that of prISon hEalthcarE pharmacY. alan EaglESon, pharmacY lEaD for prISon hEalthcarE pharmacY at thE SoUth EaStErn hEalth & SocIal carE trUSt tEllS pIf aboUt pharmacY…
I
n 2008the government made a decision to move responsibility for the healthcare of prisoners in
northern Ireland from the northern Ireland prison Service to the health & Social care board (hScb).
In turn, hScb delegated this responsibility to the South Eastern health and Social care trust (SEhSct), who are now responsible for all aspects of prison healthcare, including the provision of a dedicated pharmacy service.
to facilitate this service the in-house prison healthcare pharmacy was opened in may 2013 and is located at hmp maghaberry, nI’s largest prison, which houses around 900 of the province’s adult, male, long-term sentenced and remand prisoners.
In addition to hmp maghaberry, the pharmacy also dispenses prescriptions for hmp hydebank Wood and hmp magilligan.
hmp hydebank Wood accommodates all young male offenders aged between 17 and 21 years of age on conviction, who are serving a period of four years or less in custody
8 - pharmacY In focUS
(around 150 at present), and all female prisoners including young offenders (at present around 50).
hmp magilligan is a medium to low-security prison, which holds male prisoners with six years or less to serve, and who meet the relevant security classification. the prison currently houses approximately 550 prisoners.
Each prison has its own healthcare centre comprising rooms for visiting healthcare professionals such as physiotherapists, occupational therapists, opticians and podiatrists. the overarching principle with regard to prison healthcare is one of equivalence with community primary care - no more, no less.
In terms of pharmacy, I, as pharmacy lead for the service, am responsible for the overall management of the pharmacy department and of medicines management across the three sites.
pharmacY procEDUrES the pharmacy team at hmp maghaberry is housed in its own pharmacy premises, which are staffed by four pharmacists (including myself)
and a team of 16 pharmacy technicians and assistants. at present, we are dispensing around 11,000 prescription items per month.
prison healthcare is, in effect, very similar to community primary care in that a patient will visit one of the cohort of gps, who are based in the three prisons. Some of these gps are employed, while others are locums or sessionals. Sessions are provided every day and our patients book themselves in much in the same way as members of the community do at their local gp surgery.
the gps diagnose and prescribe on the same hS21 forms as are used in community, and the script is then dispensed by the pharmacy. once the script arrives in the pharmacy, it is subject to the same clinical checking as in community pharmacy.
When labelling and dispensing the prescriptions, we use the mclernons mpS system with which most community pharmacists will be familiar. the script is then final checked by a pharmacist or one of our accredited checking pharmacy technicians
once the medication is dispensed, it is delivered by pharmacy staff to the health centre in hmp maghaberry or taken by our delivery driver to the other two sites.
In hmp maghaberry, pharmacy technicians will issue medicines directly to our patients from a secure room. at this point, the technician is able to provide information to the patient and becomes a point of contact for the patient with regard to all aspects of medicines management.
‘In poSSESSIon’ polIcY around 75 per cent of our patients will manage their own medication and medicines are dispensed on a weekly or monthly basis depending on risk factors, with the remaining 25 per cent subject to supervised swallow.
Each nI prison operates an ‘in possession’ (Ip) policy, which ensures that all patients on medication are individually assessed to determine their ability to store and manage their own medications.
a large number of our patients are used to managing their own
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