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Partnership scheme focuses on prison healthcare


Project Echo NI logoAn innovative partnership scheme is helping prison staff across Northern Ireland deal with a number of healthcare issues within the prison population, including self-harm and palliative care.

Originally developed in New Mexico, Project ECHO® involves the use of videoconferencing technology to bring clinicians together to participate in guided practice discussions with specialist mentors.

Funded by the Health and Social Care Board, Project ECHO® Northern Ireland is being used to bring prison and healthcare staff together from all three of Northern Ireland’s prisons – Magilligan, Magheraberry and Hydebank Wood College – via video conferencing to share best practice and receive specialist advice from experts in health and justice.

Those taking part in discussions across all three prisons – known as ‘spokes’ –  acquire new skills and support from specialists who come together in a central ‘hub’. They include specialists in palliative care, hepatitis and self-harm and staff have also be able to learn from the experiences of those working in other UK prisons, including HMP Whatton in Nottinghamshire and HM Prison Cardiff.

Since 2008 the South Eastern Health and Social Care Trust has provided a range of healthcare services in all three Northern prisons.

ECHO® facilitator for Prison Healthcare, Ruth Gray, explains how the initiative works.

“Prison is a complex place to work; there are a high number of people with a lot of social and health needs and staff are often under significant pressure providing clinical care. The Project ECHO® pilot enabled a multidisciplinary group of healthcare staff from the South Eastern Trust and prison staff to meet at each ‘spoke’ so they can work together to create a safe and compassionate environment for people in custody and staff.

“Project Echo allows space for collaboration and partnership, and to ask how services could be improved. It has also broken down a number of silos, including geographical isolation.”

To date topics have included issues related to self-harm and blood borne viruses as well as palliative care, as the prison population ages.

Around 60 people attend each session, with a diverse range of staff participating, including senior staff and frontline prison officers as well as primary health care nurses, nurse managers, dentists, voluntary agency representatives, commissioners and inspectorate staff, without having to leave their work premises.

“It is a model to get people to engage from a lot of different disciplines, giving people the space to share, to learn from good practice and to be challenged in what they are currently doing and what could be done better.  In a supportive environment people can be open and honest, with the intention of asking what would ‘better’ looks like, and how can we improve. It has built capacity to do things better;  building a culture of positive reflection which will start to focus on outcomes for the benefit of those people we care for,” she said.

Feedback from participants has been positive, with many of them describing it as ‘hugely beneficial”, “an excellent project” and “an invaluable opportunity to learn from clinical experts and share knowledge across the network with the aim of improving our systems and patient outcomes”.

Hub facilitator, Paul Donaghy, says it is an innovative and dynamic way to break down barriers and help build capacity among staff.

“There is greater cultural understanding between two different services and by linking healthcare staff with prison staff it is definitely connecting the service together. The team are more focused, working collaboratively and best practice is regionally focused so all of these will be of benefit to people in custody in the long term.

It is anticipated that if evaluated as beneficial to patients and staff the initiative will be replicated in other prison settings.