Covid: Swansea prison inmates had no optician during pandemic

Inmates at Swansea prison had no eye care for nearly two years, difficult access to dentistry, and long waits for GP appointments a watchdog has found.

There was no "good quality, safe and effective healthcare services," said Healthcare Inspectorate Wales (HIW).

Swansea Bay University Health Board which is in charge of prison healthcare says it has begun making improvements.

The Category B male prison has a normal capacity of 225 inmates but there were 360 there at the time of the review.

Inspectors also said prison healthcare had a historically "low-profile" on the health board's agenda which left "weaknesses" in the system.

All relevant NHS standards in Wales apply to healthcare services for prisoners, but prison constraints can result in some exceptions to this rule.

The review was carried after concerns the health board had not followed up previous recommendations made by the prison inspectorate.

A total of 29 recommendations were made.

Some senior healthcare staff had never visited the prison before, and "a lack of presence and visibility of service leaders may be contributing to the low profile" given to healthcare there, the report found.

At the time of the review there were 360 men on remand, awaiting sentencing, or serving a determinate prison sentence.

Although healthcare staff said the facilities in the prison enabled them to deliver "safe and effective" care, only a third of the prison staff felt the same.

The prison's optician service was withdrawn in March 2020 so no-one could get sight tests or eye care until until January this year when a new contract began.

Around 60 men were on this waiting list.

One inmate said: "We need an optician because I am getting migraines straining my eyes reading or watching TV. I need glasses."

HIW said although the health board believed it had met its contract to provide dental services, apart from on a few occasions during Covid, prison staff reported that only one clinic was provided each week, while 80 men were on the waiting list.

One inmate said: "My root canal has been put off three times and I've been in pain for two months with it."

Another said: "I have been waiting three months for a dentist appointment, I've been in pain and taking paracetamol and ibuprofen every day."

HIW said although it was a secure environment, it was inappropriate to make someone wait that long for a dental appointment.

The report found that as the prison population had increased, so did demand for mental health support.

But almost 60% of prisoners surveyed said it was not easy to access mental health services.

Some comments from prisoners included "mental health is a big issue in here and should be treated as a priority" and "I'm still waiting three months to see a mental health worker".

Some prisoners described the service as "shocking" although senior health board staff were "satisfied" the service provided by the mental health team had been sufficient during the pandemic.

The report concluded prison healthcare staff "strive to provide" high quality care to patients at HMP Swansea and the pandemic brought its own challenges. But it added that improvements were needed.

There were long waits to be seen by a GP. More than half of prisoners found it difficult to get an appointment.

One prisoner said "sometimes you are waiting to see a doctor for weeks".

The health board said it recently introduced a new five-day-a week GP service, supported by a practice nurse.

Swansea Bay Health board said it was pleased with the positive feedback from a "significant number" of inmates.

"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 under way."

"The health board continues to work closely with the prison governor and our wider partners to strengthen governance and develop a robust improvement plan."

It has set up a working group to make immediate improvements where it can.