Prison health in NHS Greater Glasgow & Clyde : A health needs assessment 2012

Scotland has one of the highest rates of imprisonment in Western Europe and the prison population is rising [1]. In the last decade the average daily prison population in Scotland increased by 27% [1]. The burden of physical and mental illness in the prison population is high; disproportionately so when compared to the general population [2]. This has variably been attributed to socioeconomic disadvantage and lifestyle and behavioural factors such as substance misuse, smoking and poor nutrition which are common in the prison population [2,3]. Prisoners suffer from multiple deprivation [2,3]. Many are a product of the care system, have experienced physical, emotional or sexual abuse and have difficulties forming and maintaining relationships. Levels of educational attainment are low and unemployment high. Homelessness is common. Prior to incarceration prisoners rarely engage with health care services in the community; during imprisonment demand for health care services is high [3,6,7]. Traditionally health care services in Scottish prisons were provided by the Scottish Prisons Service (SPS). On 1st November 2011 responsibility for the provision of health care to prisoners was transferred from SPS to the National Health Service (NHS). The aim of the transfer was to ensure that prisoners received the same standard of care and range of services as offered to the general population according to need. The guiding principle is that of ‘equivalence’ of care. The aim of this Health Needs Assessment (HNA) was to provide a systematic baseline assessment of the health and health care needs of prisoners in NHS Greater Glasgow and Clyde (NHSGGC) and to identify gaps in the current service provision to inform service future planning and development. It focuses on the two operational publicly owned prisons within NHSGGC: HMP Barlinnie and HMP Greenock. A third prison, HMP Low Moss, falls under the remit of NHSGGC but it was under renovation at the time of this HNA. Information about the prison population was drawn from published literature and reports provided by staff from the Justice and Communities Directorate of the Scottish Government. Information about the prisons from HMP Inspectorate reports, direct observation and interviews with members of staff in each prison. To fully understand the level and nature of existing services a service mapping was undertaken jointly with nominated staff from the prison health teams using direct observation and extensive staff and prisoner interviews and focus groups. Overall the findings are in line with other national and international studies on prison health. Despite characteristic differences between the prisons within NHSGGC there was a high level of consensus amongst both prisoners and staff groups about health needs and priorities. The report acknowledges the thoughtful contribution of prison staff and the positive approach to improving health services that they expressed. This has impacted on the formation of recommendations that both validate existing approaches and identify opportunities and 10 priorities for health gain. In addition to more fundamental changes they identify opportunities for quick wins that do not require significant financial outlay

Process, outcome and experience of transition from child to adult mental healthcare : multiperspective study

Background Many adolescents with mental health problems experience transition of care from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). Aims As part of the TRACK study we evaluated the process, outcomes and user and carer experience of transition from CAMHS to AMHS. Method We identified a cohort of service users crossing the CAMHS/AMHS boundary over 1 year across six mental health trusts in England. We tracked their journey to determine predictors of optimal transition and conducted qualitative interviews with a subsample of users, their carers and clinicians on how transition was experienced. Results Of 154 individuals who crossed the transition boundary in 1 year, 90 were actual referrals (i.e. they made a transition to AMHS), and 64 were potential referrals (i.e. were either not referred to AMHS or not accepted by AMHS). Individuals with a history of severe mental illness, being on medication or having been admitted were more likely to make a transition than those with neurodevelopmental disorders, emotional/neurotic disorders and emerging personality disorder. Optimal transition, defined as adequate transition planning, good information transfer across teams, joint working between teams and continuity of care following transition, was experienced by less than 5% of those who made a transition. Following transition, most service users stayed engaged with AMHS and reported improvement in their mental health. Conclusions For the vast majority of service users, transition from CAMHS to AMHS is poorly planned, poorly executed and poorly experienced. The transition process accentuates pre-existing barriers between CAMHS and AMH

Risk and Business Goal Based Security Requirement and Countermeasure Prioritization

Companies are under pressure to be in control of their assets but at the same time they must operate as efficiently as possible. This means that they aim to implement “good-enough security” but need to be able to justify their security investment plans. Currently companies achieve this by means of checklist-based security assessments, but these methods are a way to achieve consensus without being able to provide justifications of countermeasures in terms of business goals. But such justifications are needed to operate securely and effectively in networked businesses. In this paper, we first compare a Risk-Based Requirements Prioritization method (RiskREP) with some requirements engineering and risk assessment methods based on their requirements elicitation and prioritization properties. RiskREP extends misuse case-based requirements engineering methods with IT architecture-based risk assessment and countermeasure definition and prioritization. Then, we present how RiskREP prioritizes countermeasures by linking business goals to countermeasure specification. Prioritizing countermeasures based on business goals is especially important to provide the stakeholders with structured arguments for choosing a set of countermeasures to implement. We illustrate RiskREP and how it prioritizes the countermeasures it elicits by an application to an action case

Drug education : an entitlement for all : a report to government by the Advisory Group on Drug and Alcohol Education

Drug And Alcohol Advisory Group – Key Recommendations: ●● Increase parents’ and carers’ knowledge and skills about drug and alcohol education and prevention enabling them to better inform and protect their children; ●● Improve the quality of drug and alcohol education by making PSHE a statutory subject – to enable schools and colleges to promote well-being effectively, and to improve the quality of training for PSHE teachers; and ●● Improve identification and support for young people vulnerable to drug misuse in schools, colleges and non-formal settings

Health of children and young people in secure settings

This small-scale descriptive study was commissioned by the Children and Young People's Public Health team within the Department of Health, in partnership with Offender Health, in order to inform preparation and implementation of an Offender Health Strategy document for children and young people. The overall aim was to review what is currently known about healthcare for children and young people in the secure estate, covering all three types of settings (Young Offender Institution, Secure Training Centre and Secure Children's Home) and all aspects of health, but with a particular focus on physical health since more is already known about mental health and substance misuse among young people in secure settings

Supporting young people: an evaluation of recent reforms to youth support services in 11 local areas [+ handout]

This survey examines the progress made in 11 local authority areas in developing new arrangements to integrate the work of various youth support agencies. An accompanying handout is included

Targeted youth support: Rapid Evidence Assessment of effective early interventions for youth at risk of future poor outcomes

This report describes the findings and methods of a systematic rapid evidence assessment (REA) of research relevant to interventions of interest to Targeted Youth Support. It was commissioned by the Department for Children, Schools and Families (DCSF) to inform the development of policy and practice in relation to this initiative