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6th Health & Justice Summit: Safety through Continuity

9:00am - 4:00pm
January 31-1, 2019
Hilton, Liverpool, 3 Thomas Steers Way,
Liverpool,L1 8LW
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A 2-day summit jointly organised by the RCGP Secure Environments Group, Broadmoor, Ashworth, and Rampton high secure hospitals, Spectrum, Care UK, NHS England, Martindale Pharma, Nottinghamshire Healthcare NHS Foundation Trust, Betsi Cadwaladr University Health Board, HMP Berwyn, West London NHS Trust, Mersey Care NHS Trust

Following on from our successful event in Glasgow in 2017, we are now focusing on ‘Continuity of Care – safety through continuity’ as this year’s theme. We recognise the need to embolden the links between primary and secondary care for people resident in secure settings and are looking to showcase examples of good practice on how we can improve on care transition to the community.

The first day will broadly address physical health in secure mental health environments, and the second day will address the health needs of people in other safe environments such as prisons, immigration removal centres and YOIs.


Councillor Barry Kushner

Labour Councillor

Norris Green Ward

Dr Alan Cohen

Salzburg Medical School

Dr. Miranda Davies

Senior Research Analyst

Nuffield Trust

Andrew Clarke

Implementation Lead – Forensic CAMHS

National Specialised Commissioning Team (Mental Health) – NHS England

Fiona Grossick

National Quality & Lead Nurse

Health & Justice Finance, Commercial and Specialised Commissioning Group

Matthew Langley

Consultant Forensic Psychiatrist

National High Secure Health Service for Women at Rampton High Secure Hospital

Joe Rafferty

Chief Executive

Mersey Care NHS Trust

Tom Hewson

Junior Academic Doctor

Manchester University NHS Foundation Trust.

Linda Harris

Chief Executive and Chief Medical Officer

Spectrum Community Health

Holly Lowther

Project Worker

Royal College of Psychiatrists

Sarah Shirley

Project Worker

Royal College of Psychiatrists

Megan Georgiou

Programme Manager

Royal College of Psychiatrists

Dr Catherine Glover BSc Hons, MRCGP

GP Medical Director

HMP Bristol

Dr Mary Kamara

Clinical Advisor

Medical Justice

Dave King

Head of Commissioning, Cumbria and North East (Health and Justice)

NHS England (North Specialised Commissioning Team)

Mike Wheatley

Senior Manager - Recovery Advisor

Her Majesty’s Prison & Probation Service

Dr Bernadette Hard

GP Specialist, Addictions

Kaleidoscope Drug Project

Dr. Emily Fargher Holmes BA (hons), MSc, PhD

Research Fellow in Pharmacoeconomics

Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University

Richard Keers

Clinical Lecturer in Pharmacy

The University of Manchester

James Routen

Health & Fitness Manager

Nottinghamshire Healthcare NHS Foundation Trust

Miss Andrea Sott

Orthopaedic Consultant

Foot & Ankle Surgery

Laura Hinchcliffe


Hanham Health and HMP Eastwood Park/ HMP Ashfield

Dr Jon Bashford

Senior Partner

Community Innovations Enterprise

Professor Louise Condon


College of Human and Health Sciences

Mark Gillyon-Powell JP

National Lead - Public Health (Secure & Detained)

Finance, Commercial and Specialised Commissioning Group NHS England

Professor Graham Foster

Professor of Hepatology

QMUL/Barts Health

Maria O'Neill

HMP Littlehey

Bethan Leach

Dietitian for Offender Health

Care UK

Anna Taylor

IDTS Service Manager

HMP Birmingham


The Agenda


    Registration, Networking, and Breakfast


    Opening – Councillor Barry Kushner (Confirmed)

    Labour Councillor for Norris Green Ward

    Cabinet Member for Children’s Services


    Introduction & Chair – Chris Packham (Confirmed)


    Prof Appleby, Managing Self-harm, Rosie study  – Bonnie Sibald


    Dr. Alan Cohen (Confirmed)

    Equally Well, the Mental Health Intelligence Network:

    Analysis of national QOF data comparing the prevalence of people with SMI in ten long-term conditions.

    “The physical health of those with a severe mental illness is held up as one of the last significant health inequalities. This presentation will explore some of the data that underpins that inequality. This will describe how it can be used to enhance services, through the development of a national learning network. Equally Well.”


