NHS England Health and Justice South West - Women's Health and Wellbeing Hub in HMP Eastwood Park.

This notice is placed as a Prior Information Notice (PIN) to seek expressions of interest from organisations who may wish to deliver services for a new Women's Health and Wellbeing Hub in HMP Eastwood Park on behalf of NHS England Health and Justice South West (the commissioner). As outlined in the National Review of Health and Social Care in Women's Prisons (published November 2023), women in prison face high levels of health inequality and often present with complex health and social care needs (i.e. severe and persistent needs across multiple domains which may be influenced by family/social contexts). They are often living with trauma, including sexual and domestic violence. Women account for a small proportion of the overall prison population in the UK and it has been acknowledged that services within prisons tend to be developed on the basis of what works for men. As such, the specific health and social care needs of women are not always consistently met. Funding has been allocated to enable NHS England Health and Justice Commissioners to establish Women's Health and Wellbeing Hubs within prisons across England. The establishment of these hubs is part of a collaborative, proactive approach to address the issues outlined above and reduce health inequality in this group. Hubs are designed to work at the interface between primary and secondary care. They provide services that may be more specialised than what is typically available in primary care settings, for health issues which do not necessarily need a referral to secondary care. Hubs are not a replacement for primary care, secondary care, or specialist services. They should not duplicate existing services and should be tailored to meet local population needs. Background: HMP Eastwood Park is a closed category women's prison located in the South Gloucestershire local authority. Although it is based in the South West, the prison serves a wide catchment area which also includes the West Midlands, the South Coast and Wales. The prison currently accommodates approximately 370 women aged 18 and over, around 40% of whom are expected to return to Wales on release. In addition to providing a secure environment for the general population of the prison, HMP Eastwood Park has a well-established mother-and-baby unit which can house up to 12 women and their babies up to the age of 18 months. Objectives: The overall purpose of the hub will be to facilitate access to a wide range of services, including preventative healthcare and early intervention, with the goal of improving health outcomes and reducing inequalities. The structure, environment and delivery of services will be underpinned by a trauma-informed approach. There will be an emphasis on improving on-site service provision, in recognition of the emotional impact and stress associated with attending appointments off-site under escort, as well as the additional demand off-site appointments place on staffing capacity. HMP Eastwood Park's hub will be expected to serve two main functions. The first is to provide access to a range of core healthcare services as specified in the national commissioning guidance (required services listed below). The second is to provide a single point of contact to facilitate multiple, integrated and opportunistic service delivery. The hub should provide signposting/clear referral pathways, and deliver health education and health promotion activities to ensure women are empowered to maintain their health and wellbeing. Wellbeing advice and support, for example advice on sleep hygiene, mindfulness, stress management and nutrition, should be provided alongside delivery of clinical interventions. The required core services are as follows. Please note that a gap analysis is currently being undertaken to establish which of these services are being either fully or partially delivered by existing providers and whether they can be accessed within HMP Eastwood Park. A key priority of the hub will be to improve access to services on-site so women are not required to attend potentially sensitive healthcare appointments under escort: • Support for menstrual problems, including but not limited to care for heavy, painful or irregular menstrual bleeding and care for conditions such as endometriosis and polycystic ovary syndrome. • Menopause assessment, treatment and review. • Contraceptive counselling and provision of full range of options. • Access to long-acting contraception fitting and removal. • Access to emergency hormonal contraception. • Pessary fitting and removal. • Cervical screening. • Screening for STIs/BBVs. • Human Papillomavirus (HPV) vaccination including catch-up provision. • Incontinence care including pathways into continence assessment and options for management such as pelvic floor physiotherapy. • Pathways for domestic abuse and sexual violence support. Key principles: 1. Collaboration with women who have lived experience: Women with lived experience of the criminal justice system should play a central role in the development, delivery and evaluation of the hub. Lived experience input can help to identify areas of unmet need, promote hub services, and support continual evaluation and improvement of the hub through patient feedback and recommendations. 2. Trauma-informed and trauma-responsive services and environment: Hubs must provide trauma-informed environments and staff should be appropriately trained in trauma-informed care. Procedures must be in place to support practitioners in managing the emotional impact of their work with consideration of vicarious trauma and practitioners' own lived experiences. Many women in contact with the criminal justice system will have experienced domestic abuse and sexual violence (DASV). It is important that practitioners recognise the nature and prevalence of DASV, the impact of DASV, and steps they can take to avoid re-traumatisation. Trauma-informed practice emphasises the need to provide physical, psychological and emotional safety to service-users and practitioners, with the goal of supporting service-users to rebuild a sense of control and empowerment. This should be given particular consideration when an individual requires an intervention or procedure which may feel invasive. A trauma-responsive service needs to develop and maintain strong links with mental health services and services providing specialist support for people who have experienced trauma. Service model: 1. Protected resource within the establishment: Hubs are designed to provide an additional resource in order to address female-specific health and wellbeing needs within women's prisons. This provision must include a protected staffing resource based within the establishment. Accordingly, hubs should offer timely access to on-site appointments which goes beyond in-reach support from community services. 2. Integration: The hub should have a joined up and collaborative relationship with other health services delivering care within the establishment. Referral routes and care pathways both in and out of the hub must be established and understood. Information must be shared appropriately between services to achieve integration and coordinated care. 3. Promotion and self-referral: Services offered by the hub must be well-promoted to ensure women have a clear understanding of what services are available and how to access them. Women should be able to self-refer and understand how to do so. It is anticipated that a contract will commence in late spring / summer 2025 and expire on 30th September 2029. The estimated contract value is £150,000 per annum. At this time, the Commissioner seeks responses to a market engagement questionnaire, the aim of which is to determine the level of provider interest in delivering these services and obtain feedback from the market to help inform commissioning. This may be followed by further questionnaire(s) and /or a pre-procurement market briefing event. If a briefing event is arranged, details will be shared with those who express an interest and return a completed market engagement questionnaire. This exercise is being carried out by NHS South, Central and West Commissioning Support Unit (SCW) on behalf of the Commissioner. Additional information: Additional information in relation to the requirements of the hub can be found within the National Health and Justice Women's Health and Wellbeing Hubs Specification and Commissioning Guidance which is available as a separate document within the Atamis, e-procurement system.