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

Therapeutic Solutions (Addictions) Limited has undertaken health needs assessments in Police Custody for a number of Force areas (and Sexual Assault Referral Centres) including:

  • Avon and Somerset Police
  • British Transport Police (including a related study on the epidemiology of suicide prevention)
  • City of London Police
  • Dorset Police (with our partners the Centre for Policy Innovation)
  • Gloucestershire Police
  • Hampshire Police
  • Metropolitan Police
  • Surrey Police (with our partners the Centre for Policy Innovation)
  • Sussex Police
  • Thames Valley Police
  • Wiltshire Police

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

Case Study:

We undertook an enhanced needs assessment for the Metropolitan Police. The study was able to identify important findings including:

  • Times of arrival into police custody for detainees with specific health needs
  • The importance of the case mix of illicit drug use and alcohol with mental health issues and to develop integrated pathways/service provision
  • Importance to detainees of the time taken to access a Healthcare Professional
  • Enhance the awareness and investigation of epilepsy among detainees
  • Enhance provision of support for substance misuse and in particular alcohol misuse, including testing and reviewing the use of brief interventions in police custody
  • Develop integrated communications for the management of medication with community-based services and;
  • Develop access to medical records using electronic information-sharing to facilitate pathways into other services.
  • Findings from this study have recently been published in the Journal of Forensic and Legal Medicine.

Recovery Services

We have offered a range of services to support the development of recovery services across the substance misuse sector including a number of reports and academic peer-reviewed papers. We have a paper written in partnership with Birmingham University on influences to 12-Step mutual self-help groups published in the European Addiction Research in September 2014.

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Our Services

We have developed a range of analytical and methodological approaches aimed at understanding the health and substance misuse needs of individuals including extensive interviews with a cross-section of service users in contact with healthcare and other related services. We have also worked to develop methods aimed at understanding the nuances of prisoner satisfaction of clinical services received. Our paper testing use of SERVQUAL as a mechanism for understanding ‘real’ satisfaction rates has been published here.

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Studies and Assessments

We have undertaken over 50 health and substance misuse specific needs assessments since 2006. These have included studies across community settings and across the criminal justice system (including detainee needs in police custody; service users in contact with Sexual Assault Referral Centres (SARCs) and prisoners in contact with health services in secure settings).

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