Woodford Correctional Physiotherapy Outreach Service Project

Initiative Type
Toolkit
Status
Sustained
Added
Last updated

Summary

Improving the health of people in prison is a public health priority, as around 1,000 people per month are released from

correctional facilities and return to living in the general community. The Queensland Prisoner Health and Wellbeing Strategy 2020–2025 is underpinned by the principle of equivalence of care to the community, and recognises the link between reduced access to health care, reduced health literacy and recidivism.

This project identifies that healthcare delivery needs to specifically address barriers to access, while recognising the rights of prisoners to human treatment and health services.

Woodford Correctional Centre (WDFCC) is a high security facility, housing a male population, including a Maximum-Security Unit (MSU). WDFCC is documented to be designed for 988 people, housed in mainstream, safety, protection, MSU and residential areas, but the population varies on a daily basis between 1440 - 1450 people.



There are two medical clinics within WDFCC, providing on-site access to pharmacological, optometry, infectious diseases, diabetes and wound management clinics, social work, sexual health, dental, psychological rehabilitation and medical management services. A significant system is in place providing access to vocational training and participation, and access to sporting opportunities, but the physical robustness of those engaged is not similarly addressed. 

Until recently, access to physiotherapy services for the WDFCC population was outsourced to the nearest available secure medical facility, more than100km in distance from WDFCC and in a separate Hospital and Health Service. Transferring prisoners for care posed significant logistical requirements, costs, risks to client and attendants, and inherent security risks. 

A three-month cost-neutral pilot project was carried out between December 2020 and March 2021. Service provision inside the internal Maximum-Security- Unit commenced in February 2021. This was a marked improvement from the previous model, whereby 30 clients were treated at the Princess Alexandra Hospital (PAH) over the entire 2020 calendar year. Client engagement proved to be optimal despite all barriers with attendance of offered appointments being 82% when not impacted by facility lockdown and COVID events.

 

 

 

Key dates
Sep 2021
Jun 2022
Implementation sites
Metro North Hospital and Health Service
Partnerships
Woodford Correctional Centre

Aim

The aim of the research project was to improve access to physiotherapy services for the Woodford Correctional Centre (WDFCC) population by integrating a physiotherapy outreach service into the existing medical clinic.

Benefits

  • The expected benefits of the model were to reduce the requirement for interfacility transfers for physiotherapy referrals, provide a level of service approaching community equivalent access, improve access to care across the facility (equitable access across blocks) and the provision of clinically effective care to enable participation in daily activities.
  • It resulted in an overwhelmingly positive experience reported by inmates and staff.
  • The implementation of the service was associated with improved health outcomes and access to care for inmates.
  • The service proved to be viable, sustainable and cost effective.
  • As a result of this project it has been approved to offer a weekly onsite outpatient service which continues.
  • Specific benefits included:
    • improved inmate wellbeing and decrease reliance on pain medication
    • cost effective
    • inmates' feedback were valued
    • a reduction in security issues

Background

Prison provides an important opportunity for people to access health care that may otherwise be delayed in the community due to competing demands of housing, employment, drug and alcohol issues, and other stressful life events.

Over the past decade, the prison population of Australia has increased by more than 30%. People in prison are considered more vulnerable and have more complex health needs than the general population. 

People in prison report a higher prevalence of health risk factors and behaviours than the general community, including high rates of tobacco smoking, high-risk alcohol consumption and use of illicit drug use and injecting drug use. 

The outsourcing of physiotherapy services to the nearest available secure medical facility, more than 100km away, required significant logistical requirements, costs, risks to client and attendants, as well as security risks. It resulted in high security inmates unable to access care. 

Solutions Implemented

The WDFCC Physiotherapy Outreach Project provided on-site physiotherapy services (one day per week), staffed by senior, experienced physiotherapists (HP4/5).

Referrals to the on-site physiotherapist were generated by Senior Medical Officer or Nurse Practitioners within the WDFCC health clinic. The primary focus of treatment was on early intervention of acute conditions/injuries via individualised education (adapted to fit constraints of prison environment).

 

Evaluation and Results

  • 38 clients were accessed service over 16 weeks, with one to five appointments each
  • Client engagement proved to be optimal despite all barriers. 
  • The initial feedback regarding the pilot clinic was universally positive from both clients and referrers. 
    • 100% of respondents said the service met their needs
    • all staff respondents rated the success of service 5/5

 

Lessons Learnt

It will be beneficial to offer the service more often and inmates need access to more equipment. 

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Key contact

Wendy Milway
Physiotherapist
Metro North Mental Health Clinical Services
07 54338625
Wendy.Milway@health.qld.gov.au

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