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					                                                     Health Care Standards
                                                      Evidence Template

Health Care Standard 10
Prescribing for Cinical Management of Drug and Alcohol Dependency

Element                  Statement                       Evidence Required          Evidence               Yes /
                                                                                  Demonstrated              No
10.1.1      A nurse carries out an assessment        Health Care Records     Written entry in Health      *Yes /
            of Addictions of all prisoners on the                            Care Record                  No
            day of arrival in prison.
10.1.2      There is evidence that the               Health Care Records     Written entry in Health      *Yes /
            assessment aims to: inform the                                   Care Record                  No
            prisoner, provide an assessment of
            their clinical state, a risk of their
            current addictions and withdrawal
            and to stabilise their condition.
10.1.3      Prisoners who bring injecting            Release protocol        Confirmation. Sight of.      *Yes /
            equipment with them into prison; if                                                           No
            unused, have their equipment stored
            for return on release, or if used have
            it removed and destroyed and a
            new, clean set, issued on release.

10.2.1      There is evidence of further medical     Health Care Records     Written entry                *Yes /
            and nursing clinical assessment                                                               No
            following initial assessment on
            reception to prison including future
            addiction related options and
            interventions.

10.2.2      There is evidence that prisoners         Health Care Records     Confirmation from sight of   *Yes /
            already on a regular substitute          Prescription sheets     written records              No
            medication programme have the
            opportunity to continue treatment in
            prison

10.2.3      There is evidence that prisoners who     Health Care Records     Written entry                *Yes /
            are not in established contact with a    Prescription sheets                                  No
            community drug problem service or
            equivalent are offered treatment to
            stabilise their condition.

10.2.4      There is evidence of a self referral     Self Referral process   Sight of self referrals      *Yes /
            system for prisoners remaining in                                                             No
            prison for over one month




          ST241006JP HCSe10
10.2.5     There is evidence that prisoners        Assessment process    Sight of assessments and      *Yes /
           who are remanded will be assessed       Health Care Record    health records                No
           along with available reports and        Community Reports
           information from community
           agencies

10.2.6     There is evidence that prescribers      Prescribing sheets    Sight of written entry        *Yes /
           record: medical contra-indications      Health Care Records                                 No
           and take appropriate actions, adjust
           drug dosage and duration to reflect
           a patients particular circumstances;
           and adjust substitute opiate dosage
           when a prisoner has taken
           dihydrocodeine while in custody

10.3.1     There is evidence that prisoners        Health Care Records   Sight of                      *Yes /
           who are established and stable on a     Prescribing sheets                                  No
           substitute programme for their
           opiate dependency in the
           community have their programme
           continued in the prison (subject to
           conditions).

10.4.1     There is evidence that motivated        Protocol              Observing protocol, ask       *Yes /
           prisoners can commence a                Health Care Records   nursing staff.                No
           substitute programme in prison
           following a thorough clinical                                 Sight of.
           assessment (subject to conditions).

10.5.1     There is evidence that drug             Prescriptions         Sight of written record       *Yes /
           treatment progress is reviewed by       Health Care Records                                 No
           addictions team and prescriber          Addiction team        Confirm with Addiction team

10.5.2     Drug treatment progress reviews         Notes , minutes of    Sight of                      *Yes /
           are pre-arranged, while testing and     meetings.                                           No
           adhoc assessment will occur at          Health Care Records
           various times, including times
           without prior notice

10.5.3     There is evidence that specimen         Health Care Records   Sight of                      *Yes /
           testing for opiates and other                                                               No
           substances is consistent with the
           strand of testing (APT) programme.

10.6.1     There is evidence that Opiate           Health Care Records   Sight of                      *Yes /
           Substitute programmes are curtailed                                                         No
           or stopped following clear and fair
           decision making processes.

10.7.1     There is evidence that detoxification   Health Care Records   Sight of                      *Yes /
           programmes exists following clinical                                                        No
           assessment, clear decision making
           processes and available support

10.7.2     There is evidence that prescribers      Prescriptions         Sight of                      *Yes /
           follow protocols for withdrawal         Health Care Records                                 No


         ST241006JP HCSe10
           regimes set out in Appendices 2,3
           and 4 of Standard

10.7.3     Prisoners are given an explanation      Health Care Record       Written entry                  *Yes /
           about the likely duration of a course                                                           No
           of withdrawal programme at the          Prisoner contact         Confirmation from prisoner
           start and, if reviewed, at the mid-
           point.

