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DATE OF MEETING: 12 June 2012 Paper Title:

Prisons Capital Bids for the refurbishment and development of the healthcare centres at HMP Wakefield and HMP & YOI New Hall.

Agenda item:05 Enclosure: CKWCB/12/137 Category of Paper Tick() Decision and Approval Position statement

Discussion

Ian Currell, Executive Director of Finance Information Ann Ballarini, Executive Director of Commissioning and Service Development

Responsible Director:

Paper Author: Danny Alba, Commissioning Programmes Manager

FOI Status: Open

Executive Summary:

We are bringing this report to the Board for information and to provide an opportunity for Board members to raise any specific issues they may have following the successful capital bid to NHSNE Capital Finance for the refurbishment and development of the two prisons’ healthcare centres (£500,000 grant for HMP Wakefield and £100,000 grant for HMP & YOI New Hall). The key points are: A capital grant of £600,000 has been secured by NHSCKW from NHSNE for the development of the physical operating environment (estate premises) of the two prisons’ healthcare centres; NHSCKW intends to allocate the grant to HM Prison Service to fund significant refurbishment of the healthcare centres, including the procurement of essential fixed medical equipment; The capital grant will help enable the implementation of new service delivery models in the prisons, i.e. intermediate care unit for HMP Wakefield and improved primary care unit for HMP & YOI New Hall; The strategic commissioning case for change is that the prisons’ healthcare operating environments are not fit-for-


purpose and this project aims to mitigate patient safety risks and to improve patient experience by providing care in a suitable and quality-driven clinical environment to facilitate service provision that is commensurate to those healthcare services a prisoner could expect to receive had she/he been living in the community as opposed to being in prison; Fit-for-purpose healthcare operating environments help to facilitate the shift of care closer to home, i.e. prisoners are able to be cared for in the prison as opposed to in hospital, and enables an appropriate and timely discharge from hospital back to prison; Delivers a number of key financial and non-financial (health) benefits, e.g. reduces spend on prisoners hospital escorts and bedwatches and supports the achievement of key health outcomes for this patient cohort; and The timeline to allocate the capital grant and the subsequent prison procurement projects to deliver the schemes are planned to align with the key competitive tender for a new intermediate care / inpatients service at HMP Wakefield and the introduction of telemedicine. Outcome of Equality Impact Assessment: Sub Group/Committee: Recommendation (s):

No groups will be disadvantaged as an outcome of the scheme. PCT/Prison Bilateral Partnership discussions and the Prisons Quality Board It is recommended that the Board: i.

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Purpose of Report

Is fully informed about the successful capital bid to NHSNE Capital Finance for the refurbishment and development of the two prisons’ healthcare centres (£500,000 grant for HMP Wakefield and £100,000 grant for HMP & YOI New Hall) and to raise any specific issues that they may have before the funds are allocated to the prisons.


We are bringing this report to the Board for information and to provide an opportunity for Board members to raise any specific issues that they may have following the successful capital bid to NHSNE Capital Finance for the refurbishment and development of the two prisons’ healthcare centres (£500,000 grant for HMP Wakefield and £100,000 grant for HMP & YOI New Hall). The key points of this report are: A capital grant of £600,000 has been secured by NHSCKW from NHSNE for the development of the physical operating environment (estate premises) of the two prisons’ healthcare centres; NHSCKW intends to allocate the grant to HM Prison Service to fund significant refurbishment of the healthcare centres, including the procurement of essential fixed medical equipment; The capital grant will help enable the implementation of new service delivery models in the prisons, i.e. intermediate care unit for HMP Wakefield and improved primary care unit for HMP & YOI New Hall; The strategic commissioning case for change is that the prisons’ healthcare operating environments are not fit-for-purpose and this project aims to mitigate patient safety risks and to improve patient experience by providing care in a suitable and quality-driven clinical environment to facilitate service provision that is commensurate to those healthcare services a prisoner could expect to receive had she/he been living in the community as opposed to being in prison; Fit-for-purpose healthcare operating environments help to facilitate the shift of care closer to home, i.e. prisoners are able to be cared for in the prison as opposed to in hospital, and enables an appropriate and timely discharge from hospital back to prison; Delivers a number of key financial and non-financial (health) benefits, e.g. supports the achievement of key health outcomes for this patient cohort, reduces spend on prisoners hospital escorts and bedwatches; and The timeline to allocate the capital grant and the subsequent prison procurement projects to deliver the schemes are planned to align with the key competitive tender for a new intermediate care / inpatients service at HMP Wakefield. 2.0

Background From 2004 through to 2006, responsibility for commissioning prisoners’ health transferred from the Home Office (now National Offender Management Service (NOMS) which is an agency of the Ministry of Justice (MoJ)) to the Department of Health (DH). At an operational and local level this meant the transfer of commissioning responsibility from HM Prison Service to the local Primary Care Trust (PCT) was effected for the two Wakefield prisons, i.e. HMP Wakefield and HMP & YOI New Hall, to Wakefield West PCT on 1st April 2005 (latterly NHS Wakefield District but now prison health commissioning is the responsibility of NHSCKW ‘direct commissioning’ and destined for the NHS Commissioning Board (NHS CB)).


