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England have been working on the guidance and standards for the Physical Health Checks in Prison Programme. This is a prevention programme which is a risk assessment and management programme aimed at 35-74 year olds who have a period of incarceration of two years or more, targeting the seven main causes of premature mortality. The guidance sets out what a health check entails and how it should be delivered within a prison setting. The standards have been developed to improve the quality of delivery of the programme and outline key standards and quality indicators.
A complete Physical Health Check in prison must include all the elements outlined in the short guidance, these include;
- smoking status
- family history of coronary heart disease
- blood pressure, systolic (SBP) and diastolic (DBP)
- body mass index (height and weight)
- General practice physical activity questionnaire (GPPAQ)
- Alcohol use score (AUDIT-C or FAST can be used as the initial screen)
- cholesterol level: total cholesterol and HDL cholesterol (either point of care or venous sample if within the last six months)
- cardiovascular risk score: a score relating to the person’s risk of having a cardiovascular event during the ten years following the health check, derived using an appropriate risk engine that will predict cardiovascular risk based on the population mix within the local authority’s area
- dementia awareness (for those aged 65 to 74)
- validated diabetes risk tool
The key aspect of the health check is delivering brief advice on lifestyle issues and referring on to either a treatment service or lifestyle intervention programme, such as physical exercise, dietary advice, or stopping smoking service.
The Health Check in Prison Programme has been especially adapted from the NHS Health Check Programme. A key difference is that the health check in prison programme is offered to people from age 35, as there is an ageing effect in prison. Prisoners tend to have a biological age about 10 years in advance of their contemporaries in the community, due to chronic health problems. It is an especially effective way to help to address potential health inequalities as people in prison often come from deprived backgrounds and are more at risk of premature mortality. Evidence form the national NHS Health Check programme estimates that in the first five years, the programme is estimated to have prevented 2500 heart attacks and strokes. It is envisaged that as the Health Check in Prison Programme is targeting people who potentially have more risk factors then it will be even more effective at preventing premature mortality.
Physical Health Checks in Prisons