This document sets out the agreed framework for out of hours primary healthcare provision at HMP Bristol, HMP Ashfield and HMP Leyhill by the Severnside Integrated Urgent Care Service.
Introduction and scope
This document sets out the agreed framework for out of hours primary healthcare provision at HMP Bristol, HMP Ashfield and HMP Leyhill by the Severnside Integrated Urgent Care Service, a BrisDoc service commissioned by Bristol, North Somerset and South Gloucestershire Integrated Care Board.
The service supports the urgent primary care needs of prisoners at HMP Bristol, HMP Ashfield and HMP Leyhill from Monday to Friday 18:30 to 08:00, with 24-hour cover on weekends and bank holidays.
Objectives
- Ensure that people within HMP Bristol, HMP Ashfield and HMP Leyhill have equitable access to out of hours healthcare provision. The service is primarily telephone based, with face to face care by exception. Video and photos are not practicable because mobile phones are not allowed within the prison establishments.
- Support the secure settings in minimising unnecessary admissions or conveyances to hospital and other urgent care centres.
- Ensure that clinical staff at the sites have timely access to additional clinical support during out of hours periods.
- Facilitate safe and appropriate face to face appointments at a Severnside Treatment Centre when required.
- Ensure that Severnside Integrated Urgent Care clinicians can gain safe and timely access to people requiring further clinical assessment when a site visit is unavoidable.
- Ensure that the Severnside Integrated Urgent Care service conforms to safety regulations within the prison establishment.
- Ensure an effective communication pathway between Oxleas Healthcare Service and Severnside, especially for prompt communication of out of hours interactions and actions.
- Overcome challenges linked to different clinical IT systems in secure healthcare settings so records can be shared effectively and care remains safe.
- Ensure that learning from interactions between these services is captured and fed back to support shared learning and improvement.
Background and service context
Oxleas NHS Foundation Trust
Oxleas NHS Foundation Trust is commissioned by NHS England to provide the in-hours primary healthcare service to HMP Bristol, HMP Ashfield and HMP Leyhill.
| Prison | Setting | Maximum population |
|---|---|---|
| HMP Bristol | Category B adult male remand prison in Horfield, Bristol | 615 |
| HMP Ashfield | Category C adult male training prison in Pucklechurch, north east of Bristol | 400 |
| HMP Leyhill | Category D adult male open resettlement prison in Tortworth, South Gloucestershire | 515 |
HMP Bristol has 24-hour on-site nursing cover. HMP Ashfield and HMP Leyhill do not have on-site healthcare cover overnight.
| Site | Monday to Friday | Saturday and Sunday | Bank holidays |
|---|---|---|---|
| HMP Bristol | 24 hours | 24 hours | 24 hours |
| HMP Ashfield | 07:30–18:00 | 07:30–17:30 | 07:30–17:30 |
| HMP Leyhill | 07:30–16:30 | 07:30–12:00 | 07:30–12:00 |
The on-site in-hours GP service at HMP Bristol, HMP Ashfield and HMP Leyhill is provided by DrPA, subcontracted by Oxleas NHS Foundation Trust.
| Site | In-hours GP service |
|---|---|
| HMP Bristol | Monday to Friday 08:00–20:00; Saturday (remote) 12:00–18:00 |
| HMP Ashfield | Monday to Friday 09:00–18:00 |
| HMP Leyhill | Monday to Friday 09:00–16:30 |
BrisDoc Healthcare Services and Severnside
BrisDoc provides the Severnside Integrated Urgent Care Service across Bristol, North Somerset and South Gloucestershire. This combines NHS 111, subcontracted to Practice Plus Group, and GP out of hours. The GP out of hours service operates from 18:30 until 08:00 Monday to Friday, and 24 hours a day across weekends and bank holidays.
Severnside clinicians can assess and manage patients by telephone, by video consultation using AccuRx where available, and face to face through appointments or visits when required. Clinicians prescribe electronically using the Electronic Prescription Service. Severnside’s clinical IT system is Cleo.
Severnside provides a Healthcare Professional Line on 0117 244 9283 for registered healthcare professionals who need clinical decision-making support. This route avoids the need for a registered healthcare professional to go through NHS 111. Where a non-healthcare professional is making the enquiry, the caller should contact NHS 111 instead.
