PROSPECT Prison Pathway Team Becci Mottershaw-King, Strategic Lead for Commissioning and Contracts What is the PROSPECT Prison Pathway Team? 2-year pilot commencing April 2024 LPC responding to actual and anticipated increases in pressure
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PROSPECT Prison Pathway Team Becci Mottershaw-King, Strategic Lead for Commissioning and Contracts<br>
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What is the PROSPECT Prison Pathway Team? 2-year pilot commencing April 2024
LPC responding to actual and anticipated increases in pressure in the prison / health pathway in Cheshire and Merseyside by developing and implementing a solution in collaboration with commissioners and providers
Jointly commissioned by PROSPECT Lead Provider Collaborative and North West Health and Justice Commissioners
Multi-disciplinary clinical team (Forensic Psychiatrist, Mental Health Nurse, Social Worker, Support Worker, Administrator, Peer Support Practitioner, Data Analyst)
Independent of prisons or health services
Work to support staff and service users / prisoners with the referral / admission / remission processes<br>
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Case for Change (2022/23 Data) Average time on MSU waiting list for prisoners 84 days; >90% waiting >28 days 30% referrals from local prisons to health services were out of area patients 30% referrals from local prisons to health services were for PICU - often unknown at outset Admission to Secure Services Remission to Prison 1 to 2 remissions per year Average LoS at discharge 594 days (226 – 1166 day range) Average current LoS in MSU 841 days
(89 – 2127 day range)<br>
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Engagement Steering Group with H&J and LPC Leads
Collaborative workshops with Medics and Clinicians and staff from HMP Altcourse and Liverpool
Report compiled by A Better Life after engagement with prisoners undertaken at HMP Altcourse and Liverpool
Key themes:
The link between health and prison services needs to be strengthened – enhancing communication and sharing of intelligence to inform decision making
Relationships need to develop, particularly with prisons outside our local area
Supporting service users with transitions between systems – familiarisation of the setting, sharing information around the set up and regime, managing expectations, being a consistent ‘face’ during the process as the prisoner/patient transfers from prison to hospital or vice versa
Staff awareness raising and training about the ‘other’ system<br>
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Aims Single point of contact between Secure Services and Prisons in the Cheshire and Merseyside area, and build networks with prisons and service Providers outside of the local area
Enhanced offer of support to prisoners whilst in prison during times of transition to hospital and seclusion including:
enhanced support to prisoners who are known to mental health services in the prison;
identifying prisoners unknown to secondary mental health services within the prison;
providing wider pathway knowledge to support referrals so the right level of security and clinical prioritisation can be informed from the start;
providing early screening and additional treatment options for prisoners whilst remaining in the prison estate; and,
co-production activities to improve communication and awareness.
Support remission back to prison at an appropriate time after treatment is completed ensuring patients are receiving the treatment in the least restrictive and most clinically relevant environment.<br>
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Caseload and Duties<br>
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Enablers MDT approach with staff who have experience of prison and health systems
Responsive in-reach teams in the local prisons
Single Point of Access referrals portal provides the team with oversight of all referrals from prison – particularly helpful for referrals from out of area prisons
Prison Pathway Team is integrated in pathway and decision-making meetings for PROSPECT services, eg. provider referrals meetings, admissions panels<br>
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Benefits Realised to Date Reducing average wait times for admission, even during periods of increased referrals Increasing number of remissions Reducing Length of Stay Positive feedback from prisons and healthcare providers around intelligence sharing and support to unblock pathways<br>
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Wait Times for Admission 2022/23 secure data showed an average wait from the point of referral was 84 days
Since April 2025 we’re at an average of 50 days wait from the point of referral
The number of patients with the longest wait times is also reducing<br>
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Remissions to Prison 2022/23 secure data showed an average of 1 remission per year
Since August 2024 there have been 8 secure remissions supported by the Prison Pathway Team<br>
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Length of Stay 2022/23 secure data showed an average length of stay at the point of remission from secure services at 594 days
Since August 2024 the average length of stay at the point of remission from secure services is 143 days
Also starting to see positive trajectory of patients with a Length of Stay under 9 months for patients in health services<br>
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Next Steps Team to develop peer support / lived experience roles
Continue monthly performance reporting
December / January full service evaluation incorporating quantitative and qualitative reporting
Development of future commissioning intentions for recurrent funding<br>