    The Leder study – University of Bristol: Safe care for learning disabled patients


    Kate Morrisey

    Safe and effective transfer from prison to secure: how are we improving?


    Panel Discussion


    Refreshments, posters, exhibition and networking


    Stream A

    Workshop 1:

    Miranda Davies, Nuffield Trust (Confirmed)

    Understanding prisoners’ healthcare needs and their use of hospital services using routine healthcare data

    This workshop will present early findings from analysis of routine healthcare data (Hospital Episode Statistics) to explore prisoners use of inpatient, outpatient and A&E hospital services in England in 2017/18. There will be an opportunity to discuss the potential uses of such data to better understand the healthcare needs of prisoners and also, what such data might tell us about how the quality of care for prisoners compares to non-prisoners.

    Workshop 2:

    Andrew Clarke (Confirmed)

    Specialist Child and Adolescent Mental Health Services for High-Risk Young People with Complex Needs (Community Forensic CAMHS)

    The National Community FCAMHS teams delivered through 13 providers across the country covering regional footprints. The teams are small and highly skilled and knowledgeable in forensic mental health presentation and interventions.
    The services are community outreach services designed to support other services with the care of these young people. The clinical model of the service is graded with advice and signposting being the first level and then referral to consultation and assessment and also intervention for the very complex cases.

    Workshop 3:

    Fiona Grossick: (Confirmed)

    Dying Well in Custody Charter:

    A whole prison approach to delivering high quality, dignified and decent palliative and end of life care in prison,

    Palliative and end of life care in prisons,

    Supporting people who are expected to die in custody can be a difficult and emotional time for the staff who care for them, the individual and their families. Good palliative and end of life care are being delivered in many establishments. The Dying Well in Custody Charter, a national framework for local action 2018, provides a set of standards for palliative and end of life care in prison and gives establishments guidelines that set out best practice.

    Workshop 4:

    Stuart Ware

    A user-friendly and personalized continuing care approach for older people on release from prison

    Workshop 5:

    Matt Langley and Marcus Bicknell: (Confirmed)

    ‘Managing sodium valproate prescribing in female patients in secure hospitals’

    Valproate has been used extensively as both an antiepileptic and a mood stabilising medication. Its teratogenic effects are also well known. In April 2018 the Chief Medical Officer in the UK issued an alert indicating that Valproate medicines are now contraindicated in women and girls of childbearing age unless certain conditions are met. It is common to find women in secure settings who are already prescribed Valproate. This workshop discusses the issues often encountered in these cases and approaches that may help professionals to manage them.



    Lunch, posters, exhibition, and networking


    Chair – Chris Packham (Confirmed)


    Joe Rafferty (Confirmed)

    High secure patients: keeping safe:


    Stream B

    Workshop 1:

    Tom Hewson: (Confirmed)

    Forensic psychiatry and physical health – Perspectives from Australia.

    Workshop 2:

    Workshop 3:

    Linda Harris (Confirmed)

    Workforce planning, skill mix, and redesign, recruitment and retention

    Workshop 4:

    Holly Lowther, Sarah Shirley and Megan Georgiou (Confirmed)

    Patient and carer involvement: what has been achieved and what should be next?

    Capturing perspectives of patients and carers in health services are fundamental to achieving a person-centred approach. However, it can be a challenge to accomplish in settings like forensic services fully. Furthermore, the workshop aims to celebrate what services and the Quality Network for Forensic Mental Health Services already have in place regarding patient and carer involvement. Also, explore what the next stages should be to embed a person-centred approach fully.

    Workshop 5:

    Tracey Tait (Confirmed)




    Stream C

    Workshop 1:

    Dr. Simon Modi & Jonathan Bickford

    Cardiac Health

    Workshop 2:

    Nikki Marfleet

    Optimizing the team to deliver outcomes and meet targets 

    Workshop 3:

    Dr. Mary Kamara: (Confirmed)

    The Impact of Immigration Detention on Health:

    Lessons learned from independent medical assessments for immigration detainees

    The transition into immigration detention from the community is often abrupt, where are the critical points of breakdown in continuity of care?

    How can we effectively identify vulnerable adults and victims of torture? what should we know about the impact of detention on health?

    Workshop 4:

    Marcus Bicknell (Confirmed)

    Safer Prescribing In Prison – critical recommendations from the 2nd edition

    Workshop 5:

    Jane Voke (Confirmed)

    Physical Health Care Team

    Developing a physical health service at Langdon hospital.