Standard operating procedure
Risk management procedures
- Irrespective of category, HM Prison Service must carry out a risk assessment of the prisoner, the environment in which treatment will take place and, where applicable, the level of staffing or security required.
- The vast majority of prisoners attending hospital or healthcare settings will be escorted by a minimum of two officers. Escorting staff will be in uniform.
- Security requirements should interfere as little as possible with medical assessment and treatment. However, the prisoner will usually be restrained by handcuffs or an escort chain to a member of staff at all times unless this is inappropriate on medical grounds.
Security measures for staff
- Other than your name and job role, do not share personal information about yourself or other staff members within the hearing of the prisoner.
- Remove all items from pockets that could be used as a weapon.
- Keep all medical equipment out of reach of the prisoner when it is not in use.
- Check with escorting prison staff before handing anything to the prisoner.
- Never tell the prisoner about any future healthcare appointment, or discuss it with escorting officers in the prisoner’s presence.
Severnside contact procedure
- Registered healthcare professionals on site should contact Severnside via the Healthcare Professional Line on 0117 244 9283 during the out of hours period.
- Non-registered health professionals or non-healthcare prison staff should access Severnside by phoning NHS 111.
Initial priority assessment during out of hours when a healthcare professional is on site
If a healthcare professional is on site, it is their responsibility to decide whether the person’s clinical needs require an emergency response through 999 or whether the condition is suitable for referral to Severnside Integrated Urgent Care.
A set of clinical observations and a National Early Warning Score 2, NEWS2, should be available for any call from a healthcare professional to support clinical decision-making. If that is not possible when a healthcare professional is present, a 999 response is likely to be required.
Procedure for contacting Severnside when a healthcare professional is on site
- Prison healthcare professional telephones the Severnside Integrated Urgent Care professional line on 0117 244 9283.
- A Severnside call handler, who is not clinically trained, takes the patient details, reason for referral and clinical observations including NEWS2 score.
- The case is transferred to the Severnside clinical advice queue. A clinician will usually call back within two hours of the referral.
- To support a timely call back, the referring clinician must confirm their name, radio call sign, usually HOTEL 1, prison wing and the telephone number of the prison control room.
- The Severnside clinician phones the prison control room, asks to speak to the healthcare professional, gathers any further information and agrees the outcome.
| Site | Prison control room number |
|---|---|
| HMP Bristol | 0117 372 3273 / 0117 372 3257 |
| HMP Ashfield | 0117 303 8009 / 0117 303 8010 |
| HMP Leyhill | 01454 264230 |
Access to prison medical records
SystmOne is the medical records system used in prisons. Severnside clinicians do not have access to SystmOne. Where a healthcare professional is on site, they can access the records and share key information such as medical history, medicines and allergies.
At HMP Ashfield and HMP Leyhill there will be times when no healthcare professional is on site. In those situations Severnside clinicians rely on information available through the Summary Care Record, which is visible in Cleo. That information will only appear if the patient is General Medical Services registered and opted in to the Summary Care Record service.
| Site | ODS code |
|---|---|
| HMP Bristol | Y02307 |
| HMP Ashfield | Y03195 |
| HMP Leyhill | Y03194 |
Potential outcomes following contact with Severnside
- Case closed with advice and reassurance for self-care.
- Case closed following clinical assessment with prescribing advice.
- Electronic Prescription Service prescription issued to an agreed local pharmacy for prison staff to collect. The medication authorisation form, Appendix 4, is completed by Severnside and emailed to the prison healthcare team mailbox for HMP Bristol and HMP Ashfield to enable administration.
- Advice to prison staff or prisoner to call 999 for an emergency ambulance.
- Recommendation to attend Emergency Department, which prison staff will facilitate.
- Recommendation for direct admission or referral to a hospital specialty. The Severnside clinician makes the clinical referral and prison staff facilitate attendance.
- Face to face appointment needed at a Severnside out of hours Treatment Centre. The Severnside operational team arranges the appointment, then sends a follow-up text message to the escorting officer mobile number provided. Officers should call the Treatment Centre host on arrival and wait in their vehicle until the patient is called in.
