Andrew Hudson, lead GP for HMP Stafford explains the challenges of being a prison GP and why he’s never looked back...
Health in Justice is developing as a niche primary care service. Care UK has taken a significant step in providing prison healthcare across 40 prison healthcare sites. I transferred in to health in justice over two years ago and haven’t looked back; yes it has at times been challenging but I genuinely have enjoyed every minute.
Although I loved my community GP partnership, increasingly my time was consumed with staff HR issues, recruiting fellow doctors, analysing LES and DES schemes for cost benefit and watching my colleagues get home too late to put their children to bed.
Now I work set hours, the patients ‘visit me’ and I don’t take my work home or access it remotely. I hugely enjoy working as part of an onsite multidisciplinary team which looks after: dental, physiotherapy, podiatry, opticians, mental health teams, substance misuse teams and primary care teams. Heads of healthcare and lead clinical nursing colleagues at each site shoulder a lot of the team’s administrative burden so I can concentrate on providing ‘clinical value’.
Care UK have been innovative and progressive with access to telemedicine from most sites to external NHS consultant led services, we can also use the telemedicine kit to speak to our GP colleagues at other sites. Care UK’s Practice Assist telephone GP service provides additional appointments and gives an element of ‘patient choice’ at prison site level which is also a fantastic tool.
The IT tools are a few years behind what you may be used to in the community but an excellent group of energetic and experienced GP colleagues along with national strategies which are driving improvement and it’s a pretty good time to ‘catch the wave’. There have been times when working can seem a little insular but this too has changed dramatically with cross site fertilisation of ideas and best practice. Regular regional clinical forum meetings are a great opportunity to discuss best practice and any improvements with colleagues and while we all enjoy an occasional ‘moan’ it is nice to feel you are a member of a team that is solutions-orientated.
The clinical pathology you see in prisons is immense and the prevalence of the QoF long term conditions will cause you to raise your eyebrows ... but it feels as though I am practicing the clinical medicine for which I was trained. You may be surprised to hear that 40% of residents at my site are over fifty and the oldest is over a hundred years old. Throw in a few frailty factors and there is some serious medicine to practice.
A big step for me was realising our skills are valuable, sought after and transferable ... Believe it or not, the vast majority of the prisoners who have often had chaotic challenging lives and poor experiences of healthcare value you and the role a GP can bring to Health in Justice.
Even just stopping a resident walking between education and his ‘wing’ to congratulate him on his newly acquired ‘maths certificate’ can give a man back his motivation and dignity. Sometimes the simplest of interactions can be so worthwhile.
I enjoy being a prison GP and I am proud to work for Care UK.
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