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Independents' Day

'I'm being overwhelmed by requests from prisons'

Offender health GP Dr David Barrett tells Pulse about the national shortage of GPs in prisons

I work at various prisons in the Midlands and it is the same everywhere. 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.

There is a national shortage of GPs available and willing to work in Offender Healthcare. It is demanding work, frequently stressful with significant risks of physical violence exacerbated by a depleted prison officer workforce. It requires GPs sufficiently skilled in managing mental health problems and those with severe personality disorders, substance misuse, musculoskeletal and traumatic injuries. Only resilient GPs with an open mind tend to stick at it; those who like the challenge, have a natural curiosity about people and extreme situations.

It can be very rewarding too, identifying years of untreated pathology and improving the psychiatric care of vulnerable prisoners. Each day can be so different. You can be presented with very unusual events where you must be medico-legally precise, triage patients and balance treatment delay risks with security risks taking account of staffing available to escort patients out to hospital.

Last year at a prison during one shift we had to send 12 ‘blue light’ ambulances out. Use of illicit drugs especially novel psychoactive substances and ‘trading’ of prescribed medication is rife in most prisons. I’ve been at two prisons when Tornado Teams have been sent to tackle prison riots, fire-setting and roof-top protests. There’s never a dull day.

Full reimbursement of medical indemnity costs would attract more GPs, since in the prison setting ‘systems and processes’ rather than individual clinical negligence failings are more likely. There also has to be a network of support for GPs which in some areas there isn’t much. I don’t work in prisons full-time as I vary my portfolio work to a level that suits my work-life balance.

Dr David Barrett is a portfolio GP in the Midlands with a special interest in offender healthcare and secure environments


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Readers' comments (8)

  • Fantastic work being done.

    But with respect any GP reading that would think keep away.

    I imagine prison GP's are rewarded with high rates of GMC referrals and no support from NHSE!

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  • Bargepole

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  • I have great respect for GPs who work in prisons. A few years ago I visited the medical facilities in a local prison and was very struck by the humanity and care.

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  • Well, I'm relieved that the DOH haven't proffered that "GPs are ideally placed to provide medical care in prisons" .

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  • Pay appropriate remuneration and they will come. Trying to do it on the cheap has led to poor workforce numbers.

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  • I am sure now Hunt have hunted 600 overseas drs who will save our nhs and prisons. I worked few times in prison. I was not allowed to take my cell phone inside, but lots of prisoners had smart phones and internet in their cells.

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  • Just Your Average Joe

    I worked in a prison - until they tried to renegotiate our practice contract to save money, so we left as it was not possible to run it at that price without subsidising the care.

    A private company took the contract at that cost, then turned around and said it couldn't run it safely and asked for almost double what we were paid originally or they would walk away - and THEY WERE PAID IT as they could not leave the prison without a healthcare service and didn't want to go through another costly and pointless tendering process as no one else had been interested.

    Just another example of double standards bias towards private companies and stup!d NHS mangers pouring money down the drain for worse care - we had a regular named GP every day - the private company uses locum cover, when they can find a GP!

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  • you should be charging at least £1,000 a day

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