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Research article
Nat Wright
Spectrum Community Health CIC
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Long-term conditions (LTCs) are a significant cause of morbidity and mortality and prisoner populations have a disproportionately high prevalence of risk factors for LTCs. The size and mean age of the prison population has increased rapidly in recent years. The UK Quality Outcomes Framework (QOF) is a national standardised framework embedded in community general practice with financial remuneration linked to assessment and ongoing review of key clinical outcomes pertaining to LTCs. However, healthcare in prisons in England is not linked to financial remuneration through the QOF framework and prison clinicians are not mandated to adhere to the framework.
Methods: Secondary data analysis of data extracted from the prison primary care record pertaining to patient self-report of LTC, level of confirmation by supporting evidence and compliance with QOF monitoring frameworks.
Results: 17% of the sample had at least one LTC, the most common condition being asthma, confirmed in 12% of the sample. Having an LTC was associated with female gender and increasing age. Prevalence rates for the other LTCs were hypertension 3%, epilepsy was 3%, coronary heart disease 2%, diabetes 2% and chronic obstructive pulmonary disease 1%. Just 34% of the eligible sample had had a QOF template completed. Higher rates of completion were associated with younger age and there were also statistically significant inter-prison differences.
Conclusion: There is a pressing need to embed standardised QOF monitoring systems within an integrated community/prison commissioning framework supported by connectivity between prison and community primary care records of not just the summary care record but also all activity related to QOF compliance. Amongst prisoner populations, there is high prevalence of risk factors for long-term conditions. This research quantifies the burden of disease and highlights under-developed systems for monitoring. There is an opportunity to enhance connectivity between community and prison GP settings to facilitate seamless monitoring of QOF outcomes.
Keywords
Long-term conditions, prison healthcare, community healthcare, Quality outcomes framework
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This is a preprint. It has not completed peer review.
Research article
Nat Wright
Spectrum Community Health CIC
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 05 Aug, 2020
No community comments so far
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Long-term conditions (LTCs) are a significant cause of morbidity and mortality and prisoner populations have a disproportionately high prevalence of risk factors for LTCs. The size and mean age of the prison population has increased rapidly in recent years. The UK Quality Outcomes Framework (QOF) is a national standardised framework embedded in community general practice with financial remuneration linked to assessment and ongoing review of key clinical outcomes pertaining to LTCs. However, healthcare in prisons in England is not linked to financial remuneration through the QOF framework and prison clinicians are not mandated to adhere to the framework.
Methods: Secondary data analysis of data extracted from the prison primary care record pertaining to patient self-report of LTC, level of confirmation by supporting evidence and compliance with QOF monitoring frameworks.
Results: 17% of the sample had at least one LTC, the most common condition being asthma, confirmed in 12% of the sample. Having an LTC was associated with female gender and increasing age. Prevalence rates for the other LTCs were hypertension 3%, epilepsy was 3%, coronary heart disease 2%, diabetes 2% and chronic obstructive pulmonary disease 1%. Just 34% of the eligible sample had had a QOF template completed. Higher rates of completion were associated with younger age and there were also statistically significant inter-prison differences.
Conclusion: There is a pressing need to embed standardised QOF monitoring systems within an integrated community/prison commissioning framework supported by connectivity between prison and community primary care records of not just the summary care record but also all activity related to QOF compliance. Amongst prisoner populations, there is high prevalence of risk factors for long-term conditions. This research quantifies the burden of disease and highlights under-developed systems for monitoring. There is an opportunity to enhance connectivity between community and prison GP settings to facilitate seamless monitoring of QOF outcomes.
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