Table 1

Compliance with guidelines

Written policy.Standard operating procedures introduced—formal written policy in progress.
Prisoner education.Available, although further ways to improve this were identified.
≥80% Vaccination coverage.
Condom and lubricant access.Now freely available on request, without prescription.
Standardised pretest and post-test discussions.
Adequate information provided, addressing various needs, awareness sessions.Translated information still lacking, and ‘expert patients’ from among peers are not currently available.
Ongoing education and training for prison staff.Wider nursing team still need DBST training to assist with BBV services.
Testing: designated staff, offer inreach services, procedure to provide results, access to DBST, handover arrangements for transfer, medical hold.Inreach services still in progress. No medical hold available.
Laboratory to ensure PHE notified of new cases.
Immunisation offered to all new and existing prisoners.57%, 2015.
Testing done simultaneously with vaccination.
Very rapid schedule used (0, 7, 21 days).
Recommend 12-month and 5-year booster doses.Sporadic recommendations are made.
Hepatitis B: All prisoners to be offered vaccine, or continue course. Test to be performed simultaneously. If negative, provide reassurance and harm minimisation, and complete course. If positive, suspend vaccination and refer for further testing.Offer was not made to all prisoners.
Hepatitis C: Testing offered to all current and new prisoners (within 72 hours). Those with negative or false-positive results receive a repeat risk assessment and test offer after every risk event or annually. Those testing positive receive confirmatory testing and referral to secondary care.100% were offered, however not all who tested positive were commenced on the management pathway.
  • Bold text indicates those that have improved since the previous review. 

  • In terms of current adherence to guidelines, ’green' corresponds with adherence, ’orange' with partial adherence, and ’red' with non-adherence.

  • BBV, bloodborne virus; DBST, dried blood spot testing; PHE, Public Health England.