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Careline - Weighing in with health advice

"We get to see clients with very diverse and possibly challenging behaviours. I’ve had cases when a client would like to go on a special diet and this may have been because it makes them stand out as being different from others."

Obesity and malnutrition are two extremes of dietary related problems that Airedale’s specialist dietitians regularly encounter when helping prisoners as part of a wider Health in Justice service.

They have been using telemedicine to give on-screen advice and healthcare to offenders throughout the country for the past two years.

Currently they have telemedicine consultations with up to three prisoners a month which could increase as Airedale bids to provide health services for more prisons. It involves using secure video conferencing equipment located both in the prison’s healthcare centre and our hospital so that our clinicians can carry out ‘virtual’ consultations, talking face-to-face with the patient and occasionally carrying out examinations using close up hand-held camera if necessary.

Under-nutrition, caused by infectious diseases patients have picked up before their life in prison such as Hepatitis or HIV, is a common problem. Another is obesity as prisoners often over-eat due to the boredom of spending a long time on their own, locked in cells. They often buy sugary snacks and may have a poor understanding about what makes a healthy diet. Other problems include diabetes, food allergies, high cholesterol or blood pressure.

Laura, specialist dietitian said: “We get to see clients with very diverse and possibly challenging behaviours. I’ve had cases when a client would like to go on a special diet and this may have been because it makes them stand out as being different from others.”

One client weighed 19 and a half stone and had developed arthritis resulting in problems exercising. He did not want to eat vegetables saying they were frozen and poor quality and was snacking on lots of cereal. Laura helped him to lose weight by educating him about healthy options to choose from the prison canteen and avoiding pastry-based food. She advised him how to take small steps towards an exercise regime.

Airedale NHS Foundation Trust has rolled this pioneering project to provide 20 prisons throughout the country with immediate medical advice using telemedicine. This covers a range of health problems including serious situations from our skilled A&E consultants and second opinions on other medical conditions via scheduled appointments with consultants.

All prisoners who have had consultations by this method would otherwise have been taken out of prison to a local hospital, which can mean an increase in both costs and the time taken to deliver medical advice, particularly as many prisons have a remote location. Telemedicine consultations reduce the risk of removing prisoners from the prison and they restore the patients’ dignity as there is no need for escorts of handcuffs.

Patients have benefited from getting healthcare and specialist advice more quickly delivered in an appropriate setting. Savings are ploughed into providing better healthcare in the future. In addition, the prison healthcare staff have benefited from working with our consultants.

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"We get to see clients with very diverse and possibly challenging behaviours. I’ve had cases when a client would like to go on a special diet and this may have been because it makes them stand out as being different from others."

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