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St George’s provides primary care and substance misuse healthcare services at HMP Wandsworth. HMP Wandsworth is a category B male prison and is the largest prison in the UK with a certified normal accommodation of 1,665 offenders.

Offenders are less likely to have accessed health services before getting to prison and are more likely to suffer from long term chronic conditions than non-offenders. There is also a higher rate of mental health conditions and addictions amongst offenders when compared to the general population.

Poor medicine management has historically been identified as a recurring theme in serious incidents reported at the prison. We are committed to improving the health of offenders and to reducing the risk of serious harm or illness through conducting medication risk assessments and developing better systems for helping offenders manage their medication.

Polypharmacy clinic

A new polypharmacy clinic was introduced at HMP Wandsworth in August 2012 as a pilot scheme. The clinic reviews offenders who are in receipt of a complex medication regime of five medications or more. Our aim for 2012/13 was to hold a polypharmacy appointment with 70 per cent of offenders who met the criteria for this.

124 prisoners met the criteria for requiring a poly-pharmacy review during 2012/13. All were offered an appointment and 99 out of 124, or 80 per cent, attended a polypharmacy clinic appointment, meaning that we achieved our target.

In-possession medication risk assessments

Medication for offenders is provided in two main ways

  • In-possession medications, where a prisoner is given a supply of medication to self administer in their cell.
  • Non-in possession medications, the offender goes to a medication hatch and receives their medication under supervision.

Where it is appropriate offenders undergo a risk assessment to hold their medications ‘in-possession’. Holding medications in-possession is a positive step in assisting offenders to take responsibility for their health. 295 offenders were assessed between January to March 2013 for in-possession medications and 88 per cent of these received their medications in-possession. This means that we also met another CQUIN target which was to have over 80 per cent of offenders risk assessed for in-possession medication.

Following the successful pilot of the polypharmacy clinic, we have made the decision to keep the clinic running indefinitely, and will continue to offer appointments to all offenders who meet the criteria.

We will also continue to promote the use of in-possession medications where appropriate after reviewing risk assessments of relevant offenders.

During 2013/14 we will also complete phase two of the SystmOne electronic prescribing and administering work programme, and will finalise the establishment of processes up for the identification and monitoring of prescribing patterns. Both of these will help us to further improve medication management in HMP Wandsworth.