A small selection of extracts ;

Recommendation : Detainees who clearly demonstrate a health need should have a care plan.  The nurse on duty should see the patient each shift and, if necessary, update the care plan. (2.21)
Accept
Comments/action : G4S will instruct the healthcare providers to implement care plans for those detainees who present a healthcare need. A nurse will see the patient on each shift if required by the plan.

Recommendation : The central log of rule 35 notifications and caseworker responses should include a copy of the notifications and responses. (2.25)
Reject
Comments/action : A central log indicating when: notifications are sent to case owner; response received and when sent to healthcare is held electronically by the UKBA team at the centre. All hard copies are held on detainees’ files.

Recommendation : Health services should establish formal links with the provider and commissioning sections of the primary care trust to promote quality assurance of services and ensure the health needs of detainees are met. (2.140)
Accept
Comments/action : Commissioners are to be encouraged to engage more than they have been prepared to in the past. The PCT, particularly with mental health, has escalated this issue to director level.

Recommendation : Health needs assessment work should include independent external input and review. (2.141)
Accept
Comments/action : The local Primary Care Trust (PCT) has agreed that public health will be involved with health needs assessment production.

Recommendation : The health provider should negotiate with the PCT to provide experienced health professionals, such as health visitors, to visit the centre regularly to ensure that the health and welfare needs of children are met. (2.152)
Accept
Comments/action : There has been a re-structure within the PCT - links with new team to be developed. Formal request to support has been made to the PCT.

Recommendation : All health staff should receive in-depth training on recognition and treatment of patients who have experienced torture and violence. (2.154)
Accept in principle   
Comments/action : UKBA is considering the provision of estate wide torture recognition training to all clinical staff within immigration removal centres and is in consultation with a potential provider.

Recommendation : Health staff should be offered external supervision. (2.156)
Accept   
Comments/action : Local specialists are working with the clinic to offer disease specific supervision. PCT to be asked to be more involved in formal supervision (01/04/2010)
 
Recommendation : There should be a consistent, multidisciplinary approach to assess and report on the extent to which a person’s physical or mental health is or could be adversely affected by detention. (2.161)
Accept   
Comments/action : Standards / thresholds for Rule 35 have been discussed amongst nursing team and documentation amended to increase information offered to UKBA. Where concerns exist, ACDT is used – and this is where multidisciplinary input features.

Recommendation : Clinical audit should be introduced and reviewed regularly. (2.173)
Accept   
Comments/action : This will be developed in line with Quality Outcome Framework and health needs assessment (1/7/2010).

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