- Face to face assessment needed but the patient cannot attend a Severnside Treatment Centre because of ill health, disability or security reasons. In that case a Severnside visiting clinician can attend the prison site. Eligibility follows the Severnside Home Visiting Policy, with the added prison-specific consideration of security or lack of escort availability.
| Mailbox | Email address |
|---|---|
| HMP Bristol Healthcare Team | oxl-tr.hmpbristolooh@nhs.net |
| HMP Ashfield Healthcare Team | hmpa.ashfieldhealthcareteam@nhs.net |
| HMP Leyhill Healthcare Team | ley-hmp.admin@nhs.net |
When a Severnside consultation is completed and closed, an electronic post event message will be emailed to the corresponding prison healthcare admin team to confirm actions taken and any recommended follow-up.
| Admin team | Email address |
|---|---|
| HMP Bristol Admin Mailbox | bris-hmp.admin@nhs.net |
| HMP Ashfield Admin Mailbox | hmpa.admin@nhs.net |
| HMP Leyhill Admin Mailbox | ley-hmp.admin@nhs.net |
Requirements for Severnside clinicians attending prison sites
Prison addresses
| Site | Address |
|---|---|
| HMP Bristol | 19 Cambridge Road, Bishopston, Bristol, BS7 8PS |
| HMP Ashfield | Shortwood Road, Pucklechurch, Bristol, BS16 9QJ |
| HMP Leyhill | Wotton-under-Edge, Gloucester, GL12 8BT |
Control room numbers while on route
| Site | Telephone number |
|---|---|
| HMP Bristol | 0117 372 3273 / 0117 372 3257 |
| HMP Ashfield | 0117 303 8009 / 0117 303 8010 |
| HMP Leyhill | 01454 264230 |
Proof of identity
The Severnside clinician must carry an acceptable form of photographic identification when visiting any prison. Failure to present this on arrival will result in refused entry. Preferred identification includes a driving licence, passport, BrisDoc or Severnside photo ID, or an NHS smartcard.
Parking
HMP Ashfield and HMP Leyhill have ample parking on site. HMP Bristol has limited parking in front of the prison through the barrier. Parking may also be available on nearby residential streets. The driver should remain in the Severnside vehicle.
Checking in
On arrival, report to the main prison gate, provide your name and show your ID. A visitor pass will be issued and must be worn at all times during the visit. Mobile phones and computers are not allowed in the prison. See Appendix 5 for prohibited items.
Home visit expectations
- The Severnside clinician will be met and escorted by at least one prison officer to the location of the patient and any healthcare professional who is on site.
- During the out of hours period the patient will often be in their cell. The Severnside clinician will be accompanied at all times.
- The driver should remain in the Severnside attending vehicle.
- Prison cells are predominantly double occupancy. The prison is expected to facilitate the patient being seen in a nearby confidential space.
- The Severnside visiting clinician will carry a diagnostic bag. The contents list is referenced in Appendix 1.
Outcomes following a home visit
- Patient requires hospital assessment or treatment. Admit via 999 emergency ambulance or through the hospital clinical site manager or operational hub in line with usual specialty referral practice.
- Care plan agreed, including medication, further monitoring, follow-up and action if the patient deteriorates.
- Severnside clinical records are logged on the Cleo clinical system. Notes are then available to healthcare staff within about five minutes on Connecting Care under the Integrated Urgent Care tab.
| Admin team | Email address |
|---|---|
| HMP Bristol Admin Mailbox | bris-hmp.admin@nhs.net |
| HMP Ashfield Admin Mailbox | hmpa.admin@nhs.net |
| HMP Leyhill Admin Mailbox | ley-hmp.admin@nhs.net |
Medicine management and prescriptions
BrisDoc professionals will not manage methadone or substitute prescribing.
Whether a prisoner can keep medicines in their own possession is determined by the in-possession risk assessment and the in-possession policy. Some people cannot hold medicines because of risk factors such as previous overdose. Others may be suitable to hold medicines supplied weekly or monthly. Some medicines, described in the policy as green meds, such as antibiotics, can be given in possession regardless of in-possession status and do not require an authorisation chart.