    Langdon hospital is a forensic mental health facility that includes medium & low secure and open wards. We have 110 male service users. The original physical health service involved using a local practice and having a visiting GP and RGN once a week.

    The new service has an integrated cross-site and primary care hub service. The multidisciplinary team members see services users individually and work alongside the psychiatric teams on the ward. Service users can also be seen in physical health clinics. Each ward is also assigned a Sports & Leisure Coordinator to offer physical activity sessions, tailored to meet individual needs.

    Many service users have been unwell for an extended period of time, and this contributes to both poorer physical health and difficulty in beneficially using a medical service. They may also have developed lifestyle habits which help to lower quality of life and shorter life expectancy.
    An excellent mental health service is patient centred, and the physical health provision requires a similar degree of flexibility.
    We would like to share our film with you and discuss what has worked and what our future plans are.



    Close of Day


    Conference drinks and award presentation


    Conference dinner, Liverpool Town Hall


Registration, refreshments, posters, exhibition, and networking


Introduction & Chair – Chris Packham (Confirmed)


Dave King And Mike Wheatley (Confirmed)

Drug Recovery Prison


Dr. Bernadette Hard (Confirmed)

GP Specialist, Addictions

Kaleidoscope Drug Project

‘Time to stop throwing the baby out with the bathwater.’

The impact of introducing Espranor into a community OST service for offenders.


Marcus Bicknell (Confirmed)

Findings and proposals from the Death in Custody Group


Nikki Marfleet:


Panel Discussion


Refreshments, posters, exhibition and networking


Stream A

Workshop 1:

Catherine Glover: (Confirmed)

Prison Emergency Treatment and ALS course for prisons that is being developed in Bristol

Myself and colleagues are developing a bespoke training course to manage clinical emergencies that may commonly be seen in prisons. We are working closely with HMPPS to make it very prison specific. I will be giving an overview of the course format and topics that we are covering and Mark Simpson from HMPPS fire and safety will talk about the process that the prison officers and fire brigade must follow in the case of a cell fire prior to us assessing the patient.

Workshop 2:

Dr. Emily Fargher Holmes & Simon Newman (Confirmed)

Management Process at HMP Berwyn: Challenging Prescribing Practice in Prisons

Berwyn: Challenging Prescribing Practice in Prisons

Modelling the health economic outcomes of ‘medicines management of sedating medications’ at HMP Berwyn.  A feasibility study.

Changing prescribing practice in prisons has economic consequences. Fewer items being prescribed reduces the pressure on pharmacy and nursing teams that gives back time that can be spent in managing the medicines that are prescribed. There is an impact on security with reduced queues at hatches and fewer illicit drugs in the environment. However, this has to be balanced against the time involved with the initial disruption when men have medication discontinued. In order to formally assess the cost-effectiveness of the sedating medicines management programme at HMP Berwyn, a feasibility study is being conducted. Using audit data and purposive reviews of the literature, this study will identify the data required to model the health outcomes and resource use of medicines management of sedating medications at a local (HMP Berwyn) and national (UK Prison Service) level.

Findings will report on the feasibility of conducting definitive research at HMP Berwyn and report on the costs and outcomes associated with this programme to date. Collecting economic data in a feasibility study ensures sufficient data at both a local (HMP Berwyn) and national (UK Prison service) level are available to produce a robust estimate of the economic impact of changes to prescribing policy in the future.

Workshop 3:

Med-co (Confirmed)

Quality and Outcome Framework in prisons: Opportunity or Threat?

Drawing on years of commissioning and providing the Quality and Outcome Framework (QoF) within prisons.

The presentation will include –

Identify challenges associated with delivering QoF in prisons.

Improving outcomes in chronic disease management

Suggest practical ways in which QoF deliver including leadership, engagement, audit, and training.

Workshop 4:

Chris Packman

Epidemiology of  CVD risk and anxiety and depression markers in 7 east midlands male-only prisons

Workshop 5:

Paramedics in prisons


Stream B

Workshop 1:

Stephanie Perrett

Public Health Wales: Infectious Disease presentation

Workshop 2:

Kate Halliday (Invited)

Workshop 3:

Laura Hinchcliffe (Confirmed)

Gender Dysphoria in Prisons

Gender dysphoria is quite topical currently and perhaps even more so within prisons, yet most GPs have little experience in this area. This session will focus on first consultations, referrals and common prison-related issues which may arise, as well as discussion of some pertinent cases.

