1. Improving quality in prison mental health services: results from the pilot of the RCPsych Quality Network Dr Huw Stone & Megan Georgiou

2. Outline Who We Are and What We Do
Standards for Prison Mental Health Services
Membership and Participation
Findings from the Pilot Year
Recommendations
Current Initiatives

3. Who We Are & What We Do Established in 2015 Part of the RCPsych CCQI
Engages clinicians, managers, frontline staff and patients in quality improvement
Promote the sharing and learning of best practice
Support services to plan improvements for the future.
Governed by a group of professionals

4. Standards for Prison Mental Health Services
Framework by which to assess quality
1st edition published in 2015
Extensive process of consultation with key stakeholders, staff & service-users
Review of key literature & documents
2nd edition published Sept 2016
Acknowledged feedback from member services & recent developments in PMH
Includes RCPsych CCQI core standards for community-based MH services (2015)

5. Standard Areas Admission and Assessment Case Management and Treatment
Referral, Discharge and Transfer
Patient Safety
Patient Experience
Environment
Workforce
Governance

6. Annual Review Process Self-review Peer-review Local Report
Action Planning
Annual Forum & Report

7. Membership & Participation
Prison mental health teams across England, Wales and Ireland
Varying category, male, female and YOI populations
Pilot Year – 18 services
Second Year – 42 services
Review visits attended by 56 people in pilot year

8. Findings from the Pilot Year

9. Percentage of Met Criteria Across All Services (range 59-81%)
The graph displays the percentage of met criteria across all services, ranging from 59% to 81%. It allows services to benchmark themselves against the other services that took part in the pilot year, with the average score being 71%.
Each service is assigned their own anonymous data label from A to R and your unique data code

10. Average % of Met Criteria Per Section
Here you can see the average percentage of met criteria per section. This graph presents the amalgamated results from all services that took part in the pilot year. The highest scoring sections are Governance and Workforce Training, CPD and Support and the areas in most need of improvement are Case Management and Treatment and Environment.

11. Key Achievements
Participation in ACCT process and collaboration with other agencies to manage self-harm and suicidal ideation.
Team communication systems
Transfer coordinator roles
Respectful
Communication with prison colleagues

12. Key Achievements Staff training and induction
Collaboration with prison to engage in clinical governance and quality improvement
Sharing of lessons learned

13. Key Challenges
Screening mental health assessment not always carried out by a practitioner trained in mental health.
Meeting the 5 day recommended response time for routine assessments.
Availability of written information for patients, or patients are not aware of information being available to them.
Access to psychological interventions
Patient involvement in care planning

14. Key Challenges Follow-up procedures Feedback systems
Mental health awareness training
Environment
Service disruption – regime and competition for rooms
Few written arrangements and procedures
Patient involvement in governance systems

15. Recommendations
Establish recommended minimum levels of staffing and specialist input.
MH assessment should be carried out by MH professional.
Patients should be more informed about their care and treatment.
Care planning should be carried out in collaboration with patient.
Mental health awareness training – mandatory requirement for all prison staff.
Formalisation of policies, agreements and joint working practices.
‘Through-the-gate’ support.

16. Member Feedback
Very interesting to visit another service and see what they are doing well or differently to us. Helps to consider what we are doing well and how we can improve.
The network is the best thing that's come up professionally in a very long time.
This is a very useful process and I think as it develops it will be of great benefit across the prison mental health services.
It was useful to receive the feedback and discuss the comparisons between us and the peer reviewers. It was a supportive experience.
Found it very enlightening seeing how much effort is put into providing good quality and effective care by our colleagues engaged in prison mental health.
These are the comments received from the host services and the peer-review teams following the visits.
Helps to consider what we are doing well and how we can improve.
The best thing that's come up professionally in a very long time.
As it develops it will be of great benefit across the prison mental health services.
A supportive experience.
Really good to meet peers and discuss their services.
Found it very enlightening
Seemed very worthwhile - really good to meet peers and discuss their services. Felt a good way to quality assure our services.

17. Current Initiatives
Development of standards for prison inpatient and enhanced care settings
Managing dual diagnosis and NPS in prisons event: 28 November 2016
Introduce option of accreditation

18. Communications Website www.qnpmhs.co.uk
Newsletter Twice yearly & published on the website
Discussion Group

19. Questions? megan.georgiou@rcpsych.ac.uk 0203 701 2701