At HMP Leyhill, because of the prison category, all medicines are held in possession except opioid substitution therapy and Schedule 2 controlled drugs.
Routes for supplying medicines
- Issue from prison stock.
- Electronic Prescription Service and collection from a local community pharmacy.
- Issue from Severnside stock.
Issuing medicines from prison healthcare stock
Medicines held in prison healthcare stock are listed in Appendix 2. These can only be accessed if an Oxleas NHS Foundation Trust healthcare professional is on site. If a drug is issued from prison stock, Cleo consultation notes and the prison medication authorisation chart are required.
Issuing from prison stock after a Severnside telephone consultation
Consultation notes will be available in Connecting Care within about five minutes and or by post event message email. This provides evidence of prescribing advice. Medicines needing specific authorisation to administer will be prescribed on the prison medication authorisation chart, Appendix 4, and emailed from severnside.referral@nhs.net to the prison healthcare team.
| Healthcare team | Email address |
|---|---|
| HMP Bristol Healthcare Team | oxl-tr.hmpbristolooh@nhs.net |
| HMP Ashfield Healthcare Team | hmpa.ashfieldhealthcareteam@nhs.net |
| HMP Leyhill Healthcare Team | ley-hmp.admin@nhs.net |
Issuing from prison stock after a home visit or Severnside Treatment Centre appointment
Provide the Oxleas authorisation chart to the prison healthcare professional so they can record administration.
Medicines not held in prison stock, or where no Oxleas healthcare professional is on site
If Severnside is prescribing a medicine that is not held in prison stock, or prison stock cannot be accessed, Severnside will either send an Electronic Prescription Service prescription to an agreed local pharmacy or issue medicines from Severnside stock held at Treatment Centres or in visiting cars.
To send an Electronic Prescription Service prescription, the Severnside clinician must speak with the prison duty lead clinician to agree the local pharmacy. The prescription should show the prison address as the patient’s address so that no prescription charge is raised. The prison is responsible for collecting the medicine from the agreed pharmacy.
| Site | Prison address for prescriptions |
|---|---|
| HMP Bristol | 19 Cambridge Road, Bishopston, Bristol, BS7 8PS |
| HMP Ashfield | Shortwood Road, Pucklechurch, Bristol, BS16 9QJ |
| HMP Leyhill | Wotton-under-Edge, Gloucester, GL12 8BT |
Electronic Prescription Service prescriptions should not be sent to Easton Day and Night, to protect staff safety.
If pharmacies are closed and the patient needs to start treatment before they reopen, a Severnside visiting clinician can issue from car stock and a Treatment Centre clinician can issue from Treatment Centre stock, using usual Severnside stock processes.
Safeguarding and information sharing
- Severnside works in partnership with Oxleas to ensure safeguarding policies and local operating procedures are in place so statutory duties and BrisDoc’s core values are upheld within prison service provision.
- If a Severnside clinician has a safeguarding concern after a face to face, telephone or prison visit consultation, they should follow the BrisDoc Safeguarding Vulnerable Adults Policy.
- All three prisons use their own reporting process and do not refer directly to local authorities within Bristol, North Somerset and South Gloucestershire in the usual way.
- Initially, safeguarding concerns should be shared with the prison staff involved in the person’s care. Prison staff will report concerns through their internal safeguarding process.
- Severnside clinicians should record details of the safeguarding concern on Cleo and tick the safeguarding concern button at the end of the consultation.
- If the concern is significant or linked to a serious event, the clinician should also follow the information-sharing and escalation route below.
Referring and sharing information
- Complete a Learning Event on BrisDoc Weblinks via incident.brisdoc.co.uk.
- Speak to your line manager and the Safeguarding Lead for Severnside Integrated Urgent Care, or the Head of Safeguarding for BrisDoc, as listed in the BrisDoc Safeguarding Policy.
- Consider a direct referral to the prison or contact the safeguarding lead within the relevant prison if the concern is serious or urgent.
Prison safeguarding leads can be contacted through the prison control room Monday to Friday 09:00 to 17:00. Outside those hours, ask to be put through to the Duty Governor.
