HMP Durham

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked at 2 quality statements in this key question. Patients received appropriate assessment and onward referral during early days in custody. Staff attended daily safety huddles to ensure patient safety and risks were discussed and actioned. Patients with complex care needs were managed effectively. Patients on the EPCU had regular access to a multidisciplinary team, however, care records were not always up to date.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

New prisoners received comprehensive primary and secondary health screening assessments, followed by further assessments if needed by the relevant specialism. Staff checked up on new prisoners who refused their initial health screening assessments.

Staff effectively monitored and managed patients with complex care needs. A multidisciplinary approach and improved processes capturing more detailed patient information had strengthened the provision of care for those with complex needs.

Wing-based pharmacy technicians got to know their patients well, which helped with conversations about maintaining good healthcare and discussing risks associated, for example, with poor compliance with medicines or refusal of essential monitoring tests. This also helped with identifying new or unmet needs leading to referrals to the relevant services.

However, care records for patients admitted to the EPCU were not always accurately maintained as required. Of the 4 records we reviewed, we found delays to 2 EPCU admission assessments and their associated care plans. Daily entries in care records did not always capture the progress of patients in relation to their identified needs. Although patients received the required care, there was no oversight of these gaps.

The judgement for Delivering evidence-based care and treatment is based on the latest evidence we assessed for the Effective key question.

Following the appointment of a lead nurse for the EPCU, a weekly multidisciplinary ward round had been introduced to review patient care. Key people involved included a pharmacist, GP, ACP and nurse. These meetings enabled professionals to meet jointly with patients and discuss their care. Further referrals, such as to the physiotherapist, were made and actioned as part of this meeting. Additional professionals, such as the complex care lead would also attend when required to do so.

Staff had introduced some processes to improve patient care, such as a daily handover document and daily/weekly task sheets. However, these required further development and embedding into practice to ensure all staff, including senior nurses, were aware of their responsibilities when working on or overseeing the EPCU.

An administrative team supported the healthcare service. Administrative staff supported a range of clinical functions such as receiving and processing patients’ healthcare applications, booking clinical appointments, and managing external appointments. However, we found there were no standard operating procedures available to guide staff in their work. Spectrum, with support from NHS England, had commenced a project in April 2024 to establish a standardised approach to administrative working practices. This project was completed in March 2025 and a recent report identified key recommendations to improve the service offer across health and justice administration teams. However, we found no recommendations relating to the development of SOPs in relation to key administrative tasks such as reviewing tasks, electronic applications on the kiosk system and the management of external hospital appointments.

Staff raised patient-related concerns at daily safety huddles and handovers. We reviewed the notes of 3 recent safety huddles. These meetings were multidisciplinary and had a clear agenda focusing on key areas such as receptions, transfers and discharges; patient-related concerns and updates; and incidents and risks. Staff identified actions needed and followed them up.

We attended 2 handovers during our inspection. These were well attended by primary care and pharmacy staff. They were patient-focused with staff sharing information about patients they were concerned about and updates from any interventions. Staff discussed, agreed and allocated actions.

Healthcare staff had good working relationships with prison managers. Staff had the opportunity to raise issues at daily ‘morning meetings’ as well as at forums such as local delivery boards. Generally, healthcare and prison staff cooperated to find solutions to their challenges, for example, allowing reception screening assessments to take place until midnight; improving the management of medicines’ administration queues; and supporting additional external appointments. However, healthcare staff expressed concern about how often the enhanced primary care unit was left without prison officer support, which meant patients had to remain locked up in their cells, which then limited staff’s access to them.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

The judgement for Consent to care and treatment is based on the latest evidence we assessed for the Effective key question.