The Pharmaceutical Journal
Vol 271 No 7257 p37
12 July 2003

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'A pharmacy service for Prisoners' (PDF 490K)
'A pharmacy service for Prisoners': questions & answers (PDF 110K)
Prison healthcare: Pharmacy services for prisoners (PDF 90K)
HM Prison Service (www.hmprisonservice.gov.uk)

Prison pharmacy services in England need to be brought up to NHS standard

Pharmacy services within prisons in England need to be brought up to standards equivalent to those within the National Health Service over the next three years, according to a new report. During this period, primary care trusts (PCTs) with prisons in their areas will take responsibility for commissioning health care for prisoners.

Funding for health services within English prisons was transferred from the Home Office to the Department of Health in April this year. There are 137 prisons, and pharmacy services are provided in a number of ways. In-house pharmacy departments serving major prisons and smaller units that are part of "cluster groups" make up three-quarters of the service. The rest are contracted out to local hospitals, community pharmacies or pharmacy companies.

The report, "A pharmacy service for prisoners", was drawn up by a joint Department of Health and HM Prison Service team. It says that at present pharmacists and their staff within prisons "tend to be isolated, both from the health care staff within the establishments they serve and other prison pharmacy service providers". As a consequence, services are "fragmented and have largely pursued an individual, independent and largely uncoordinated course". There are pockets of excellence but the services they provide fail to spread to other prisons. To overcome this, the DoH is to fund regional pharmacy development leads who will have responsibility for putting many of the report's recommendations into practice.

Joe Asghar, regional pharmaceutical adviser for the NHS Executive's Northern and Yorkshire office, was one of those consulted by the team drawing up the report. He said that the report gives those involved a chance to take stock of what is happening and what needs to change. Development of the prison pharmacy service is part of a wider development of the health service within prisons as a whole.

"Prisoners have the same rights to self-care and health as the general public, taking custodial issues into account," Dr Asghar said. He believes that there is unlikely to be any one-size-fits-all model for reformed services because different prisons have different needs. "PCTs will have to understand how the prison health service operates and how it can be brought into alignment with the NHS. It will be a challenge for all concerned."

Sharon Kebell, pharmaceutical adviser to Durham and Chester-le-Street PCT, said that the PCT had set up a working group which includes pharmacists from HMP Durham. "The PCT recognises its role in prison health but work is at an early stage."

The report says that the aim is to move to a patient-focused service where pharmacists and their staff provide a greater level of clinical advice to prisoners. In general, prisoners should be able to take responsibility for their own medication (if appropriate) and to have access to pharmacy services similar to those provided in primary care, both in terms of dispensed medicines and access to medicines for self-care.

To support better prescribing within prisons, pharmacy information technology needs to be upgraded and repeat prescribing and dispensing systems established in parallel with those in the NHS. The courses of medicines for prisoners to have in their own possession should be standardised through a move to patient packs, the report advocates.

In total, the report makes 29 recommendations. These are concerned with bringing the prison pharmacy service up to NHS standards and with ensuring that pharmacy staff have the support, standards and personal and career development they need.

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