Nurses scoop honour for flagship prison scheme

An innovative team helping prisoners with long term lung conditions breathe better and feel better have won a Nursing Times Award for their flag ship project.

The group of six, who all work at Maidstone Prison, scooped the Respiratory Award 2013 prize after diagnosing more prisoners with conditions like Chronic Obstructive Pulmonary Disease (COPD), helping them to exercise more and save the NHS money.

Senior nurse Nina Turner and specialist physiotherapist Helen Jefford, from Oxleas NHS Foundation Trust, and prison fitness instructors Vaughan Hill, Ian Watson, Shane Donnelly and Grant Dyer have led the project of exercise and education.

Miss Turner was praised for her efforts in ‘driving forward’ the programme, was described as a ‘rising star in the nursing world’ and specially mentioned by The Prince of Wales as she met him in Clarence House as part of the award.

“It’s been really good to work with the prison healthcare team, the staff, the fitness instructors and the prisoners themselves,” said Mrs Jefford.

“And it’s actually been an easy programme to set up and run. Patients with COPD are really expensive to the NHS and many have repeated chest infections in the winter. In one way, I’m here as a cost-cutting measure because this programme will help reduce the number of hospital admissions and the cost of medication – just as it would do in the community.”

Smoking is not banned in prisons and many inmates indulge in their cells, usually smoking hand-rolled cigarettes.

The team, directly commissioned by NHS England Kent and Medway Area Team, went into HRM Maidstone and tested everyone aged over 40 years who had a history of smoking or asthma. Ten further patients were found to have COPD, often triggered by many years of smoking.

A group of 40 was set up of long term patients and those newly diagnosed where patients had a two hour session of education and exercise to help them manage their conditions while in prison.

An hour of education run by a nurse, physio, pharmacy assistant, GP or dietician, for example, discusses topics including smoking cessation and mental health as well as the benefits of exercise, sputum clearance, how to breathe well and the importance of taking medication regularly.

Instead of pressing the call bell for assistance if they feel breathless, for example, and ending up having an expensive hospital visit, the prisoners now know what to do themselves.

In the exercise hour they concentrate on cardiovascular fitness and strengthening muscles because if they are fitter and feel they have more control of their lung disease, their quality of life will improve.

The nurses hope the scheme will become a regular feature at Maidstone – and perhaps more widely in other prisons too. From now on, they also hope to screen everyone routinely as they come into the prison.

‘I don’t want to say we are doing a lot for prisoners. What we are doing is providing really good care for people who have got long-term conditions,’ said Mrs Jefford.

‘Many of the prisoners have jobs such as gardening around the prison site. One was saying he gets flak from his employer when he feels fatigued – a huge element in COPD.

“Because his employer doesn’t understand this, the man can lose privileges which affects his wellbeing. If the prison staff and the prisoners know that some days people with COPD can’t go to work, it’s brilliant.’

Some of the men have also quit and get products to help them stamp the habit out.

Before the scheme began, patients were generally treated promptly when problems arose and were sometimes sent under escort to the town’s hospital.

But even those with a long history of COPD knew little about their condition or about the practical steps they could take to prevent it worsening.

The cost to the prison of escorting a prisoner to hospital is around £500, so they have saved money already.

The scheme was funded from existing resource and Oxleas FT supported it with their staff as an opportunity for Continuing Professional Development.

Canterbury Christchurch University will now write up the findings to be published in a national physiotherapy journal and shared as best practice across the prison service.

The team attended a fantastic award ceremony at the Grosvenor House hotel, London.

The programme is called Pulmonary Rehabilitation and was run by Nina Turner, Helen Jefford and the prison fitness instructors Vaughan Hill, Ian Watson, Shane Donnelly and Grant Dyer.