Healthy Ageing Clinic in a Prison Service
Overview
Langi Kal Kal Medical is located in the Prison service in Trawalla, fifty kilometers outside of Ballarat. A Healthy Ageing Clinic for prisoners with chronic health conditions was established with the aim of improving the health of the prisoner population using preventative measures. The clinic was initially designed for prisoners over the age of sixty to coincide with Chronic Health Care Planning, however it became evident that there were prisoners under the age of fifty with complex health conditions who would also benefit from the service and so the age criteria was amended to reflect this need.
29 referrals were made for cardiac rehab
6 patients had a new condition diagnosed
57 patients were immunised
Model
The clinic offered cardiac, pulmonary and diabetes consultations, chronic disease screening, and provided health promotion activities including falls and balance classes, promotion of healthy lifestyle, and safe independent living.
The clinic ran every second week and nurses would see 3-4 new patients per day. A 6-week course was then offered to patients, this included:
- a detailed initial health assessment
- appointments focused on individual health needs and goals
- Physiotherapy assessment
Three weeks into the program, the doctor provided a full assessment – exploring the patients’ chronic condition(s), reviewing medication, and establishing the patient’s knowledge, understanding and capabilities to self-manage.
The final two weeks focused on providing advice to support patients to manage their health conditions. Nurses in the clinic also developed health promotion materials for patients to have in their rooms to refer to.
People in prison usually come from disadvantaged backgrounds, with poorer physical and mental health than the general population. They are less likely to have accessed health care services, and more likely to have a history of risk behaviours. Most people in prison are there for short periods, and many cycle through prison and the community multiple times. So, the health of people in prison is public health. – AIHW 30 May 2019
Funding
Prison health services in Victoria are block funded by the Victorian Government, therefore are not dependent on Medicare’s fee for service model. A sustainable clinic is dependent upon the current allocation of resources, therefore making this nurse-delivered clinic financially viable.
Outcome
Patients began taking more responsibility for their chronic health conditions and now have more health literacy. They discuss their conditions with doctors and show a good understanding of how their conditions impact their health and lives.
- 62 patients were seen in the clinic
- 6 patients had a new condition diagnosed
- 57 patients were immunised
- 29 referrals were made for cardiac rehab
“The most significant change is the prisoners, they’re more enthusiastic to engage in things. They actually seem to be taking a lot more responsibility for their own chronic health conditions, and it helps they also have an increase in health literacy.”