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Speakers Corner - New scheme to register offenders

This month Leighe Rogers explains how various agencies are coming together to support offenders to register with GPs. Leighe works in the justice system on behalf of NHS England London. The offender registration scheme will launch on 14 September, Leighe can be contacted for information: leighe.rogers@sutton.gov.uk

NHS England London, together with Dr Nicola Lang Director of Public Health (Sutton) and the London Community Rehabilitation Company are introducing a scheme to help offenders to register with a GP.

Probation officers, youth justice or substance misuse workers will make a referral to GP practices who in turn will be asked to register offenders who are released to, or living in, their catchment area. A unique feature of the scheme is the ability to use their supervising officers’ premises as a proxy address. Also new to the scheme are arrangements for prison healthcare staff to check and record a prisoner’s GP status and share this information (subject to the necessary permissions), with criminal justice staff. The London prisons computer system (System1) is being upgraded to allow GP access to patient notes held by prison healthcare teams. When this happens GPs themselves will be able to confirm directly; what medication has been prescribed to patients on the day of their release from prison.

Offenders are a ‘hard to reach group’; many are homeless or have complex health needs which they frequently ignore. Some, particularly those with mental health or substance misuse problems, fail to deal with or appreciate the need to take care of their own health needs. This means that relatively easy to treat issues can develop into more complex difficulties, which are more intense as a result of personal neglect or indifference. Many find it too difficult to navigate or engage in the process of registration necessary to see a GP. There are many reasons for this including poor communication skills, difficulties with completing the necessary paperwork, fear of refusal, lack of the necessary skills to navigate the processes and sometimes having to deal with unsympathetic people. Understandably some GPs or their staff may be worried about taking on people who are likely to have complex problems and may also have concerns about staff and other patients’ safety. Many, if not all, GPs will have similar patients that they are treating already, so a great deal of the likely issues will be familiar.

So, why at a time of scarce resources, is this a good thing to do?

Accessing mainstream healthcare in the same way as the rest of the population is essential to help offenders fully reintegrate into society. If they do not have access to a GP they cost taxpayers more money and divert NHS resources away from GPs. If their health needs are met in the community, they do not become more acute and end up presenting at A&E. A visit to A&E can cost up to three times more than a GP and takes up capacity for those suffering conditions which can only be seen in A&E.

As I go ‘round the London boroughs I can understand the reluctance of some to engage in yet another project, but this really does represent a win-win situation for both the offender and broader society, and make best use of NHS resources to the benefit of GPs.

Last updated : 17 Aug 2016

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