Prison mental health
HM Inspectorate of Prisons last week published a major report on the mental health of inmates. It concluded that the needs of prisoners with mental health needs were still not being met, even though the NHS had taken over responsibility for care.
The report made the following key recommendations:
1) The Department of Health, through the Care Service Improvement Partnership, should issue commissioning guidance to local PCTs to try to ensure that there is sufficient proactive support, case management and care in the community for those with multiple needs that include mental health needs, as well as provision of sufficient secure and acute mental health beds.
2) There should be a national service specification for court diversion and liaison schemes that specifies funding, governance, services, staffing, location and accountability, and that requires monitoring by ethnicity, disability and gender.
3) There should be a blueprint for delivering mental healthcare in prisons, which ensures appropriate support and governance for mental health staff and which specifies the services required, based on the complex needs of those in prison, including the specific needs of women and black and minority ethnic prisoners, drawing on the detailed recommendations in this report.
4) The Department of Health and the National Offender Management Service should ensure that commissioning arrangements, protocols and guidance to staff emphasise and support joint working between mental healthcare services and other services and staff in prisons, to ensure the delivery of coordinated care and management for each individual prisoner.
5) Reception screening in prisons for mental health needs should be improved and consistently implemented, so that those who may have previously undisclosed mental or emotional problems, and those with learning disabilities, can be professionally assessed and appropriate mental health and/or other interventions put in place.
Unions and NHE Employers last week agreed a series of proposals on minimum standards for long-term sick leave and retirement as a result of ill-health.
The joint proposals, which are out to consultation for three months, include the following:
1) The introduction of a two-tier payment system for ill health retirement benefit with those unlikely to ever work again due to ill health receiving greater benefits than those who have a reasonable prospect of finding alternative work
2) New minimum standards for employers around managing sickness absence ensuring employers support staff who are off sick, offering them options including phased return, redeployment to another job and access to services such as physiotherapy and cognitive behavioural therapy
3) Creating the right financial incentives for employers to help staff to stay in work by recharging them the cost of ill health retirements by their staff (currently borne by the NHS Pension Scheme)
4) Ensuring there are clearly defined roles for line managers making them responsible for recognising health problems at an early stage and taking appropriate steps to minimise their impact, working closely with the staff member, HR, occupational health departments and senior managers.