Workshop 4:

Professor Louise Condon and Nerys Williams (Confirmed)

Improving continuity of care for burn victims between prison and the community: a specialist outreach nursing service in Wales

A specialist nursing service in Wales addressed a need to improve burn care in prisons by developing a collaborative educational programme for prison healthcare staff.

As a result of increased referrals for burn injuries from prisons in South Wales, an outreach team developed a programme of education for prison staff to improve the quality of referral and treatment in prison. The evaluation showed that this service resulted in enhanced collaboration, with a consequent benefit for patients.

Workshop 5:



Lunch, posters, exhibition and networking


Chair – Chris Packham (Confirmed)


Dr. Ruth Armstrong (Invited)

The Institute of Criminology at Cambridge University: Reintegration into the community


Mark Gillyon-Powell JP & Professor Graham Foster (Confirmed)

National Lead – Public Health (Secure & Detained)

Hep C Elimination


Stream C

Workshop 1:

Maria O’Neil (Confirmed)

Palliative care in the prison setting

Workshop 2:

Dr. Jon Bashford (Confirmed)

Inside gender identity,

Meeting the health and social care needs of transgender people in the criminal justice system.

Findings from a review of transgender individuals in the criminal justice system, and the subsequent report Inside Gender Identity highlights the broader range of ways in which health and social care needs for trans individuals in the criminal justice system can result in heightened risk and vulnerability. Particularly with respect to mental health, well-being and the experience of fractured and disjointed care pathways.

The workshop will explore the findings from the report and highlight the particular work that needs to be done. How to improve safety and effectiveness of services including greater inclusion of the lived experience of transgender offenders.

Workshop 3:

Bethan Leach (Confirmed)

Healthy Inside – Tackling Prison Malnutrition

There are well-documented links between poor nutrition and chronic disease, which is a feature of prisons.

This workshop builds on the work by dietetic undergraduates in one male prison, exploring nutrients in a prison menu, the menu choices men make and how these compare to recommended dietary reference values (DRV’s).

Workshop 4:

Richard Keers (Confirmed)

‘Improving medication safety in prisons. What is the Patient Safety Research Unit doing about this and what can I do where I work?’

Medication safety in prisons

Medication safety challenges in prisons are poorly understood, which also could stifle the development and impact of improvement efforts on the ground. This workshop aims to report on the exciting projects being undertaken by the Patient Safety Research Unit to address this need and also how you might get involved, and to equip you with the knowledge, motivation and fresh ideas needed to go back to your place of work and make a difference!

Health in secure environments; prisons, immigration removal centres, and YOIs.

Workshop 5:

James Routen: (Confirmed)

Implementation of high support swimming sessions in a high secure services

Managing the potential for Violence and aggression, in a high risk area. Enabling and promoting access to this area for all patients.

The workshop will aim to share best practice and showcase the success of the recently devised and established training package. The implementation of the high support swimming session within the high security has led to the introduction of the PFD training. Personal flotation device (PFD) which provides individual high risk patients during a swimming pool sessions, in order to ensure that effective risk management is maintained. Also, allowing for positive and meaningful activates to take place.




Stream D

Workshop 1:

Caroline Watson

Multi-disciplinary Pain clinic experience

Workshop 2:

Dave King/Mike Wheatley (Confirmed)

From theory to practice:

Workshop on Drug Recovery Prison

Workshop 3:

Dr. Gareth Ruse and Andrea Sott (Confirmed)

Improved access to primary GP and secondary care

Workshop 4:

Denise Farmer (Confirmed)

Continuity of medicines on admission and release: What makes this safer?

Workshop 5:

Anna Taylor: (Confirmed)

HMP Birmingham IDTS  Naloxone on release and Espranor to maximise recovery potential.

HMP Birmingham IDTS supports 200 patients on mediation with an average stay of 6 weeks. We have a deep commitment to enabling recovery and have introduced Naloxone on release and changed to Espranor to maximise recovery potential. This workshop discusses some of the barriers we overcome.



Marcus Bicknell (Confirmed)

Safer Prescribing in Prison – Key recommendations from the 2nd edition


Prize draw hamper



Close of Day

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31st January 2019 @ 9:00 am
1st February 2019 @ 4:00 pm
£25.99 – £152.99
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Hilton, Liverpool
3 Thomas Steers Way,
Liverpool,L1 8LW

Daniel Snape



0161 820 0631

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