corrections health service complaints management system in nsw prisons
TRANSCRIPT
Corrections Health Service
Complaints Management System in NSW Prisons
Presenters
Leslie Tak
A/Health Planner
Maria Hatzidimitris
A/Client Liaison & Policy Officer
Session Outline
Context - Complaints in the NSW Correctional System
– Health Services– Demographics– Constraints
Complaints Management System– Flow Chart– Statistics– Case Study– Quality Activities– Future Directions
Is a statutory corporation that provides a wide range of health services across NSW:
– 29 correctional centres
– 10 detention centres and
– 6 court/cell police complexes
Corrections Health Service
Health Services Provided by CHS
• Mental Health• Primary Health• Public Health• Drug & Alcohol• Clinical Services
Oral Health Physiotherapy Art Therapy Occupational Therapy
Radiology
Inmate Profile
Inmates have a substantially lower socio-economic
status than in other communities (Essential Equity)
As socio-economic status is a powerful predictor
of health status, this fact also has implications for
Corrections Health Service
Inmate Population The full time inmate population is projected to
increase from 7,300 in 1998/99 to 9,500 in 2008/09
Predominantly young males, with a shift toward older inmates and increase in females inmate numbers.
71% Australian born and 16% born overseas in a non English speaking country
Approximately 16% Aboriginal and Torres Strait Islander
Inmate Health Status: General Trends
80% of inmates have been incarcerated for offences related to drug and alcohol use
Some 60% of males and 70% of females have a history of illicit drug use.
Around one third of the males and two third of females are hepatitis C positive
Approximately one third of males and half of females have been assessed or treated for mental illness
Constraints Impacting Health Delivery
16,000 annual receptions
Length of Stay– 27% less than 8 days– 17% between 8 and 30 days– 56% greater than 30 days
Movements– 7,500 escorts to court per month– 127,000 internal movements per year
Constraints cont.
• Corrections Health Service as separate from Department of Corrective Services
• Access • Security issues supersede health issues • Language barriers • Cultural barriers • Expectations of health services may be
unrealistic or non-existent.• Public Opinion re Inmates & Health Service
Complaints Management
Corrections Health Service has a strong
commitment to improving the health of people
in the NSW correctional system
Complaints Management is an integral part
of the quality monitoring and improvement
cycle
Complaints Management - Review
1998 CHS conducted a formal review :
NSW Better Practice Guidelines for Frontline Complaints Handling
NSW Ombudsman’s Effective Complaint Handling Guidelines Statewide Complaints Data Collection Better Health Good Health Care
Complaints Management System
• Flow Chart: Path flow for complaint process
• Statistics: <3% of the inmate population have lodged a complaint
18% of these unsubstantiated
• Case Study: Symptoms
Investigation
Outcome
• Quality Activities
• Future Directions
Source 3%
1%
6%
5%
5%
2%
0%
1%
11%
4%
4%8%
Direct from complainant
50%
CHS Staff
Commonwealth GovernmentDepartmentDepartment of CorrectiveServicesDirect from complainant
Health Care ComplaintsCommission (HCCC)Legal
Member of Parliament
Multiple of Above
NSW Department of Health
NSW Ombudsman
Official Visitor
Other State GovernmentDepartmentRelative
Issues 4% 3%3%
11%
5%
4%
8%
14%6%
7%
6%
3%
5%
21%
Administrative Services
Attitude
Coordination of Treatment
Delay in Admission ortreatmentDischarge or TransferArrangementsInadequate Treatment
Inadequate/No response tocomplaintMedication*
Referral
Refusal to Admit or Treat
Resources/ServiceAvailabilityTransport
Wrong/InappropriateTreatmentOthers
Case Study - BackgroundComplaint to Official VisitorSymptoms:
Shortness of BreathSwollen joints & limbsSkin rashPins & needlesWeakness & muscle fatigueSymptoms of arthritis Sharp pains in lower chest
Case Study – Investigation Outcomes Referred to hospital Missed five appointments High level security required for external
medical appointments Appointments cancelled due to lack of staffing Prescribed anti-inflammatory and analgesics Referred to hospital after symptoms persisted
Case Study – Investigation Outcomes
Venous Ultrasound negative & diagnosed with cellulitis
Commenced on antibiotics Symptoms temporarily reduced Security measures improved & referred back to
hospital Diagnosed with pleural effusion & anaemia During admission diagnosed with SLE
Key Issues
1. Diagnosis
2. Inadequate Treatment
3. Wrong/Inappropriate Treatment
4. Negligent Treatment
Summary of Investigation Outcomes
Delays in diagnosis due to environmental
constraints
DCS and CHS believed to be one
organisation
Mr X reluctant to seek medical attention after
hours
Resolution Mechanism
Resolution process initiated
Mr X satisfied with the treatment provided
Enhanced communication
Promotion of CHS as a separate entity
Quality Activities from Investigation
Clinic hours reviewed to address needs of
working inmates
In-service for CHS staff relating to the impact
of security measures
Promotion of CHS (via posters, brochures,
video)
CHS Quality Activities
External Audit of Complaints Management System
Reports to Quality Council, CHS Board, Clinics across the State, NSW DOH
Specialty reports Complainants’ Satisfaction Survey Education Sessions Consultation with Consumers, Consumer and
Community Representatives
Inmate Health Survey 2001 Encourage inmates to view complaint as
a positive partnership and as constructive measure for improvement
Promotion of the Service as separate to the Department of Corrective Services
Multilingual Patient Information Brochure
Posters for inmates on how to lodge a complaint
CHS Future Directions