A different kind of patient

We woke up on New Year’s Day to hear of the riots at Ford Prison in West Sussex.  There has been criticism of the staffing levels on New Year’s Eve; the National Prison Officer’s Association claim that nationally there is a shortage of 1,000 prison officers before the planned redundancies take place over the next year; The National Governor’s Association provided insight into the judgement calls that staff have to make when staffing levels are low and the impossibility of robustly monitoring the perimeter fences.   Last night, it was announced there would be a review into staffing levels at the prison.

The whole situation raises the profile of how difficult it can be to manage the workforce within the prison service and the day-to-day challenges that they face. Prison officers are required to hold a particular skill set which will enable them to manage the delicate tensions between prisons and staff such as treating others with dignity & respect, conflict management skills, and emotional intelligence.

I have no experience of HR within the prison service, and so I cannot comment on the extent that the prison workforce has the necessary skills to support them in this difficult role.  However, issues relating to staff competency had previously been identified within Prison Inspection reports as highlighted in today’s Guardian Editorial .

I have worked with healthcare teams within prisons.   Last year I was asked to provide individual and group coaching to a team who had been through a difficult period:  two members of the team had “moved on”, and a new manager had been appointed.  My role was to enable the team to move forwards and positively approach the new challenges that they faced.

Unsurprisingly, the factors that affected them went beyond the interpersonal relationships between the remaining team members and included the environmental factors in which they worked.  A key theme that emerged was the behaviour of the prisoners towards the healthcare team.

The told me stories of how prisoners would kick the door repeatedly if they felt that a consultation was taking too long.  There would be verbal abuse if a nurse would not provide non-prescription medication (eg for a headache) when she judged that the prisoner was not in need of it.  And in quiet moments, some of the prisoners told the staff that they were the best healthcare team they’d experienced within the prison service.

The prisoners treated the healthcare staff with disrespect and this had a direct impact on their attitude towards their work.  They made decisions that were influenced by how a prisoner was acting, and they recognised at times that these decisions led to inequality in their treatment of prisoners.  In order to gain respect, they needed to ensure that they were acting professionally, fairly and appropriately according to need.  They also needed to work as a team, not just with the prison-based healthcare team, but with the wider set of healthcare professionals who undertook sessional work.

Another impact of the prisoner’s behaviour was that they felt that they were always fire-fighting; they were reactive to the demands that changed from day-to-day.  Their vision was very different:  they wanted was to deliver pro-active healthcare that would have a lasting effect on the prisoner’s health long after they had left prison (eg helping prisoners to give up smoking).   The team decided that they no longer to accept “the way things are” and set about changing the culture so that they could achieve their vision.

So my thoughts in the aftermath of the Ford Prision riots are for the healthcare team.  I hope that the review includes the views of this valuable (but often unrecognised) team as they will be able to provide a different perspective into the issues that contributed to the events on New Year’s Eve.

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One comment on “A different kind of patient

  1. [...] This post was mentioned on Twitter by Michael Carty. Michael Carty said: #hr RT @karenwise: New post on #fordprision #nhs : A different kind of patient http://wp.me/pKqEe-bT. #hrblogs #connectinghr [...]

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