HMP Leyhill
Referral form: Adult Safeguarding Concern Referral Form
HMP Leyhill Safeguarding Lead – Head of Public Protection: 01454 264230
HMP Bristol
Local Operating Procedure: Adult Safeguarding Local Operating Procedure; Referral form for a significant event: HMP Bristol Referral Form
HMP Bristol Safeguarding Lead – Head of Safer Prisons & Equalities: 0117 372 3273 / 0117 372 3257
HMP Ashfield
Local Operating Procedure: LOP Safeguarding – HMP Ashfield; Referral form for a significant event: HMP Ashfield Adult Safeguarding Concern
HMP Ashfield Safeguarding Lead – Assistant Director Safety, Decency and Respect: 0117 303 8009 / 0117 303 8010
Monitoring, incidents and governance
Consultations will be monitored in line with Severnside’s audit framework.
Learning events and incidents will be reported in line with the Severnside Incident Management Policy and shared with the Head of Healthcare for inclusion in the incident reporting system for review and management.
Enquiries, incidents, learning events and complaints about Severnside should be emailed to severnside.governance@nhs.net.
Enquiries, incidents, learning events and complaints concerning the prison healthcare team should be sent to oxl-tr.systems@nhs.net and oxl-tr.patientpathways@nhs.net.
Related documents
- Comprehensive Infection Prevention and Control Policy.
- PPE Policy.
- Incident Management Policy.
Appendices
Appendix 1 – Master list of equipment in Severnside diagnostic bag
Appendix 2 – Stock medication
HMP Bristol prison stock medication
| Product description | Strength | Pack size |
|---|---|---|
| Accamprosate Tablets | 333mg | 168 |
| Amitriptyline Tablets | 10mg | 28 |
| Amitriptyline Tablets | 25mg | 28 |
| Amlodipine Tablets | 5mg | 28 |
| Aspirin Dispersible Tablets | 75mg | 28 |
| Atorvastatin Tablets | 20mg | 28 |
| Aymes Complete vanilla flavour | 200ml | |
| Bendroflumethiazide Tablets | 2.5mg | 28 |
| Bisoprolol Tablets | 2.5mg | 28 |
| Carbamazepine Modified Release Tablets | 200mg | 56 |
| Carbamazepine Tablets | 200mg | 84 |
| Cetirizine Tablets | 10mg | 30 |
| Chlordiazepoxide Capsules | 10mg | 100 |
| Chlorphenamine Tablets | 4mg | 28 |
| Citalopram Tablets | 20mg | 28 |
| Clopidogrel Tablets | 75mg | 28 |
| Clonazepam Tablets | 500mcg | 100 |
| Co-codamol Tablets | 30/500mg | 100 |
| Co-codamol Tablets | 8/500mg | 100 |
| Codeine Phosphate Tablets | 15mg | 28 |
| Dextro Energy Tablets (dextrose) | 10 pack | |
| Diazepam Tablets | 2mg | 28 |
| Diazepam Tablets | 5mg | 28 |
| Fluoxetine Capsules | 20mg | 30 |
| Furosemide Tablets | 40mg | 28 |
| Gabapentin | Various strengths | |
| Gliclazide Tablets | 80mg | 28 |
| Glucagen injection | 1mg | 1 |
| Ibuprofen Tablets (minor ailments issue) | 200mg | 84 |
| Ibuprofen Tablets | 400mg | 84 |
| Lansoprazole Capsules | 30mg | 28 |
| Laxido sachets | 30 | |
| Levothyroxine Tablets | 25mcg | 28 |
| Levothyroxine Tablets | 100mcg | 28 |
| Loperamide Capsules | 2mg | 30 |
| Loratadine Tablets | 10mg | 30 |
| Metformin MR Tablets | 500mg | 56 |
| Metformin Tablets | 500mg | 84 |
| Metoclopramide Tablets | 10mg | 28 |
| Mirtazapine Tablets | 15mg | 28 |
| Mirtazapine Tablets | 30mg | 28 |
| Mirtazapine Tablets | 45mg | 28 |
| Naltrexone Tablets | 50mg | 28 |
| Naproxen Tablets | 500mg | 28 |
