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Standards for health services in Australian prisons

Criterion 4.1.2 Occupational health and safety

Our health service implements strategies to ensure the occupational health and safety of our staff.


Indicators

A. Our health service and office equipment is appropriate for its purpose (direct observation).

B. At least one staff member, in addition to a GP or another member of the clinical team is present when our health service is open for routine consulting (interview).

C. Our staff can explain how our health service supports their health and wellbeing (interview).

D. Our health service has a documented occupational health and safety policy (document review).

E. Our staff have mechanisms to immediately alert others of a risk to their safety (direct observation).


Explanation

The occupational health and safety of health service staff is governed by occupational health and safety (OH&S) legislation which may vary from state to state. Health services need to consider how they ensure the service is a safe working environment for all staff.

To support occupational health, safety and wellbeing, during normal opening hours health services need to be staffed by at least one additional person who is trained to take telephone calls, make appointments and assist with medical emergencies and CPR. Normal opening hours are defined as those hours the health service advertises as being its regular hours of opening for routine consultations.

The health and wellbeing of all staff is an important occupational health and safety issue and health services might find the following resources useful.

Health services can support the health and wellbeing of staff in many ways. For example, scheduling regular breaks in consulting time may reduce fatigue and support the health and wellbeing of the medical and clinical staff as well as enhance the quality of patient care. Fatigue and related factors, sometimes called human factors, are associated with increased risk of harm to patients.

Health services can make information available to staff about support services in their state or territory. Another possible strategy is to have a plan for reallocating work flow if a GP or another member of the clinical team is unexpectedly absent from the health service.

Supporting the psychological health and wellbeing of staff is an issue that has been of growing concern to the medical community. Providing healthcare to people in Australian prisons may be emotionally and professionally challenging for health professionals. Systems of professional support for medical and other clinical staff working in such services (eg. clinical supervision, employee welfare programs and grievance processes) are important for health and wellbeing and also for retaining good staff.

Indicator D requires a health service to have a documented occupational health and safety policy. Given the risks to the safety and security of health service staff posed by some patients, the OH&S policy needs to be explicit about safety and security. The security component of the policy will need to be negotiated with the relevant government department and the prison management company. The health service should have its own occupational health and safety policy that is consistent with, but does not rely on the prison management company’s OH&S policy. However, the prison management company is likely to be an expert source of appropriate OH&S procedures for a correctional context.

Providing healthcare to patients who are incarcerated means safety and security issues need to be considered carefully. Staff should have mechanisms for immediately alerting others to risk. For example, there may be a duress alarm in consultation rooms or personal duress alarms for individual staff. There is a cultural convention in prisons that necessitates prison staff being ‘within sight and sound’ of a patient. Health service staff need to liaise with prison management to determine under what circumstances a prison officer needs to be present during a consultation, and the mechanisms that will be used by the health service to maintain patient privacy and confidentiality. Where a third party is required in a consultation, the rationale for their presence needs to be explained to the patient (see Criterion 2.1.3: Presence of a third party).

Health services are referred to the information about safety for GPs and their practice teams on the RACGP’s website (www.racgp.org.au/gpandpracticeteamsafety/safety). Health services are advised to consider in advance what action will be taken in the event of a security breach.

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