NHS England » Ensuring GP practices and community pharmacy are ready to support individuals being released early from prison as part of the initiative to help tackle prison pressures

Classification: Official
Publication reference: PRN01535

To:

integrated care board (ICB) primary care directors
primary care network leads
GPs
community pharmacy leads
regional primary care directors

cc.

national and regional health and justice commissioning directors and heads
practice managers
ICB chief executives

Dear colleagues

Ensuring GP practices and community pharmacy are ready to support individuals being released early from prison as part of the initiative to help tackle prison pressures

Your support is needed to ensure the continuity of care for individuals who will be released from prison as part of a Ministry of Justice measure to help relieve prison capacity pressures. Those eligible for this initiative will be released from prisons across England on 10 September 2024 and 22 October 2024.

While health and justice commissioners and providers have been working closely with His Majesty’s Prison and Probation Service and NHS colleagues to support the safe release of individuals, we are seeking your support on several requirements relating to general practice and community pharmacy.

Please review the information below and the required actions for your area, ensuring your colleagues and networks are briefed and can support this as required.

GP registration

As part of healthcare release planning, prison healthcare providers will support the registration of individuals with a community GP following pre-registration guidance. This includes identifying a suitable GP practice, sending a pre-registration notification to the receiving practice and arranging the electronic transfer of patient records to support registration with the community practice on their release day.

Where a GP2GP transfer did not take place when an individual was sent to prison, prison healthcare will upload a copy of the patient’s record to Primary Care Support England (PCSE) so this can be transferred to the new GP practice (or held in archive until there is a new registered GP practice).

GP practices in the community should ensure processes are in place to support pre-registration and the subsequent transfer of care. This is part of meeting the contractual requirements to facilitate individuals being registered before they leave prison. See this pre-registration guidance.

When registering an individual, it is not necessary for individuals to have a home address, proof of ID or an NHS number. GP registration should be managed sensitively and the inability of anyone to present such information is not a reason to refuse registration. Patients who do not have a permanent address can still register using a temporary address or the address of the GP practice (subject to the practice’s agreement).

GP registration and the Special Allocation Scheme

Patients who were under the care of a Special Allocation Scheme (SAS) provider at the time of their detention will return into the care of SAS when they are released from prison. SAS services provide alternative primary medical care to patients who have been removed from a GP practice registered list due to violence towards staff, ensuring a safe environment for staff and visitors. Patients remain in SAS until they have been discharged from the scheme.

Prior to release, prison healthcare providers have been asked to check patient records for a SAS flag and pre-register flagged individuals with SAS. SAS will register them with a practice in the scheme. Prison healthcare providers will advise patients of which SAS provider they have been registered with.

New patient assessments

We encourage practices to prioritise new patient assessments for those released under the early prison release scheme. Practices are advised to consider the patient’s past medical history, including mental health, drug, alcohol and substance misuse needs, which may require further consideration to ensure immediate continuity of care. As part of pre-release processes, prison medical centres will have provided a discharge summary of any ongoing care needs.

Medicines supply on release

Prison medical services will have provided 28 days of medicines on discharge to allow time for primary care prescribers and patients to access the next supply. For opioid substitution therapy (OST), prison medical services will have provided a prescription (FP10/FP10MDA) for up to 14 days or a short-term interim supply as per local arrangements. This action will be taken as part of the continuity of substance misuse treatment.

Community pharmacy

Community pharmacy teams have an important role in supporting patients with ongoing medicines supply and walk-ins, and are asked to note the following:

For urgent medicines that have previously been prescribed as repeat prescriptions, individuals can access these by calling NHS 111.

Pharmacy First Service:

patients can access care for a specific range of conditions using the Pharmacy First Service, which enables them to get certain prescription medications directly from a pharmacy, without a GP appointment
healthcare professionals can use the NHS Service Finder to find pharmacies participating in this service and patient information is on the NHS.uk website
patients can contact 111 or access 111 online to be referred to a pharmacy that provides the full range of Pharmacy First services

NHS Pharmacy Contraception Service:

for women being released from prison, the NHS Pharmacy Contraception Service provides an accessible and convenient place to receive advice and support for contraception management
individuals do not need to be registered with a GP to access this service and pharmacies should only inform the GP practice that individuals have accessed the service with the individual’s consent
see the NHS.uk website for details of pharmacies that offer the contraceptive pill without a prescription

Electronic Prescription Service:

The Electronic Prescription Service (EPS) is now being rolled out across the detained estate and contractors may see an increase in the presentation of non-nominated EPS prescription barcodes and/or FP10MDAs issued on discharge. These prescriptions will carry the following information on the front of the form:
- the letters ‘HMP’
- prison name and address
- prison telephone switchboard number
- prescribing code
Community pharmacy teams are reminded that patients presenting these prescriptions are exempt from prescription charges.

Thank you for your continued support. Our priority is to ensure continuity of care and the effective management of long-term conditions for early prison leavers. At a time of great uncertainty for many of these men and women, who are our patients both in prison and in the community, the ongoing provision of care and treatment is a crucial element in supporting their rehabilitation, reducing health inequalities and minimising the risk of reoffending.

If you have any queries regarding the information in this letter, please contact your local integrated care board.

Yours sincerely

Kate Davies CBE, National Director of Health and Justice, Armed Forces and Sexual Assault Referral Centres, NHS England