| Olanzapine Tablets | 5mg | 28 |
| Omeprazole Capsules | 20mg | 28 |
| Pabrinex injection | 10 | |
| Paracetamol Tablets | 500mg | 100 |
| Peppermint oil capsules (Mintec) | 0.2ml | 84 |
| Peptac (peppermint) | 500ml | |
| Prednisolone Tablets | 5mg | 28 |
| Pregabalin Capsules | Various strengths | |
| Promethazine Tablets | 25mg | 56 |
| Prochlorperazine Buccal Tablets | 3mg | 50 |
| Propranolol Tablets | 40mg | 28 |
| Quetiapine Tablets | 25mg | 60 |
| Quetiapine Tablets | 100mg | 60 |
| Quetiapine Tablets | 150mg | 60 |
| Quetiapine Tablets | 200mg | 60 |
| Quetiapine Tablets | 300mg | 60 |
| Ramipril Capsules | 5mg | 28 |
| Rivaroxaban Tablets | 20mg | 28 |
| Senna Tablets | 7.5mg | 60 |
| Sertraline Tablets | 50mg | 28 |
| Sertraline Tablets | 100mg | 28 |
| Sodium Valproate Gastro-resistant Tablets | 200mg | 100 |
| Sodium Valproate MR Tablets | 500mg | 100 |
| Sodium Valproate Gastro-resistant Tablets | 500mg | 100 |
| Thiamine Tablets | 100mg | 100 |
| Venlafaxine Tablets | 37.5mg | 56 |
| Venlafaxine XL Tablets | 75mg | 30 |
| Venlafaxine XL Tablets | 150mg | 30 |
| Warfarin Tablets | 1mg | 28 |
| Warfarin Tablets | 3mg | 28 |
| Warfarin Tablets | 5mg | 28 |
| Zopiclone | 7.5mg | 28 |
In-possession medication to be given against a prescription
| Product description | Strength | Pack size |
|---|---|---|
| GTN Spray | 400mcg | |
| Chloramphenicol Eye Ointment | 1% | 4g |
| Salbutamol Inhaler | 100mcg | |
| Amoxicillin Capsules | 500mg | 15 |
| Amoxicillin Capsules | 500mg | 21 |
| Clarithromycin Tablets | 500mg | 14 |
| Nitrofurantoin Modified Release Capsules | 100mg | 14 |
| Flucloxacillin Capsules | 500mg | 20 |
| Flucloxacillin Capsules | 500mg | 28 |
| Paracetamol Tablets | 500mg | 56 |
| Paracetamol Tablets | 500mg | 42 |
| Ibuprofen Tablets | 400mg | 21 |
| Ibuprofen Tablets | 200mg | 42 |
HMP Ashfield and HMP Leyhill stock medication
Antibiotics
| Item description | Pack size | Stock level |
|---|---|---|
| Amoxicillin 500mg capsules | 21 | 2 |
| Clarithromycin 500mg tablets | 14 | 1 |
| Clindamycin 300mg capsules | 28 | 1 |
| Co-amoxiclav 500/125mg tablets | 21 | 2 |
| Doxycycline 100mg capsules | 8 | 2 |
| Flucloxacillin 500mg capsules | 28 | 2 |
| Levofloxacin 500mg tablets (not EWP) | 10 | 1 |
| Metronidazole 400mg tablets | 21 | 2 |
| Nitrofurantoin MR 100mg capsules (EWP only) | 6 | 2 |
| Nitrofurantoin MR 100mg capsules (not EWP) | 14 | 2 |
| Phenoxymethylpenicillin 250mg tablets | 28 | 2 |
| Trimethoprim 200mg tablets (EWP only) | 6 | 2 |
| Trimethoprim 200mg tablets (not EWP) | 14 | 2 |
Analgesia
| Item description | Pack size | Stock level |
|---|---|---|
| Co-codamol 30/500mg tablets (not Bristol or EWP) | 30 | 2 |
| Naproxen 500mg tablets | 14 | 2 |
| Paracetamol 500mg tablets | 16 | 4 |
Respiratory
| Item description | Pack size | Stock level |
|---|---|---|
| Prednisolone 5mg tablets | 28 | 2 |
| Salbutamol inhaler 100mcg | 1 | 1 |
Antiemetic
| Item description | Pack size | Stock level |
|---|---|---|
| Metoclopramide 10mg tablets | 14 | 2 |
| Metoclopramide injection 10mg/2ml | 10 | 1 |
ENT and eyes
| Item description | Pack size | Stock level |
|---|---|---|
| Chloramphenicol 1% eye ointment | 4g | 1 |
| Gentisone HC ear drops | 10ml | 1 |
| GTN spray | 1 | 1 |
