Qual-P is the acronym for the study Understanding and improving the Quality of Primary care for people in prison: a mixed methods study. With funding from the National Institute for Health Research (NIHR), Qual-P will explore gaps and variations in the quality of primary care [see glossary] for people in prison and identify quality improvement interventions to promote high quality care.
Why do this research?
We have relatively little data on the quality of healthcare provision in prison for making comparisons with care in the community. We do know that compared to people in the community, people in prison experience more chronic health problems, long-term illness, disability, communicable disease (spread from one person to another), mental illness, and drug and alcohol problems. We also know that people in prison find it more difficult to get treatment even though they consult their GP more often. We do not know, however, how well healthcare in prison manages these problems.
More specifically, we do not know:
- What is the quality of care provision in prison?
- What aspects of care could be improved?
- What aspects of care are done well?
- How much variation is there between the care provided by different prisons?
Without this information it is difficult to make improvements.
Care provided to the population in the community is monitored using the Quality Outcomes Framework (QOF).
The Quality and Outcomes Framework (QOF) is a voluntary annual reward and incentive programme for all GP surgeries in England, detailing practice achievement results. It is not about performance management but resourcing and then rewarding good practice.https://qof.digital.nhs.uk/
Under this system, GPs record the care they provide and receive funding for meeting targets. GP practices gain points depending on how well they are doing against the indicators set out in QOF. The indicators cover things like:
- Management of common chronic conditions such as asthma and diabetes
- Management of public health issues such as smoking and obesity
- Providing preventative services such as screening or blood pressure checks
There is no equivalent system for monitoring or incentivising care within the prison system.
The Qual-P study
The Qual-P study will identify a set of quality indicators based on national guidance that can be assessed using routinely collected data. We will use these indicators to examine the anonymised health records of people living in 12 prisons in the UK. The study has four stages:
Qual-P aims to drive a new improvement agenda for primary care provision in prisons with a view to informing strategies aiming to close gaps between health care and outcomes for people in prison and their counterparts in the community.
Want to know more? Read the study protocol or contact us with your comments and questions. If you want to get involved in the study there are multiple ways to do so. We look forward to hearing from you!