Trust Headquarters, 350 Euston Road

We carried out an announced focused inspection of healthcare services at HMP Aylesbury provided by Central and North West London NHS Foundation Trust, remotely on 23 and 24 February 2023 and onsite on 28 February and 01 March 2023. The prison can hold up to 402 male adult prisoners. On 1 October 2022, the prison had been re-designated a category C training establishment.

Following our last joint inspection with His Majesty’s Inspectorate of Prisons (HMIP) in December 2022, we found that the quality of healthcare provided by Central and North West London NHS Foundation Trust required improvement. We issued a Warning Notice in relation to Regulation 12, Safe Care and Treatment and Regulation 17, Governance and 18 Staffing, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The purpose of this focused inspection was to determine if the healthcare services provided were meeting the legal requirements of the Warning Notices that we issued in December 2022 and to find out if patients were receiving safe care and treatment. At this inspection we found that improvements had been made and the warning notice no longer applies.

We do not currently rate services provided in prisons.

At this inspection we found:

• The service had a high vacancy rate for nursing staff, shifts were covered by regular temporary staff to ensure services provided to patients were safe. Staff working for the service completed training and were provided with supervision. Staff cared for patients safely and ensured that monitoring was undertaken for patients where indicated and any deterioration in a patient’s wellbeing was escalated as required.
• The service had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the provider learned from them and improved their processes.
• Systems and processes to administer medicines for patients were safe, however, we found that equipment used to monitor blood glucose levels was not always maintained in accordance with manufacturer’s instructions and when fridge temperatures were out of range this was not always escalated.
• Identified risks were documented and the risk register reviewed and updated, and performance data was reviewed and checked for accuracy.
• The complaints process and guidance was inconsistent and meant that patients did not always receive a response in line with policy.

The areas where the provider should make improvements are:

• Review the management of equipment for monitoring blood glucose levels.
• Review the storage of insulin in current use to ensure that it is being stored in line with the manufacturer’s guidance.
• Review the management of medicines when the fridge temperature readings are outside of the recommended range.
• The provider should ensure that the complaints guidance is clear and consistent.