IADPC’s Spring 2024 newsletter

The Independent Advisory Panel on Deaths in Custody’s (IAPDC) Spring newsletter (link) provides an overview of the key activities over the past few months.

OHID substance misuse leads issue information

Following a Medicine Supply Notification issued by DHSC on 3 April 2024 about a national shortage and proposed discontinuation of parenteral (injectable) forms of Pabrinex, there has been concern among clinicians treating alcohol dependence and withdrawal in secure environments. OHID substance misuse leads have now issued the following information:

“…Clinical guidance for use in alcohol dependence is still being worked up but the consensus advice of leading clinicians is that, as and when you run short of Pabrinex, you simply replace it with an equivalent dose of injectable thiamine, ie 200-300mg thiamine for 1 ampoule/pair Pabrinex (which contains 250mg thiamine). This will mean you sourcing appropriate supplies of thiamine when they are needed.

The Medicines Supply Team in DHSC is working to ensure that thiamine stock is available in this country but, where stock is from imports of formulations not licensed in the UK, (it will need to be individually prescribed because) PGDs cannot be used for unlicensed products.“

The Independent Advisory Panel on Deaths in Custody (IAPDC) have published the latest statistical analysis of recorded deaths in custody between 2017 and 2021.

Some key findings from the report include:

• People in custody are at a significantly elevated risk of death compared with the general population.
• While numbers of deaths in police custody remain low, its rate of death is comparable to prisons and detention under the Mental Health Act, if the approximate length of time spent in detention is factored in
• Prisons have the highest number of deaths, with an average of 322 per year over the five-year period.
• When rates are considered, people detained under the Mental Health Act have the highest mortality rate across custody, including three times higher than prisons.
• People in custody under the age of 40 have the highest rate of suicide and other unnatural deaths.
• Men continue to have a significantly higher rate of overall deaths across all custody settings, particularly in prisons and police custody.

An important webinar on Health and Justice Continuity of Care (CoC) of medicines will be held on Thursday 18th April 2024 from 2:00pm – 3:30pm.

This online event will provide an opportunity to discuss the briefing findings, best practices, HMPPS systems and processes, SEAT templates used for recording medicines and prescriptions supplied for release and transfers and a pilot scheme for improving the security of medicines and prescriptions during transport. 

The webinar is for colleagues (NHS, healthcare providers, HMPPs, etc.) who are keen to learn more about:

• CoC briefing and key actions identified.
• HMPPS – End of Custody Supervised Licence (ECSL) and Fixed term recall (FTR) schemes; using BaSM and dPER systems.
• Sharing best practice in medicines supply for continuing care: Achieving practice Improvement and operational tools. 
• Using SEAT templates for release and transfer.
• HMP Bullingdon evidence bag pilot. 

Speakers include: Tim Allen (Prison Group Director – Capacity Gold) and Roy Stevenson (Deputy Head Prisoner Escort and Custody) from HMPPS; NHS England HJ CoC; and colleagues showcasing good practice from HMP Winchester, Spectrum CiC and HMP Bullingdon.

The webinar will conclude with time for questions from the audience. 

The World Health Organisation (WHO) International Conference: Mental health and wellbeing in detention centres: prison health is public health is being held in Amsterdam 18-19 April 2024.

There will be livestream plenary sessions from the conference, to allow for as many people as possible to join the event. Follow the stream using the link below, and feel free to share the link with other stakeholders to benefit from this important gathering. 

Day I: Thursday, April 18

• 09:00 – 09:30: Official opening
• 09:30 – 09:50: Keynote I | Criminal justice and mental health: international and Dutch perspective by Michiel van der Wolf
• 09:50 – 10:10: Keynote II | Mental health and human rights in detention centres by Elena Kountouri Tapiero
• 10:10 – 10:30: Keynote III | Meaningful engagement of people with lived experience by Piet Broenland
• 10:30 – 11:00: Coffee & tea break
• 11:00 – 12:00: Plenary theme session I: Epidemiology and risk factors of mental health and wellbeing in detention centres (Elena Leclerc, Daniel Lopez Acuna, Filipa Alves da Costa and Liesbeth Vandam) 
• 12:00 – 16:45: No livestream
• 16:45 – 17:15: Summary report & closing remarks

Day 2: Friday, April 19

• 09:00 – 10:00: Effective strategies in health promotion and disease prevention for mental health and substance abuse in detention centres (Thomas Martinelli, Anja Busse, Éamonn O’Moore and Maha Aon)
• 10:00 – 10:30: Coffee & tea break
• 10:30 – 11:30: Effective treatment and rehabilitation strategies in mental health and substance abuse in detention centres (Heino Stöver, Ledia Lazeri, Kate Davies and Joost Walraven)
• 12:00 – 15:25: No livestream
• 15:25 – 16:00: Summary report, poster award & closing remarks

Workstreams include: 

• Working collaboratively to improve investigations into, and data on, deaths under the Mental Health Act.
• Responding to the prison capacity crisis which has seen diminished access to purposeful activity, time out of cell, and key work.
• Building on the key strategic recommendations of the Angiolini review into deaths and serious incidents in police custody.
• Focusing on improvements to the operation of key safeguards in the immigration detention estate, in particular Rules 34 and 35, to improve the protective mechanisms for those who are most vulnerable.

The updated guidance for health professionals published on 20/03/24 covers:

• Clinical diagnosis of measles and differential diagnosis
• Management of suspected or confirmed measles
• All ages across all healthcare settings

The British Association for Sexual Health and HIV (BASHH) publishes its new Standards for the Management of Sexual Health in UK Prisons.

“The Standards for the Management of Sexual Health in UK Prisons have been created to promote and support the equity of sexual healthcare for those in UK prisons. Those in prison should have rapid access to sexual health care; appropriate assessment of their sexual health needs with the most appropriate tests and timely results; their confidentiality should be maintained; they should receive good quality services from adequately trained staff; and where needed, be referred on to other specialities. To fully understand the barriers faced and the needs of those affected, people in prison need to be included in the development of sexual healthcare services in prisons.

The standards will support commissioners, healthcare providers and those in prison to ensure sexual health care provision in prison settings mirrors that of the community. Additional measures are outlined in the standards to promote equity of care, such as opt-out screening for blood borne viruses on arrival and further discussion at 14 days. Screening on arrival at each secure unit will help overcome the rapid turnover and sometimes frequent movement of those in prison.”

— Forward, Standards for the Management of Sexual Health in UK Prisons, BASHH

We are thrilled to announce that the winning poster submission from the 10th Health and Justice Summit (2023) was Joelle Booth’s “Co-producing a Film Showcasing the Dental Experiences of Community Returners (Ex-offenders)” poster.

Joelle and colleagues based their poster on the fantastic work they had done to co-produce a film that would showcase the dental experiences of community returners, in a bid to stimulate conversation, change perceptions and inform oral health research priorities.

Congratulations to Joelle and all the other contributors to this project and poster.