A massively overcrowded prison is failing to address some of the basic healthcare needs of its inmates, inspectors have concluded. HMP Swansea, a category B prison, currently holds 360 men but has a baseline capacity of 255.
A report by Healthcare Inspectorate Wales (HIW) found that some prisoners were left in pain for months waiting for basic dental surgery like a root canal treatment. Swansea Bay University Health Board, which is in charge of healthcare at the facility, also failed to provide optometry services for almost two years which impacted on residents' health and wellbeing.
A survey completed by prisoners discovered that more than half found it difficult to access GP services, except for substance misuse. One prisoner said it took "weeks" for them to see a doctor.
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One staff member at the prison said healthcare provision needed to be evaluated as it "nowhere near" provides adequate care for prisoners. They added that the mental health provision was "woefully short" and left staff and prisoners vulnerable.
While the prison did provide a mental health in-reach team (MHIRT) service, during the pandemic many of the appointments were done virtually which impacted negatively on patients. The service was also shared with HMP Parc in Bridgend, a privately-owned category B prison and young offenders' institution in Bridgend.
Meanwhile a member of prison healthcare staff told HIW that panic alarms were situated in the wrong part of the clinic room and could not be used in an emergency. Inspectors said this comment raised an issue around maintaining staff security and safety.
Despite a new electronic pharmacy system being put in place to improve the accuracy of dispensing, training was not yet complete. Inspectors also found that Swansea Bay University Health Board, which is in charge of healthcare at the prison, did not hold the necessary Home Office controlled drugs (CD) license to possess and dispense medication. However, a licence was finally granted in May 2022.
From a healthcare staff perspective, inspectors said most prisoners were satisfied with the quality of healthcare given to them. However, responses from the prison staff reflected more negatively. One staff member said: "Healthcare team in HMP Swansea provide excellent standards of care within the limitations imposed on them by appalling availability of resource (primarily labour hours). I've spent years watching healthcare team members work in very difficult conditions providing the best levels of care within their abilities."
The report added that most staff believed there was a culture of openness and learning in their department, with most healthcare staff and just under two-thirds of prison staff in agreement with this. Staff also indicated a good working relationship between healthcare staff and prison staff. The majority of staff also indicated they were actively encouraged to report incidents or concerns.
The report added: "The head of nursing and lead nurse have a close relationship with the prison staff and have line management responsibilities for healthcare staff within HMP Swansea. Whilst we were told that they maintain visibility with the teams within the prison and overall prison healthcare services, a number of other senior managers and independent members said they had never visited the prison."
HMP Swansea is made up of those on remand, others awaiting sentencing, and those who have been given a determinate prison sentence. According to Public Health Wales, people in prison often have much higher death rates and suffer greater health inequalities than the general population.
In response to the HIW report, a spokesperson from Swansea Bay UHB said: "We are pleased to see the review recognised the positive feedback from a significant number of service users. However it is also clear that there is much more we can do to work with prisoners, to better understand how we can deliver care, and address health inequalities and that work is already well underway.
"The health board continues to work closely with the prison governor and our wider partners to strengthen governance and develop a robust improvement plan. A working group has been established to focus on both the improvements we can make immediately, and also a new Health Delivery Plan 2022-25 which we will be publishing shortly. As part of our ambitious programme of improvement, the plan is focused on improving wellbeing, mental health alongside better access to integrated care." To get more news like this straight to your inbox, subscribe to our newsletters here.
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