Aim
The aim of the research project was to improve access to physiotherapy services for the Woodford Correctional Centre (WDFCC) population by integrating a physiotherapy outreach service into the existing medical clinic.
Outcomes
A three-month cost-neutral pilot project was carried out between December 2020 and March 2021. Service provision inside the internal Maximum-Security- Unit commenced in February 2021. This was a marked improvement from the previous model, whereby 30 clients were treated at the Princess Alexandra Hospital (PAH) over the entire 2020 calendar year. Client engagement proved to be optimal despite all barriers with attendance of offered appointments being 82% when not impacted by facility lockdown and COVID events.
- The expected benefits of the model were to reduce the requirement for interfacility transfers for physiotherapy referrals, provide a level of service approaching community equivalent access, improve access to care across the facility (equitable access across blocks) and the provision of clinically effective care to enable participation in daily activities.
- It resulted in an overwhelmingly positive experience reported by inmates and staff.
- The implementation of the service was associated with improved health outcomes and access to care for inmates.
- The service proved to be viable, sustainable and cost effective.
- As a result of this project it has been approved to offer a weekly onsite outpatient service which continues.
- Specific benefits included:
- improved inmate wellbeing and decrease reliance on pain medication
- cost effective
- inmates' feedback were valued
- a reduction in security issues
Background
Prison provides an important opportunity for people to access health care that may otherwise be delayed in the community due to competing demands of housing, employment, drug and alcohol issues, and other stressful life events.
Over the past decade, the prison population of Australia has increased by more than 30%. People in prison are considered more vulnerable and have more complex health needs than the general population.
People in prison report a higher prevalence of health risk factors and behaviours than the general community, including high rates of tobacco smoking, high-risk alcohol consumption and use of illicit drug use and injecting drug use.
The outsourcing of physiotherapy services to the nearest available secure medical facility, more than 100km away, required significant logistical requirements, costs, risks to client and attendants, as well as security risks. It resulted in high security inmates unable to access care.
Improving the health of people in prison is a public health priority, as around 1,000 people per month are released from correctional facilities and return to living in the general community.
Woodford Correctional Centre (WDFCC) is a high security facility, housing a male population, including a Maximum-Security Unit (MSU). WDFCC is documented to be designed for 988 people, housed in mainstream, safety, protection, MSU and residential areas, but the population varies on a daily basis between 1440 - 1450 people.
There are two medical clinics within WDFCC, providing on-site access to pharmacological, optometry, infectious diseases, diabetes and wound management clinics, social work, sexual health, dental, psychological rehabilitation and medical management services. A significant system is in place providing access to vocational training and participation, and access to sporting opportunities, but the physical robustness of those engaged is not similarly addressed.
Until recently, access to physiotherapy services for the WDFCC population was outsourced to the nearest available secure medical facility, more than100km in distance from WDFCC and in a separate Hospital and Health Service. Transferring prisoners for care posed significant logistical requirements, costs, risks to client and attendants, and inherent security risks.
