Managing people suspected of concealing drugs internally in the secure environment.

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Coroner’s Inquests are one of the greatest worries for healthcare workers in secure environments. Frequently, they are perceived as being quite distressing for healthcare staff as their practice can be dissected in minute detail, sometimes in front of a Jury, other colleagues, members of the deceased’s family and a number of barristers.

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When a person voluntarily stops eating food this is known as food refusal. If they voluntarily stop drinking fluids, it is known as fluid refusal.

This resources looks at practical considerations for managing food and fluid refusal in UK secure settings.

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Across the UK prison estate, there is a high prevalence of chronic illness, particularly among older people.

The Quality and Outcomes Framework (QOF) nurse-led model of care used for LTC management in community general practice provides a structured systematic approach which can be adapted well to stable populations in the secure estate.

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Community drug treatment services can supply naloxone without a prescription for ‘saving life in an emergency’ and prisons have a responsibility to provide harm reduction measures that are equivalent to the community. Training in naloxone use prior to release and provision of naloxone at the point of release is an achievable harm reduction measure.

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High-quality health screening is an important part of providing equivalent care in secure environments since risk factors for cardiovascular disease are more common than in the general population, partly due to health inequalities associated with deprivation and partly due to adverse lifestyle choices.

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Guidance on working with people with a diagnosis of personality disorder in secure environments.

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Patients experiencing psychosis may present with unpredictable behaviour, posing a risk to themselves and to others. Specialist assessment and individualised care planning is essential, however it is not uncommon for teams providing primary care or drug and alcohol treatment in prison to encounter patients who are unwell with acute psychosis.

This brief guidance covers the basic principles of prescribing and monitoring.

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Segregation, special accommodation, isolation, care and separation, removal from association, solitary, close supervision centres, cellular confinement or ‘the block’ all refer to regimes where people are physically isolated and deprived of meaningful contact with others.

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People experiencing Severe Mental Illness die on average 15-20 years earlier than the general population due to preventable physical health problems. It is important to ensure that these patients receive high quality health promotion and physical health care.

This resource provides guidance on monitoring the physical health of patients with severe mental illness in prison.

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The primary care team is well-placed to support families of those in contact with the criminal justice system through the challenges of this experience.

This resource provides guidance for supporting families of people in contact with the criminal justice system.

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This resource looks at how the primary care team can support patients and their families at the risky time of approaching court or entry into prison.

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Release from prison represents the start of a period of increased risk for patients but it can also be the start of a new pathway in life. The community primary care team is ideally placed to influence and support patients to achieve their goals towards transformation and improved health outcomes.

This resource provides guidance and tips on how to support people when they are released from prison.

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This resource looks at the principles of trauma informed care of the person being cared for within a context of safety, choice, collaboration, empowerment and trust.

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Further resources from the RCGP Secure Environments Hub are available. Click here