In many ways, prescribing and medicines management for patients who happen to be located in a secure environment is the same as in any other setting.

In the community, we often unconsciously take account of the patients’ individual circumstances when making prescribing decisions – their age, jobs, ability to comprehend and comply with treatment for instance.

Secure environments similarly have their own issues which need to be taken into account when prescribing, some of which are just more concentrated in these settings and some of which are unique;

The high levels of morbidity in these populations with particular regard to mental illness and substance misuse. Patients are often under huge stress and are at significantly increased risk of self-harm and suicide. Availability of illicit drugs is often limited when compared to the community leading to them seeking prescribed sources often of medications that would have no real ‘street value’ in the community. Custody involves long periods of inactivity and any sedative medication has a value. Any  medication valued by the community may put the patient at risk of assault or bullying to obtain that medication.

This website will aim, when completed, to;

1. Provide clinical teams with information on prescribing in secure environments.

2. Provide this in an easily accessible manner through an A-Z directory linked to the NELM. This is arranged in a ‘tree’ structure;
A high level short guide to prescribing enabling quick access for new staff, locums or part time staff with an interest. An overview where relevant to prescribing under BNF chapter headings Information where relevant on individual drugs [alphabetically listed]

3. Current HOT issues

4. Ability to highlight current issues

5. Links to relevant policy in various Web sites including Prison service, DH.