An Oral Health Needs Assessment of Prisoners in HMP Brixton

Prison Oral Health Care♦ In 2003 The DH & HM Prison Service‘Strategy For Modernising Dental Services ForPrisoners In England’♦ Office for Public Management was commissionedby the Chief Dental Officer for England♦ In April 2006 PCTs♦ Free of charge♦ Demand based by prisoners

Brixton Profile♦ 5 Wings♦ Operational Capacity: 805♦ CNA: 790♦ High turnover♦ 45% White, 43% Black, 7% Asian and 5%other

Dental Care Service Provision in HMPBrixton♦ 4.5 weekly scheduled sessions♦ KCH: Community Special Care Dentistry♦ Fully equipped dental surgery in the health carebuilding♦ NHS rules and regulations

Barriers in obtaining dental care services♦ Access, anxiety♦ Long waiting lists♦ Emergency treatment♦ High turn over♦ Complex medical, dental and social cases♦ Detoxification programmes♦ High incidence of pain♦ High perceived and normative need

About the researcher♦♦>3 years in prisonsInformal interviews1. Knowledge and views of oral health2. Past use of dental services3. Dental treatment experience4. Their current oral health status

The Oral Health Needs AssessmentAim:To investigate the oral health statusand dental treatment requirements ofprisoners in HMP Brixton.

Objectives♦ Factors that affect prisoners’ general &oral health♦ Perceived oral health needs♦ Normative oral health needs♦ To compare their needs♦ To inform the dental service providers♦ To develop the dental action

Method♦ Permission and ethical approval♦ Study designQuestionnaire/structured interviewOral health examination♦ Study sampleRecruitment to the pilot study♦ Consent and data protection

Ethical approval♦ The Governor and the Head of the HealthCare in HM Brixton prison♦ Local Research Ethics Committee inJanuary 2004♦ Northern and Yorkshire Multi-CentreResearch Ethics Committee (MREC)

Ethical approval♦ Time♦ Unaware of prison population♦ Committee placed in the different location♦ The committee’s members

Recruitment to the studyInformation sheet–Staff–Prisoners

The pilot study♦ Questionnaire was fully understood by theparticipants♦ Recorder of the clinical examination wasfamiliar with the charting form♦ To uncover any unforeseen problems

Problems1. Forms♦♦Not returnedWere missing because prisoners had beenreleased, bailed or transferred.2. No dental treatment no participation

Reasons for refusal to participationMaden et al., 1995♦♦♦Prison officers’ tight schedulesType of the prison establishmentType of prisoners

Reasons for refusal to participationKatz et al. (2003)• Fears of abuse by researcher from a legal,historical or ethical perspective• Cultural factors• Socioeconomic status• Educational level• Understanding of the purpose of research• Perceptions of the costs and benefits

Main study♦ Between October 2004 & March 2005♦ Invited verbally♦ An interest was expressed the informationand consent sheets were discussed andexplained face to face

The main studyProblemsSupport♦ Ethical approval♦ Prison: staff &prisoners♦ Time♦ Available literature♦ Implement therecommendations♦ Head of theDepartment♦ Supervisors from KCL♦ HMP Brixton staff♦ Senior Dental Nurse♦ Resources

Recommendations♦ Further clinical sessions♦ Commission form the local PCT♦ Multidisciplinary team♦ Clinical governance♦ Staff support♦ Resources

Thank you