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GP practices piloting pre-registration of prisoners due for release

Practices are set to pilot a pre-release registration scheme for prisoners, in an effort to maintain continuity of care.

The pilot scheme, which will launch over the summer, will see prisoners in Sheffield registered with a GP near the prison up to one month ahead of their release.

GP leaders have welcomed the pilot, saying it will ensure GPs are ‘fully equipped’ when ex-offenders visit the practice.

The pilot scheme, which will be rolled out across the country by 2020, follows negotiations by the BMA’s GP Committee over changes to the GP contract in 2017/18 that allowed for the pre-registration scheme to be implemented.

According to the contract changes last year, the scheme will have ‘an emphasis on medication history and substance misuse management plans, to enable better care when a new patient first presents at the practice’.

The 2017/18 GMS guidance states that the preferred practice will be notified by telephone and recieve a signed GMS1 registration form ’up to one month prior to the date of release’, adding that there is ’no need for the patient to attend the practice for the purposes of registration’.

This is in contrast to the GP registration for offenders scheme launched in London in 2016, which sees offenders register with a local practice after their release as part of their reintegration into the community.

NEL, formerly North East London CSU, was commissioned by NHS England to run the scheme as part of the support it provides to healthcare services in prisons.

A spokesperson for NEL said that, with ex-offenders only released with seven day’s worth of medication, the scheme particularly intends to help patients who have been imprisoned for 10 to 15 years and have no GP records.

Dr Mark Sanford-Wood, BMA GP Committee deputy chair, said: ‘It is important that GPs have full, up-to-date information about all patients so that they can provide the best possible care.

‘This scheme improves the sharing of records between the secure environment and the practice so that GPs are fully equipped with the patient’s medical history when they first visit the surgery.

He added that the new scheme ’will help both practices and patients, reducing potential harm from lack of information’.

The NEL spokesperson said the scheme to register ex-offenders ‘with a community GP before they are released’ plans to ‘ensure that those without a registered GP will receive continuity of care’.

‘As this moves into its pilot phase over the summer, GP practices close to the patient’s place of release may be contacted by healthcare teams to pre-register the patient. 

‘This work is part of NEL’s national work across the health and justice system, commissioned by NHS England.’

Readers' comments (5)

  • Have to say I think this is a good idea. Grumpy prisoners turning up on a Friday, withdrawing from clonazepam, dumped in a town they’ve never been to before because they’ve got an injunction to stay away from their exes. No money, dumped in a bed sit by the seaside. It’s all too familiar. Least if we knew they were coming we could get the gabapentin and clonazepam ready, and wouldn’t have to listen to the threats.. if you don’t prescribe I’m going to have to mug an old lady or get into a fight etc.
    Here’s another thought. Get them off the drugs before you kick them out clucking

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  • This is good idea (for once). The usual suspect drugs they request and have been on in prison haven't been prescribed by the medical wing....they have been obtained from other inmates from supplies smuggled in......instead of getting them 'ready' for collection for them it should hopefully mean we are in a better position to say no!

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  • Prisoners in Sheffield?? Do you mean Doncaster/Wakefield?

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  • If we get them off their opiates and then release them they tend to overdose and die.

    The clonazepam and gabapentinoids side of things often comes from the community originally and we do our best to get these whilst in custody, but often they come out and are put straight back on them by well-meaning GPs due to the lack of communication. We almost never start them in prison.

    I agree with "Don't believe the hype" - it would be ideally placed to help community GPs say now and continue to say no. Communication is poor currently leaving these guys able to exploit the system.

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  • David Banner

    Fascinating discussion of a neglected issue that causes massive headaches for GPs.

    One Friday evening I encountered a patient recently released from Her Majesty’s pleasure demanding his 20mg daily diazepam, with no documentation (natch). I drew up a lengthy withdrawal programme as a condition of his registration, only for him to complain to the local authorities that he would likely “kill someone” if he withdrew, resulting in my being strong armed into continuing his scrip ad infinitum , then facing the wrath of Med Mgmt for my benzo prescribing.

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