Prisons Contract: 2015/16 Objectives Dental Services within HMP Highpoint, HMP Hollesley Bay, HMP Warren Hill and HMP Chelmsford Objectives of Service: ● Improve oral health awareness and change behaviour ● Encourage prevention and self-help amongst prisoners ● Reduce waiting times for prisoners ● Reduce travel to A&E for emergency dental care

Prisons Contract: 2015/16 Social Impact Report Headlines Dental Services within HMP Highpoint, HMP Hollesley Bay, HMP Warren Hill and HMP Chelmsford As at year end: All waiting lists have been reduced to ensure that prisoners are routinely seen within the required 6 week period. 1266 prisoners were provided with a treatment plan which has aided the prevention of recurring initial sessions and the process of re-referrals. 96% of prisoners reported a decrease in pain over the course of their treatment. No prisoners required external appointments for treatment of dental emergencies. Greater than 70% of prisoners reported positive change in tooth brushing habits after their treatment plan. Over 200 prisoners reported decreased sugar consumption. In agreement with Care UK all prisoners were prescribed sugar-free methadone. Over 140 prisoners attended smoking cessation and drug & alcohol support sessions to encourage healthy behaviours. No prison staff and health care staff incident forms were reported in relation to dental issues abuse.

Total Prisons Contract: SROI Review Dental Services within HMP Highpoint, HMP Hollesley Bay, HMP Warren Hill and HMP Chelmsford Per the SROI calculation: ● Over £20k savings have been obtained by preventing prisoners attending emergency appointment by providing treatment for pain reduction. Also, as a result of zero prisoners in pain at the start of their treatment requiring an external appointment, an approximate saving of £35k has been calculated. ● 467 FP17 forms were completed indicating prisoners had no active dental decay by the end of treatment. Assuming that if dental decay had not been treated and at least one further nurse session would be required, this would cost approximately another £16k. ● 1266 treatment plans were completed which included a comprehensive patient history and treatment plan ensuring that re-referral would be unlikely. On the basis that this has avoided further Band 1 introductory session costs, this has provided savings of over £24k. ● Waiting times have been reduced to ensure that the next available routine appointment is within the recommended time of 6 weeks. At the time of inheriting the contract, over 250 prisoners were waiting greater than this threshold for the next available appointment. Therefore assuming that longer waiting times result in worsening conditions and more severe treatment required, a saving of nearly £14k has been made. ● Overall, for every £1 invested 36p of social value is delivered. (contracts total greater than £300k)

HMP Highpoint: 8 month review HMP Hollesley Bay: 8 month review 72% of prisoners reported positive change in tooth brushing habits after their treatment plan. 92% of prisoners reported a decrease in pain over the course of their treatment. 59% of prisoners reported decreased sugar consumption. 153 prisoners treated for active dental decay. 32 prisoners attended smoking cessation sessions. 11 prisoners attended drug/alcohol support sessions. 270 prisoners provided with a treatment plan. Next routine available appointment time reduced by 9 weeks. 75% of prisoners reported positive change in tooth brushing habits after their treatment plan. 98% of prisoners reported a decrease in pain over the course of their treatment. 58% of prisoners reported decreased sugar consumption. 109 prisoners treated for active dental decay. 11 prisoners attended smoking cessation sessions. 9 prisoners attended drug/alcohol support sessions. 142 prisoners provided with a treatment plan. Next routine available appointment time reduced by 4 weeks. HMP Warren Hill: 8 month review HMP Chelmsford: 12 month review 81% of prisoners reported positive change in tooth brushing habits after their treatment plan. 100% of prisoners reported a decrease in pain over the course of their treatment 53% of prisoners reported decreased sugar consumption. 58 prisoners treated for active dental decay 14 prisoners attended smoking cessation sessions 8 prisoners attended drug/alcohol support sessions 58 prisoners provided with a treatment plan. Next routine available appointment time reduced by 2 weeks. 66% of prisoners reported positive change in tooth brushing habits after their treatment plan. 95% of prisoners reported a decrease in pain over the course of their treatment 53% of prisoners reported decreased sugar consumption. 147 prisoners treated for active dental decay 15 prisoners attended smoking cessation sessions 41 prisoners attended drug/alcohol support sessions 796 prisoners provided with a treatment plan. Next routine available appointment time reduced by 2 weeks.

Prisons Contract: Action Plan for 2016/17 Recommendations: ● Measure impact of CDS service and treatments on improving prisoner self-confidence by capturing data via prisoner questionnaire before and after completion of their treatment plan. ● Provide training for prison staff and health care staff to deliver oral health preventative messages to ensure these staff build confidence in their knowledge of this area and subsequently reduce the number of sessions prisoners require with oral health specialists. Improving knowledge Changing behaviour Creating healthier environments Improving oral health