Brooker Charlie, Sirdifield Coral, Ramsbotham Lord David, Denney David
School of Law, Royal Holloway, University of London, Surrey, UK.
School of Health and Social Care, University of Lincoln, Lincoln, UK.
Health Soc Care Community. 2017 Jan;25(1):137-144. doi: 10.1111/hsc.12283. Epub 2015 Oct 1.
National guidance in England exhorts Clinical Commissioning Groups [groups of general practices established to organise delivery of National Health Service (NHS) care in their local area (CCGs)] to commission healthcare for those living in the community who are serving non-custodial sentences called 'community orders'. This includes 'approved premises' - accommodation providing enhanced supervision for offenders and individuals on bail who may present a high risk of harm to the public. In this national survey of CCGs in England, we compared the extent to which healthcare services were commissioned for probationers in 2014 with similar data we collected in 2013. A freedom of information (FOI) request was sent to all CCGs (n = 212) and Mental Health Trusts (organisations commissioned to provide health and social care services to individuals with mental health disorders) (n = 53) in England. Mental Health Trusts were included as they were known to fund mental health services for probation as part of their block funding allocations. A small number of basic questions were asked. The response rate was good with 65% of CCGs (n = 137) and 68% (n = 36) of Mental Health Trusts responding. The findings show that the proportion of CCGs commissioning healthcare for probation reduced from 7% to 1%, with 20% of CCGs stating that funding healthcare for this group was the responsibility of the NHS England Area Teams. There was also a reduction in the proportion of Mental Health Trusts funding healthcare for probation but from a much higher baseline, that is from 70% to 61%. The prevalence of mental health disorders in probation is high, so it was of concern that only 12% of Mental Health Trusts provided a service to support approved premises and just 32% provided clinics in probation. The results are discussed within the context of the NHS reforms and the government's plans in England to reform probation.
英国的国家指南敦促临床委托小组（为在当地组织提供国民医疗服务体系（NHS）护理而设立的全科医疗小组，即CCG）为那些被判处非监禁刑罚（称为“社区令”）的社区居民委托提供医疗保健服务。这包括“核准场所”——为可能对公众造成高危害风险的罪犯和保释人员提供强化监管的住宿场所。在这项针对英格兰CCG的全国性调查中，我们将2014年为缓刑人员委托提供医疗服务的程度与我们在2013年收集的类似数据进行了比较。我们向英格兰所有的CCG（n = 212）和精神健康信托机构（受委托为有精神健康障碍的个人提供健康和社会护理服务的组织）（n = 53）发送了信息自由（FOI）请求。纳入精神健康信托机构是因为它们作为整体资金分配的一部分，已知会为缓刑人员的精神健康服务提供资金。我们提出了一些基本问题。CCG的回应率良好，有65%（n = 137）的CCG做出了回应，精神健康信托机构的回应率为68%（n = 36）。调查结果显示，为缓刑人员委托提供医疗服务的CCG比例从7%降至1%，20%的CCG表示为该群体提供医疗资金是NHS英格兰地区团队的责任。为缓刑人员提供医疗资金的精神健康信托机构比例也有所下降，但起始基线要高得多，即从70%降至61%。缓刑人员中精神健康障碍的患病率很高，因此令人担忧的是，只有12%的精神健康信托机构提供服务以支持核准场所，仅有32%的机构在缓刑期间提供诊所服务。我们将在NHS改革以及英国政府改革缓刑的计划背景下讨论这些结果。