10.7.4     There is evidence that detoxification   Health Care Record       Written evidence               *Yes /
           treatment programmes have no set        Prescriptions.                                          No
           maximum number                          Addiction staff          Confirmation from addiction
                                                                            team
10.8.1     There is evidence that female           Health Care Records      Sight of                       *Yes /
           prisoners with an addiction who may                                                             No
           be pregnant are viewed as a top
           clinical priority

10.8.2     Medical staff engage in effective       Discussion with Health   Confirmation from Healthcare   *Yes /
           joint clinical management by liaising   care professional        professionals                  No
           with lead clinical specialist in the
           community.                              Health Care Records      Sight of

10.9.1     Prior to liberation there is evidence   Health Care Records      Sight of                       *Yes /
           to support communications between                                                               No
           local healthcare staff and
           community treatment providers for
           short term prisoners staying in
           prison less than three months.

10.9.2     There is evidence to support            Health Care Records      Sight of                       *Yes /
           consideration for a drug substitution   Prescriptions                                           No
           programme for prisoners staying for
           at least three months if a community
           prescriber is willing to continue the
           treatment.

10.9.3     There is evidence of a structured       Health Care Record       Sight of                       *Yes /
           planning assessment for long term                                                               No
           prisoners and those staying for a
           period of over 6 months

10.9.4     Prior to liberation there is evidence   Health Care Records      Sight of                       *Yes /
           of effective communication between      Note of                                                 No
           prison prescriber and community         meeting/discussion
           prescriber to confirm care
           arrangements and continue
           substitute prescribing.

10.9.5     There is evidence that a member of      Health Care Records      Sight of written entry         *Yes /
           the addiction management team           Appointment process                                     No
           secure an immediate appointment in
           the community prior to a prisoners
           release to support substitute
           prescribing and addictions
           management.


         ST241006JP HCSe10
10.9.6     Local protocols are in place in each    Local Protocol               Sight of                        *Yes /
           establishment to support continuing                                                                  No
           addictions management, including        Health Care Record
           liaison between prison-based            Notes of discussion /
           prescribers and the addictions          meeting
           service provider in the community
10.9.7     There is evidence of effective          Transfer documentation       Sight of                        *Yes /
           transfer of relevant care information                                                                No
           to the community provider and / or      Health Care Records
           addictions service provider.

App.       There is evidence that all prisoners    Health Care Records          Written entry                   *Yes /
5.1        are interviewed on their alcohol use                                                                 No
           with a view to defining potential
           problems

App.       There is evidence that prisoners        Health Care Records          Written entry                   *Yes /
5.2        reporting problems with alcohol are                                                                  No
           offered a range of interventions,       Guidance on                  Sight of guidance, policy and
           treatments and support to improve       Interventions, support and   environment
           their understanding and assist them     treatment opportunities
           manage complications or
           dependency problems.

App.       There is evidence to support that       Health Care Records          Sight of                        *Yes /
6.1        prisoners who smoke are                 Health Promotion material                                    No
           encouraged to address their
           addiction

App        Prisoners who want to give up           Health Care Records          Sight of                        *Yes /
6.2        smoking and who are expected to                                                                      No
           stay for a further 6 months or more
           are offered support subject to
           available prison resources.

App        There is evidence that prisoners are    Behavioral programmes        Sight of                        *Yes /
6.3        offered learning and behavioural                                                                     No
           programmes to develop ways of           Health Care Records
           controlling consumption and building
           resilience to offers of tobacco.

App.       There is evidence that smoking          Health Care Records          Sight of                        *Yes /
6.4        related health complications are                                                                     No
           sought through normal clinical
           consultation.


         * Please delete as appropriate
         Comments
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         Signed ……………………………………………………


         ST241006JP HCSe10
Dated …………………………………………………….




ST241006JP HCSe10

				
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