Procedure - Admission to External Medical Facilities

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Purpose
1.	Process
2.	Routine admission to a local public hospital
3.	Urgent admission / transfer
4.	Return to facility
5.	Unscheduled admissions to Princess Alexandra Hospital secure unit
6.	Admission to a mental health facility
7.	Information required by the authorised mental health service
8.	Return transfer of prisoners from the authorised mental health service.
9.	Contact People
10.	Private Hospitals
11.	Advising an offender's primary contact or other person of admission to an external medical facility
12.	Clothing supplied to an offender admitted to an external medical facility for an extended period

Purpose

To facilitate the continuity of health care, including transfers to external facilities when clinically necessary.

1. Process

This procedure will cover the admission of prisoners to-

1. local public hospitals;
2. Princess Alexandra Hospital secure unit;
3. authorised mental health facilities; and
4. private hospitals.

Medical records must not accompany prisoners to external medical facilities. A referral letter must accompany the prisoner setting out full clinical details of the event, any past relevant clinical history, any current medications, known allergies and any other relevant material that could impact on the health care of the prisoner.

2. Routine admission to a local public hospital

Names of prisoners requiring routine admission to a hospital must be given to appropriate facility personnel to allow removal orders to be generated.

The health services staff must-

1. ensure administrative form - P96 Medical Transfer accompanies the prisoner to appointments; and
2. forward any relevant x-rays with prisoner.

3. Urgent admission / transfer

If a prisoner requires urgent transfer to hospital the clinical nurse may authorise an ambulance. The doctor on call should be advised of any such transfers. If time permits, administrative form - P96 Medical Transfer should be completed.

4. Return to facility

On return to the facility from any external medical appointment or admission, the prisoner must present at the health centre with accompanying medication, completed administrative form - P96 Medical Transfer and any other relevant documentation. The health services staff may then assess health needs and consult with the prisoner regarding any ongoing health care.

5. Unscheduled admissions to Princess Alexandra Hospital secure unit

Prisoners requiring admission to the Princess Alexandra Hospital secure unit should be referred by the visiting doctor. The visiting doctor must contact the Director, Princess Alexandra Hospital Secure Unit to discuss the requirements of admission. All admissions must be accompanied with administrative form - P96 Medical Transfer.

In the event of an after hours admission, the prisoner must be taken to the Accident and Emergency Department.

When the prisoner is ready for return to the facility, the health services co-ordinator will be notified by the Princess Alexandra Hospital secure Unit, nurse practice co-ordinator regarding the suitability of return to the block/wing or to the observation ward. If there is any difficulty with acceptance of the prisoner, provision of ongoing medical care, or suitable accommodation then the visiting doctor is to be informed. The visiting doctor will then discuss the suitability of return with the Director, Princess Alexandra Hospital secure unit.

6. Admission to a mental health facility

When a corrective services officer becomes aware that a prisoner may be suffering from a mental illness the corrective services officer may require the person be examined by a doctor or an authorised mental health practitioner.

If on examination, the doctor or authorised mental health practitioner is satisfied the person meets all of the assessment criteria a Recommendation for Assessment (Queensland Health) may be made.

Once the Recommendation for Assessment (Queensland Health) is made an Agreement for Assessment must be sought from an authorised mental health service. Each facility should have the contact details of the administrator of the local authorised mental health service.

After the Recommendation for Assessment (Queensland Health) and Agreement for Assessment are in place the custodian may, if satisfied the person should be detained in an authorised mental health service, make a Custodian's Assessment Authority (Queensland Health). The authority will state the name of the service where the assessment will be carried out (the service that provided the agreement).

One copy of each form is required in the-

1. prisoner's medical file; and
2. prisoner's offender file.

The prisoners clothing and personal effects, including radio, cassette etc, must be sent with the prisoner to authorised mental health service.

The prisoner's medical file must remain at the referring corrective services facility. If the prisoner is released to the community from the authorised mental health service, the medical file must be sent to Medical Records for storage.

The Custodian's Assessment Order authorises the police or corrective services officer to transport the person as soon as practicable (but within 7 days) to the in-patient mental health service facility stated on the order.

On arrival at the authorised mental health service facility and production of the Recommendation for Assessment (Queensland Health) and Custodian's Assessment Authority (Queensland Health) the person becomes a classified patient. Note that in most circumstances the authorised mental health service will already have the original Agreement for Assessment.

The patient is now detained in the authorised mental health service facility, and the administrator of the authorised mental health service facility assumes legal custody of the classified patient while detained in the health service facility.

7. Information required by the authorised mental health service

Photocopies of relevant clinical assessment or progress notes and a copy of the current medication chart should be forward to the authorising mental health service.

8. Return transfer of prisoners from the authorised mental health service.

When the person no longer needs to be detained as a classified patient the process for returning a patient to custody includes-

1. the Director of Mental Health will forward a Patient to be Returned to Custody notice to the corrective services officer who made the Custodian's Assessment Authority (Queensland Health);
2. within one (1) day after receiving the Director of Mental Health's notice, the custodian must organise a police officer or corrective services officer to take the patient from the authorised mental health service into the corrective services facility.

The authorised mental health service should prepare a discharge summary giving details of the prisoner's condition, treatment etc. This letter will be given to the escort officers to deliver to the clinical nurse at the correctional facility that the prisoner is returned to.

The clinical nurse will inform the visiting doctor of the arrival of the prisoner for review at her/his next session.

During normal business hours, Offender Assessment Services Directorate must complete a Form 9 - Order for Transfer of a Prisoner in the departmental electronic recording system for return prisoners.

For after-hours occurrences, the general manager or nominee of the facility must complete the approved Form.

9. Contact People

Director of Mental Health
Forestry House, Floor 16
60 Mary St
Brisbane Qld 4001
Telephone: (07) 3234 0698
Facsimile: (07) 3234 1362

Mental Health Act Liaison Officer: Telephone (07) 3234 0160 or (07) 3234 0706.

Enquiries may also be directed to Queensland Corrective Services Director, Health and Medical Services.

10. Private Hospitals

Admission to private hospitals will only occur when services are not available from the public sector. All referrals and admissions to private hospitals require prior approval by the Director, Health and Medical Services.

Prisoners and doctors must be aware that prisoners in a high or low security facility do not have Medicare cards or Medicare numbers and are therefore ineligible for any Medicare reimbursement.

11. Advising an offender's primary contact or other person of admission to an external medical facility

Where an offender is admitted to an external medical facility and the medical condition indicates a serious threat to the offender's health and/or an extended period of admission, the following must occur-

1. the offender should be asked whether they would like contact to be made with their primary contact/s to make them aware of the offender's admission to an external medical facility;
2. where the offender is not able to be asked permission for contact to be made with the offender's primary contact/s the general manager or nominee must consider the nature of the offender's medical condition, expected duration of the offender's admission to an external medical facility, relevant security/escape related information and determine whether the offender's primary contact/s should be advised of the offenders admission.

The general manager or nominee will be responsible for making contact with the offender's primary contact/s where consented to under a) or determined necessary under b).

The Health Services Coordinator must ensure that the external medical facility has an up to date record of the offender's primary contact/s details.

12. Clothing supplied to an offender admitted to an external medical facility for an extended period

If an offender is to be admitted to an external medical facility for more than a 24 hour period, the offender must be transferred with a clean set of prison clothing, personal underwear and toiletries.

F P Rockett
Director-General

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