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Action for Prisoners ’ Families Families of Older Prisoners Seminar 11 July 2013

Action for Prisoners ’ Families Families of Older Prisoners Seminar 11 July 2013. End of life care at HMP Frankland Gill Scott, Macmillan Prison Project Jackie Hall, HMP Frankland. Improving the Standards of Cancer Palliative and End of Life Care in the Prison Service Project.

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Action for Prisoners ’ Families Families of Older Prisoners Seminar 11 July 2013

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  1. Action for Prisoners’ Families Families of Older Prisoners Seminar 11 July 2013

  2. End of life care at HMP Frankland Gill Scott, Macmillan Prison Project Jackie Hall, HMP Frankland

  3. Improving the Standards of Cancer Palliative and End of Life Care in the Prison Service Project Gill Scott Macmillan Prison Project Lead Jackie Hall Family Liaison Officer HMP Frankland Action for Prisoner Families Conference July 2013

  4. Aim • North East Palliative, End of Life Care Project • Role of the Family Liaison Officer • End of Life Care in Prison DVD

  5. National Drive High quality equitable care should be available wherever the person may be: at home, in a care home, in hospital, in a hospice or elsewhere. End of Life Care Strategy (2008)

  6. National Drive As the prison population ages, the number of deaths from chronic disease or simply old age is expected to rise. Learning from PPO Investigations End of Life Care (2013)

  7. Natural Deaths • January 2007 to October 2012 the PPO investigated 647 natural deaths in prison • A disproportionate percentage of prisoners, compared to the prison population as a whole, were in a high security prison when they died (19% compared to 7%).

  8. Improving the Standards of Cancer Palliative and End of Life Care in the Prison Service Project North East Drive 2010-2013 • Implement prison service model for palliative and end of life care into the North East Cluster of 7 prisons. Including development of palliative care pathways and standards of care to ensure equivalence • Development of in reach services • Confident and competent workforce

  9. Progress • Macmillan Adopted Prison Standards MAPS • Prison Health and Discipline Champions • Palliative Care Registers • Education Adapted End of life care tools • Policy development • Prisoner working groups – Education, DVD, patient information • Improving the Environment • Chemotherapy pilot • Macmillan National Conference End of Life Care in Prisons • Prison palliative care teams - FLO

  10. Family Liaison Officer Palliative CareFrankland Model Involving families in the end of life care process is a key part of an end of life pathway and should ideally happen at the earliest stage in a prisoner’s terminal diagnosis Learning from PPO Investigations End of Life Care 2013

  11. Family Liaison Officer Palliative CareFrankland Model • Palliative Care Register • Introduction to the patient • Family point of contact • Supported visits • Multidisciplinary team • Care after death

  12. Challenges for Families • Communication • Specific needs • Children and elderly relatives • Prison protocol • Financial challenges

  13. Challenges There is evidence that death in prison is perceived as something to be avoided, the notion of a “good death” is counterintuitive to some staff Prof Sheila Payne (2010)

  14. Challenges • Culture and attitude • Fear of external criticism • Prison regime – personalised care • Prescribing – drug issues • Wing – prisoner and staff support • Environment • 24 hour care • Access to family • Access for outside agencies • Staff knowledge and experience • Competing priorities

  15. Outcomes • Earlier identification • Patient centred care – improved choice • Improved support for family/ significant other • Appropriate communication , timely referral -ERCG • Key worker • Opportunities to advance care plan • More patients dying in their preferred place of care • Less inappropriate admissions to hospital • Increased use of end of life care tools • Skilled and confident workforce • Improved partnership working

  16. National Drive “How we care for the dying is an indicator of how we care for all sick and vulnerable people. It is a measure of society as a whole and it is a litmus test for health and social care services”. The End of Life Care Strategy ( 2008)

  17. Thank you for your attention g.scott3@nhs.net Jackie.hall@hmps.gsi.gov.uk

  18. References • DoH (2008) End of Life Care Strategy-promoting high quality care for all adults at the end of life. Department of Health, London • Prison and Probation Ombudsman Learning Lessons End of Life Care Report (2013) • Turner, M. (2011) Dying behind bars an evaluation of end of life care in prisons.

  19. Action for Prisoners’ Families Families of Older Prisoners Seminar 11 July 2013 www.prisonersfamilies.org.uk

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