The prevalence of diabetes is substantially higher than among the majority Diabetes is twice as prevalent among Hispanics as among the majority of the population. …
| |Prison Service Instruction |Number|
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| | |07/200|
| | |2 |
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| |National Service Framework for Diabetes: |
| |Standards |
| |3500: - Health Care for Prisoner |
| |18 February| |19 February |
| |2002 | |2002 |
|CONTAINS MANDATORY INSTRUCTIONS |
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|For Action |Monitored by |
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|Governing Governors, Directors |Health Policy Unit, Standards |
|and Controllers of contracted |Audit, Self-Audit |
|out prisons |
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|For Information |On authority of |
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|All Staff |Prison Service Management Board |
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|Contact Point | |
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|Kim Dhadda, Prison health Policy Unit 020 7217 3932 |
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|Other Processes Affected | |
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|Supports delivery of Health | |
|Services for Prisoners Standard | |
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|NOTES |
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|References to governors apply equally to Directors of |
|contractually managed prisons |
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|Issued
|18/02/200|
| |2 |
NATIONAL SERVICE FRAMEWORK FOR DIABETES: STANDARDS
1 The Department of Health with the help of leading clinicians,
managers and staff sets national standards and defines service models
for key conditions and care groups through a series of National
Service Frameworks NSFs NSFs are based on what works and on
experience from around the country The Department of Health has
recently published the first part of the National Service Framework
for Diabetes: Standards copies of which are being sent to each prison
with this PSI for information and as a means of facilitating learning
and the spread of good practice A copy of the full text of the NSF
for Diabetes: Standards document is also available on the Department
of Healths website at wwwdohgovuk/nsf/diabetes together with more
detailed supporting information on interventions and service models
2 In line with requirements of the Health Services for Prisoners
Standard, this NSF will support prison health care staff in delivering
a service to people with
diabetes in prison broadly equivalent to that
delivered by the NHS A summary of key principles of particular
interest to people working in prisons is attached at Annex A
3 One of the central themes highlighted in this NSF is the need to
target those population groups at greatest risk These include people
from minority ethnic groups and socially excluded groups, both over
represented in prison populations The NSF also focuses on the
importance of integrated cross agency working to ensure that people
with diabetes experience well co-ordinated care appropriate to their
health needs whatever the setting
4 Governing Governors must arrange for copies of this PSI to be drawn
to the attention of:
Heads of Health Care along with a copy of the National Service
Framework for Diabetes: Standards document which should be retained in
the Health Care Centre
Impact and Resource Assessment
5 There are no additional staff or non-staff resources required to
implement this PSI The NSF for Diabetes: Standards outlines best
practice and will support prison staff in their ongoing work to
deliver high quality diabetes care in prison settings equivalent to
that provided in the community
Dr Felicity Harvey
Director of Prison Health and Head of Prison Health Policy Unit
Annex A
NATIONAL SERVICE FRAMEWORK FOR DIABETES : STANDARDS
1 Diabetes is becoming a more common condition world-wide It can
affect people of all ages in every population The National Service
Framework for Diabetes: Standards highlights the impact diabetes can
have on the physical, psychological and material well-being of
individuals It can lead to complications such as heart disease,
stroke, renal failure, amputation and blindness There is also
evidence to show that:
the onset of Type 2 non insulin dependent diabetes can be delayed,
or even prevented;
effective management of the condition increases life expectancy and
reduces the risk of complications;
self management is the cornerstone of effective diabetes care
2 The
National Service Framework for Diabetes: Standards document sets
out twelve new standards summarised in the table on page 5 and key
interventions necessary to raise the standards of diabetes care
Further detailed supporting information can be found on the Department
of Health website at http://wwwdohgovuk/nsf/diabeteshtm A second
stage of the NSF the National Service Framework for Diabetes: Delivery
Strategy will be published in summer 2002 following further
consultation on service models and will set out early milestones for
delivery in the NHS over the ten year implementation programme
Key messages for prison healthcare staff
3 Central themes highlighted in the NSF of particular interest to
people working in prisons focus around the need to tackle variations
in care to ensure consistent high quality diabetes care wherever
people are living and the importance of reaching communities at
greatest risk
Equivalent standards of health care for people with diabetes in prison
settings
4 In line with the overarching
Health Services for Prisoners Standard
to provide prisoners with access to the same range and quality of
services that the general public receives from the National Health
Service, this first part of the National Service Framework for
Diabetes makes clear that people with diabetes living in custodial
settings should be managed in line with the standards set out in this
NSF see paragraph 9 of the supporting material on Health Inequalities
published on the Diabetes NSF website
5 Close partnership working between the prison health care team and
local NHS specialist diabetes service is essential to underpin this
and drive up standards Regular liaison particularly with the diabetes
specialist nurse will ensure for example:
an inclusive approach to care planning at local level The community
specialist diabetes nurse can provide advice and support on individual
case management where necessary and increase confidence in day to day
diabetes management both for prisoners with diabetes in line with
Standard 3 of the NSF on empowering people with diabetes and
prison
health care staff;
that there is regular surveillance of prisoners with long term
diabetic complications in line with Standard 10 of the NSF
Regional Prison Health Leads will be able to advise prison health care
staff if they have any difficulty in identifying or engaging with this
service
High risk groups over represented in the prison population
6 Diabetes does not affect everyone equally Significant inequalities
exist in the risk of developing diabetes, in accessing health services
and in health outcomes The burden of disease falls disproportionately
on people from minority ethnic and socially excluded groups For
example, Type 2 diabetes is up to six times more common in people of
South Asian descent and up to three times more common amongst those of
African and African Caribbean origin compared with the white
population Both mortality and morbidity resulting from diabetic
complications are increased by socio-economic deprivation
7 On any day the prison population in England and Wales averages around
65,000 Most prisoners are
in custody for less than 6 months In
general, prisoners have poorer health than the population at large,
many have unhealthy lifestyles and have had little or no regular
contact with health services before entering prison Prison
populations reveal strong evidence of health inequalities and social
exclusion Whilst the prevalence of diabetes amongst prisoners is
unknown, the NSF makes clear that high risk hard to reach groups are
over-represented in this population see page 10 of the NSF standards
document and also pages 1 and 2 of the Health Inequalities section
and that a period of imprisonment can be an opportunity to screen for
diabetic complications and improve care Establishing a register of
diabetes patients in the prison can be a single first step towards
planning and managing care for this group of prisoners
Source:medicareadvocacy.org
