HMP WAKEFIELD: Physical Education Officer: Neil Evans Older Persons Lead Nurse : Janet Richards

1. HMP WAKEFIELD: Physical Education Officer: Neil Evans Older Persons Lead Nurse: Janet Richards Meeting the needs of older prisoners and responding to the challenges of cardiac care in a high security prison.

2. Introduction to HMP Wakefield • Maximum Security Prison within the High Security Estate. • Established as a prison on this site since 1593. * • We currently hold 729 prisoners including 148 Category A’s & 4 High Risk. (Correct on the 8-10-15)

3. Facts & Figures In comparison with the prison population, HMP Wakefield has one of the oldest population with nearly 50% of prisoners over the age of 50! This comes as no surprise given the increasing historical sex offender population. Breakdown of age groups at HMP Wakefield at October 2015:

4. Opportunities/activities for the older population at HMP Wakefield cont…. GYMNASIUM • Sports & Social Club • Exercise Referral Scheme • Education (Disabilities, Dementia Awareness, Stress man, Sports qualifications) • Treatment of Injuries • Weight Management • Cognitive Care • Health & Wellbeing Events • Cardiac Care Supervised by Appropriately Qualified Staff.

5. Cardiac Programme…… Gymnasium/Healthcare Every Friday morning: Although not specific to the older population; they do pose a higher risk • A programme for those with specific cardiac issues. • Minimum 15 week programme. • Regular screening by Healthcare. • Circuit and Individualised progressive training programmes specific to strengthening the heart. • Education. STRICT CRITERIA; THE INDIVIDUALS CONDITION MUST BE STABLE.

6. Service Needs Analysis for Cardiac Care at Hmp Wakefield…… • Increasing prevalence of chronic disease/illness due to people living longer • Increasing number of hospital re-admissions following cardiac events • Security and high risk escorts, needs an upstream approach ( prevention is better than cure) • Issued guidelines for PE departments dealing with prisoners experiencing known cardiac issues accessing gym facilities. PE Bulletin (2009) • Inequalities between community and custodial services

7. Barriers to Implement Cardiac Care in a High Secure Estate……… • Lack of partnerships between clinical and exercise professionals • Lack of qualified/dedicated personnel to deliver service requirements • Adapting community services to fit into a prison environment/regime • Difficulties experienced between care v custody • Engaging prisoners due to a lack cardiac education • Engaging managers to ‘Buy in’ to the service • Funding to deliver and maintain cardiac care services

8. Implementation….. • Received funding from the British Heart Foundation (BHF) to employ a cardiac specialist nurse for 2yrs. • A member of the PE team received funding from the establishment to gain the necessary qualifications • ‘Memorandum of understanding’ was developed between the contracted healthcare services (spectrum) and the establishment to ensure multi-disciplinary approach to the service. • Scheduled exercise and clinical appointments allocated within in each discipline • Partnership working with community services to ensure quality assurance • Linking services to National Resettlement Pathways to maintain sustainability and drive forward change

9. Acute Cardiac events reduced by 60% within 4 years Blueprint for the service has been established and endorsed by the BHF for other prison establishment Recognised as profiled work within the establishment Empowered and educated patients/prisoners to take responsibility for their own health Prisoners actively engaging with the service (mentors etc) National recognition across the healthcare, community and prison services (BJN, BHF, NOMS, Spectrum) Multi-agency working across cardiac services to develop a better understanding of the prison/patient restrictions Linked to National Pathways to maintain sustainability and raise the profile of this service …Success!!!!

10. ….HMP Wakefield Cardiac Care Thank you for your time.