On the record – June 2014

Half of all those sentenced to custody are not registered with a GP before they go to prison. NHS England, (the organisation that oversees prison health) is aware that prisoners are more likely than the general population to have poor health and are working to improve their situation.

Someone should be able to easily get medical treatment in the community then in prison and then again on release. This is called ‘continuity of care’. Prison Service Order 3050 Continuity of Healthcare for prisoners explains that if a prisoner is not registered with a GP in the community, then the prison health care service must help the prisoner register with one before release. Prisoners should also be provided with contact details for local services such as GP surgeries, walk in centres, drug agencies, Samaritans and NHS Direct. However, a 2010 inspection report by the Inspectorate of Prisons and Care Quality Commission found that of a sample of 21 Primary Care Trusts, only one had a policy in place to ensure continuity of healthcare during transfer and release, and that the situation seems to be getting worse rather than better.

At the moment, someone in prison is automatically de-registered from their outside doctor after 2 years. This is due to change in 2016, when a new system will come in. It is hoped this will mean better continuity of care. Under the new system, prisoners will be asked during the reception process whether they would like to register with the prison GP practice. If they do, the medical records from their community doctor would be brought into the prison. The prison healthcare team should also help the person leaving prison to register with a community GP when they are released.

If the prisoner chooses not to register with the prison GP, they would continue to receive treatment from the prison healthcare team as usual but would still be automatically de-registered from the outside GP after 2 years. Even though these prisoners would technically be counted as being non-registered (including not being registered with the prison) they should still get assistance to register with a GP when they are being released.

In working for better engagement of prisoners with services, we also support the promotion of the health trainers’ programme and having elected prisoner health representatives and peer support and advocacy groups.

Generally the prison GP or the community GP can’t access medical records without someone’s permission. However, there are exceptions and if there is a risk of harm to the patient or it is felt to be in their best interests, the records can be shared without permission.

Currently, when a prisoner gives permission for information to come from the outside GP, this is recorded on the community system and is there when they are released and register outside. Similarly, when someone on release registers with a new GP they will be asked for their previous address to obtain medical records. If this is provided, the new GP will therefore know they have been in prison. This may result in people having the ‘prison’ label with them for life in their health records.

We are interested in finding out any views you have on this, or any good or bad experienced registering with a doctor. Have you found that doctors in prison had access to your previous medical records? Do you have any concerns about a community GP knowing that you have been in prison?

 
from insidetime issue June 2014