| Minims Fluorescein 1% | Each | 4 |
| Minims Tetracaine 1% | Each | 4 |
| Otomize spray | 1 | 1 |
Miscellaneous
| Item description | Pack size | Stock level |
|---|---|---|
| Aspirin 300mg dispersible tablets | 16 | 2 |
| Ceftriaxone 1g vial | 1 | 1 |
| Chlorphenamine 4mg tablets | 28 | 1 |
| Hydrocortisone 1% cream | 15g | 1 |
| Lidocaine 1% injection 5ml | 10 | 1 |
| Methylprednisolone 40mg/1ml vial | Vial | 2 |
| Methylprednisolone 40mg/1ml plus Lidocaine | Vial | 2 |
| Rivaroxaban 15mg tablets | 7 | 1 |
| Rivaroxaban 20mg tablets | 7 | 1 |
Appendix 3 – HMP Bristol, HMP Ashfield and HMP Leyhill minor ailments stock
| Medication | Form | Strength | Pack size |
|---|---|---|---|
| Anusol | Cream | 23g | |
| Aspirin (IP) | Soluble Tablet | 300mg | 16 |
| Aspirin (NIP) | Soluble Tablet | 300mg | 300mg |
| Beclometasone | Nasal Spray | 1 | |
| Clotrimazole | Cream | 1% | 20g |
| Hayfever eye drops | Drops | 1 | |
| Ibuprofen | Gel | 5% | 50g |
| Ibuprofen (IP) | Tablets | 200mg | 16 |
| Lactulose solution (NIP) | Solution | 300ml | |
| Loperamide (IP) | Capsule | 2mg | 6 |
| Loratadine (IP) | Tablets | 10mg | 14 |
| Paracetamol (IP) | Tablets | 500mg | 16 |
Appendix 4 – Oxleas authorisation chart
Appendix 5 – Prohibited items
The full list of prohibited items is made available in the gate area of the prison being visited. If you have a listed item with you, you must tell prison staff in the gate area. You will either be directed to return the item to your vehicle or secure it in a prison locker.
It is a criminal offence to take prohibited items beyond the gate area and into the main prison unless you have written authorisation from the prison’s security department.
- Explosives, weapons or ammunition of any description, including imitation items.
- Tools of any description, including scissors and pen knives.
- Manicure sets, including nail files, tweezers, clippers, nail polish and polish remover.
- Mobile phones and chargers.
- Computer equipment.
- Cameras, video recorders and audio recorders.
- Smart watches, Fitbits and other wearable technology.
- SIM cards, memory sticks and any other data transfer device.
- Unauthorised drugs.
- Alcohol.
- Cigarettes, tobacco, lighters and matches.
- Metal cutlery.
- Glass containers.
- Mirrors, including makeup compacts with built-in mirrors.
- Aerosols.
- Chewing gum.
- Blue tack or similar products.
- Tin foil.
- Wire.
- Clothing with offensive logos.
- Umbrellas.
- Chemicals or cleaning equipment.
- Large amounts of cash, defined in the policy as anything over £20.
This list is not exhaustive.
Appendix 6 – In-possession policy
Change register
| Date | Version | Author | Changes |
|---|---|---|---|
| 16 February 2018 | 1 | D Coates | Minor changes and clarifications. Change in the availability of onsite GP service at HMP Bristol. Change to prison control room contact telephone numbers. |
| 2 March 2021 | 3 | C Dykes | Change to Severnside Integrated Urgent Care Service, addition of remote assessment via AccuRx, promotion of electronic prescribing and remote authorisation of medication. |
| 22 November 2022 | 4 | Dr K Ryan | Full review to incorporate the addition of HMP Ashfield and HMP Leyhill. |
| 29 July 2025 | 4.1 | Renuka Suriyaarachchi | Changes to Cleo from Adastra. |