The two prisons that we are responsible for commissioning health services for are very different: HMP Wakefield is a large, high security prison for men (located near to the city centre of Wakefield), and HMP & YOI New Hall for girls and women (located in Flockton, halfway between Wakefield and Huddersfield). This paper focuses on the development of the physical operating environment in the two prisons, specifically the locations where healthcare is delivered which are the healthcare centres. HMP Wakefield is a Victorian prison and HMP & YOI New Hall was built in the 60s so the estate, particularly the healthcare centres, are no longer fit-for-purpose as they are outdated and rather run-down. To enable NHSCKW to commission high quality health services in the prisons from our providers we are working with the respective prison governors to improve the operating environment within the broader ‘healthy prison’ concept. HM Chief Inspector of Prisons has four tests of a healthy prison and the criteria are: Safety – prisoners, even the most vulnerable, are held safely; Respect – prisoners are treated with respect for their human dignity; Purposeful activity – prisoners are able, and expected, to engage in activity that is likely to benefit them; and Resettlement – prisoners are prepared for their release into the community and helped to reduce the likelihood of re-offending. The current physical state of the two prisons’ healthcare centres does not support these tests adequately from a care environment perspective so a significant refurbishment and development scheme of the premises would go a long way in making a real difference to the day-to-day delivery of healthcare services. 3.0

Key Risks The key risks related to the current state of prison healthcare estate, and including risks to delivery of the project are: Current physical environment is not fit-for-purpose so there are risks in terms of patient safety, clinical risks, infection control risks, not being able to provide quality services effectively, and patient experience – mitigation is to improve the physical resources / operating environment to the required standard; Risk potential is political / media interest, particularly due to the high profile of Wakefield Prison but mitigation is that any procurement processes for refurbishment and buying equipment should be carried out by HM Prison Service in full compliance with EU Public Procurement Law / Public Procurement Rules / Public Contracts Regulations 2006; Risk to delivery of the project is the considerable business change required at the prisons but mitigation is robust project management of all key projects, including this one, and also the new physical operating environment and new intermediate care service at HMP Wakefield will be augmented by an innovative telemedicine scheme; and Board members to please note that the:


Key link to the Cluster Board Assurance Framework, specifically the financial risk associated with HMP Wakefield’s prisoner hospital escorts and bedwatches activity and the significant overspend – mitigation is that by commissioning enhanced healthcare provision in an improved and fit-for-purpose operating environment facilitates a shift from secondary care to primary care / intermediate care delivered in the prison reducing hospital stays and therefore the overspend on escorts and bedwatches. 4.0

Benefits The key benefits from having a modern, safe, quality-driven and fit-for-purpose physical environment are: Makes provisions for intermediate care which fills the existing gap between primary care and secondary care at Wakefield and makes provisions for excellent primary care in fit-for-purpose healthcare operating environments; Improved health of prisoners through better clinical management of long-term conditions leading to a reduction in the health inequality gap, especially in terms of patient experience in suitable clinical operating environments; Improved patient safety for prisoners, including improved safety of staff, with a reduction in serious incidents and no occurrence of ‘never events’ through improved access to better healthcare in improved physical surroundings; Developed integrated care pathways enabling seamless care between primary and secondary care and between health care and custodial care in appropriate care locations; Delivers against the NHS Outcomes Framework 2012/13; specifically: domain 2enhances quality of life for people with long-term conditions – enhancing quality of life for people with mental illness; domain 4 - ensuring that people have a positive experience of care especially improving people’s experience of out-patient care and improving experience of care for people with mental illness; and domain 5 - treating and caring for people in a safe environment and protecting them from avoidable harm; and Improved quality of healthcare delivery to deliver optimal sub-acute and intermediate care provision including meeting the Transforming Community Services (TCS) key indicators, i.e. ‘care closer to home’, ‘health and wellbeing’, ‘rehabilitation’, ‘long-term conditions’, and ‘end of life care’. Improved integrated case management for individual prisoner-patients in a fit-forpurpose clinical environment for improved continuity of care across the prison and local health systems; Better aligned health, social and custodial care delivery to meet the holistic needs of high security prisoners in a fit-for-purpose clinical operating environment; Fit-for-purpose healthcare operating environments help to facilitate the shift of care closer to home, i.e. prisoners are able to be cared for in the prison as opposed to in hospital, and enables an appropriate and timely discharge from hospital back to prison; and Delivers a number of key financial and non-financial (health) benefits, e.g. supports the achievement of key health outcomes for this patient cohort, reduces spend on prisoners hospital escorts and bedwatches.

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Next Steps


To allocate the capital grants to the prisons and work in partnership with the prisons and healthcare providers over the next 12 months to deliver the two respective projects with the purpose of improving the physical operating healthcare environments that will enable the PCT/Prisons Partnership to achieve the key objective of improving and developing the delivery of commissioned prisoner healthcare services. 5.0

Recommendations It is recommended the Board: i. Is fully informed following the successful capital bid to NHSNE Capital Finance for the refurbishment and development of the two prisons’ healthcare centres (£500,000 grant for HMP Wakefield and £100,000 grant for HMP & YOI New Hall) and to raise any specific issues before the funds are allocated to the prisons.

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Link to appendices - K:\Strategy\Danny Alba\Prisons Capital Bids Summary paper / short form business case to apply for a grant for HMP Wakefield; Summary paper / short form business case to apply for a grant for HMP & YOI New Hall; Equality impact assessment; and Letter of support from Dr Salim Meghjee, Consultant in Respiratory Medicine, Mid Yorkshire Hospitals NHS Trust.

CKWCB-12-137a_Prisons_Capital_Bids_Cluster_Board_Paper_12_June_2012_amended_6_June  

http://www.kirklees.nhs.uk/fileadmin/documents/meetings/12_June_2012/CKWCB-12-137a_Prisons_Capital_Bids_Cluster_Board_Paper_12_June_2012_ame...

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