Criminal Justice Health Needs Assessments

Studies have been undertaken in over 25 prisons since 2006 examining substance misuse and recovery services alongside wider general health HNAs. The methodologies for adults and young offender estate all adhere to the Public Health England template and the Chimat template. These approaches include:

• Access, data cleaning and interrogation of management information or surveillance systems including SystmOne, National Drug Treatment Monitoring System (NDTMS) and the Drug Intervention Record (DIR – formerly part of the Drug Intervention Programme)
• Undertaking epidemiological analysis of data including developing multivariate models of treatment outcomes where appropriate
• Process mapping of pathways into health-related services and post-release into the community
• Prisoner perception surveys based on a representative sample of prisoners (driven by appropriate power calculations)
• Prisoner focus groups including in-depth semi-structured qualitative discussions with prisoners focusing on key topics including service satisfaction and bespoke topics including pain management
• Staff consultation approaches including in-depth qualitative interviews and staff surveys examining organisational environment; staff attributes and training needs

Similar studies utilising broadly the same approaches have been undertaken for Sexual Assault Referral Centres (SARCs) and in Police Custody. The HNAs undertaken for SARCs and for Police Custody have allowed for the development of bespoke methodologies. For police custody, this has involved:

• Interrogation of electronic police risk-assessment data (for example, direct data analysis from NSPIS)
• Analysis of clinical records from Forensic Medical Practitioners (FMEs) and Nurse Practitioners. Two methods utilised have included auditing a representative sample of clinical records and interrogation of clinical management information systems. As these systems have tended to be under-developed (for example, in comparison to data capture systems such as NDTMS) this has involved a significant degree of data cleansing and recoding
• Comparative epidemiological analysis benchmarking the prevalence of key diagnoses in Police Custody with a derived dataset of over 40,000 records

Example of Practice: Metropolitan Police Service (MPS) Health Needs Assessment

In the absence of defined data capture systems, Therapeutic Solutions (Addictions) Limited invited clinicians across the MPS to develop a prospective clinical survey aimed understanding the needs of detainees at the point of arrest. The survey was undertaken for one month and included weekly electronic and telephone updates with clinicians to assess progress. This approach allowed for any issues in data capture to be resolved ‘in real time’ as well as allowing for clinicians to discuss specific cases that occurred that week. This allowed for a greater contextual understanding of the prospective survey results.