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GPs urgently required to address 'very significant risks' in prison health system

Exclusive GPs are being asked to urgently come forward to work in the prison health system and help ‘shore-up’ the service against ‘very significant risks’, according to the community health trust responsible.

In a letter seen by Pulse, Bridgewater Community Healthcare NHS Foundation Trust is requesting GPs able to work day time shifts at HMP Wymott, Leyland, Lancashire Monday to Friday.

Bridgewater, which took over health services at HMP Wymott and nearby HMP Garth in April this year, said workforce is in a ‘very fragile state’ with a scarcity of experienced staff to deliver very complex care.

A spokesperson for the Trust told Pulse that recruiting to GP posts in prison was a challenge nationally and it is doing its ‘utmost’ to address problems in HMP Wymott that became apparent in the contract handover.

It added it was in ‘close contact’ with the prison governor and CQC on their plans for a long-term turnaround of the service.

But GP leaders said the problems in prisons are 'yet another alarm bell warning' of the acute workforce crisis facing the UK and leaving GPs too stretched to take on additional roles.

In the letter sent by interim operations director Caroline Williams, the Trust says that significant risks have led it to ask for extra GP support.

Funding will be available to practice to cover GPs working in the prisons.

The letter says: ‘I really do appreciate the fact that every provider is enduring its own staffing pressures, particularly during peak holiday periods, and I would not ask for this assistance were the risks not very significant in this service.’

The same appeal also asks for practice nurses, and advanced nurse practitioners, who can offer support with long-term conditions management

The letter sent to local commissioners this month says: ‘The services at HMP Wymott are in a very fragile state in terms of the numbers and experience of clinical staff compared to the levels and complexity of demand for health care services.

‘Recruitment to the service is very difficult, and the systems and processes supporting the delivery of high quality care are in need of significant remedial attention.’

A spokesperson for Bridgewater Community Health NHS Foundation Trust told Pulse: ‘During the transition period we identified issues that we are doing our utmost to address. 

'Recruiting to prison healthcare and GP positions is widely acknowledged to be challenging and due to the current significant demands on the health service in HMP Wymott we submitted a genuine appeal to partners and other NHS providers with a view to providing a short term solution whilst we work to bring more stability to the service in the longer term.’

Dr David Barrett, a portfolio GP who works in offender health at prisons and secure sites in the Midlands, said HMP Wymott is far from an isolated case.

He told Pulse: 'I am being overwhelmed by emails and text messages from prisons and locum agencies with long lists of empty rota slots to fill. Rates of pay are increasing but even then I avoid certain prisons as it is just not worth the personal risks.'

Dr Richard Vautrey, BMA GP committee chair, told Pulse: 'This is yet another alarm bell warning of the GP recruitment and workload crisis.

'There are far too few GPs and those that are available are far too overstretched and far less able to take on additional roles such work in prisons. There is an urgent need to invest in general practice right across the board, not only in practices but in prison, out-of-hours services and other areas that depend on GPs to deliver services.'

The worrying state of the nation's GP workforce has been highlighted again this week.

The BMA warned that a reported increase in GP numbers in the three months from March to June mask the fact that nearly 450 qualified, full-time equivalent GPs have been lost since 2015.

Meanwhile Pulse revealed that NHS England was ramping up its recruitment of GPs from overseas, with 600 to be ready to recruit by April 2018 and 2,000 by 2020 - rather than the 500 originally planned.

Readers' comments (14)

  • I don't really understand why everyone is worried......

    The government is working to deliver 5000 new GPs by 2020. I heard it is doing pretty well so far needing only another 5500.

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  • This a prison service problem and a department of health problem
    NOT a GP problem

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  • Secure environments GP

    The prisoners come out and register with community practices, so it's a knock-on effect if they don't get the care needed in prison. A bit like secondary care work shift, you will get loads to fix because GPs are "last man standing" when others have not done the work.

    And by the way, few scary moments and close calls, but never been physically assaulted. GPs are in the most part very respected by prisoners, one said "thank you for working in this place... no one cares about us". Unfortunately, that still wasn't enough to counter-balance the expletives thrown at me that particular day...

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  • AlanAlmond

    The only people concerned about this are the poor folk tasked with providing health care in prisons. Do you see anyone else anywhere calling out this problem?
    Prison work is not pretty. Is it any suprise that at a time when General practice is stretched everywhere, such services are finding it especially difficult to recruit? The worse thing about it all is that noone out there beyond this bubble gives a crap.

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