Former Leeds prison health boss explains why proper services for prisoners matter
The question of whether prisoners are getting high quality healthcare is unlikely to trouble most people, but Leeds nurse Dawn Jessop sees things differently.
Having led the transformation of health services within HMP Leeds, she believes improving the physical and mental wellbeing of those serving time can help to reduce reoffending and save public funds in the longer term.
It is this belief that has seen her appointed to the new role of deputy director of services at Health in Justice, which provides healthcare in 47 prisons nationwide.
Drawing on more than 20 years in the nursing profession, the mum-of-two from Ilkley will be working with commissioners and Practice Plus Group’s Health in Justice clinical teams on large projects, technological innovations, and winning and setting up new contracts.
"I believe that excellent prisoner healthcare – that addresses the needs of the whole person and supports them to heal their past and find a healthy future – could help address reoffending," she said.
"Early in my career I worked with women prisoners. I came to understand that many of them were, in fact, victims themselves. Too often they were victims of abuse and horrendous home lives that set them on the wrong path from a young age. In many cases, their addictions stemmed from a form of self-medication that was further harming them.
"There are striking links between offending behaviour and substance misuse. Treating and supporting substance misuse reduces reoffending, and that can only be a good thing for the wider community."
Ms Jessop qualified as a mental health nurse at York University in 1995, later gaining a degree in Mental Health Studies from the university.
After a decade spent as a clinical nurse specialist at the Yorkshire Centre for Forensic Psychiatry and the South West Yorkshire Partnership NHS Foundation Trust, she moved into addiction therapy, working as clinical lead and service manager for South and East Leeds Drug Treatment, where she also studied for an MA in Addiction Studies.
Ms Jessop then became the head of healthcare at HMP Leeds, where she raised inspection results in that area from 'poor' to 'excellent' by working alongside the Prison Service, officers, subcontractors and commissioners.
She said: "Prison healthcare is full of challenges and you never have it completely cracked. New challenges arrive whether that is the pandemic, higher prisoner numbers, a greater number of people with addictions and mental health issues or the consistent challenge of attracting more staff.
"As with any prison, healthcare, good teamwork, partnership working and patient engagement are the keys to improvement."
HMP Leeds is a Category B men's prison with nearly 700 rooms, spread across six wings, which house more than 1,100 prisoners. As a Victorian jail first opened in 1847, it was not originally designed to support older people, people with mobility issues or those with long-term health conditions.
"It is an extremely busy local remand prison and, as such, teams face constant challenges in delivering stable healthcare to those arriving, as well as those who have longer stays," Ms Jessop said.
"Because many prisoners are held on remand – a period before trial – the teams are also responding to the immediate and sometimes serious needs of those coming in from the community, whether that is mental health crisis or drug addiction, or right down to a broken tooth."
Changes brought about to better support those patients include bringing in dedicated pharmacy technicians who dispense medicines to ensure people have the correct treatment for their conditions, freeing up nursing time in turn.
Healthcare teams were also integrated to ensure a seamless experience in getting different treatments needed for any condition, while work was undertaken to address the most common problem - patients not attending appointments and conditions worsening without the knowledge of doctors and nurses.
Ms Jessop said: "To help this, we have encouraged patients to become healthcare representatives, so they can help us understand why prisoners do not attend. Not only does this approach address some barriers in services, but also it works to empower and educate patients about their health; assisting them to support others and the service by doing so.
Following her stint at HMP Leeds, Ms Jessop took over responsibility for the local cluster of prisons. She next became regional manager and then regional director of healthcare for more than 20 prisons in the north and east of England.
During this time, she and her team won the Tilley Award from the UK Home Office Policing and Reducing Crime Unit, and a Health Service Journal Patient Safety Award. She also had papers published in a number of peer-reviewed psychiatry and addiction publications.
"Sadly, and troublingly, a large proportion of the prison population suffer from mental health issues," Ms Jessop said. "This is aggravated by the lack of secure mental health facilities outside of the prison estate.
"Many people have often gone undiagnosed and untreated in the community. Stabilising them and accessing treatment in prison can have positive benefits, and offers an opportunity to make progress with psychological interventions.
"Again, with physical health, many people in prison have not been accessing healthcare in their communities, leaving long-term conditions unidentified, untreated and deteriorating. If we can identify and treat these in prison, we can reduce pressures on the NHS and prevent conditions becoming more serious."
Studying for a second Masters - an MSc in Mindfulness - has also led Ms Jessop to reflect on how this might be used to support prisoners in creating positive habits.
"It is the antithesis of addiction, where people fall into bad and even destructive habits that only serve to reinforce their issues," she said.
“We have started using mindfulness within our teams to help develop resilience and we hope to roll this out as a nationwide programme. My hope is that we can develop a mindfulness programme to support our patients and reinforce cessation and mental health programmes.”
While those serving time in prison are there as part of their punishment, Ms Jessop added that this does not mean they stop being a part of the community.
She said: "They are all sons and daughters and they will be returning once their sentences are served.
"Prison can be an opportunity to demonstrate and reinforce positive behaviours and values; treating people with respect and dignity is part of their rehabilitation for that return."
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