Update: Initial Feedback on the SONAR Data Portal Go-Live

As our earlier blog said, the SONAR Data Portal went live in a number of secure custodial sites last month – a very exciting moment for us. I’m very grateful indeed for the team’s hard work. We now have one month of feedback on the SONAR Data Portal in action.

There are two key findings:

Outcomes are Improving

Key healthcare metrics show marked positive change over the last month. The SONAR Data Portal’s data analysis shows that trends are forecast to continue to improve.

These metrics include:

• Patients in the secure custodial setting with an NHS number.

• Patients waiting for a reception screening.

• Patients receiving Hepatitis B and Hepatitis C screening.

• Patients receiving HIV screening.

This is key evidence as it demonstrates having improved access to healthcare data enables managers to identify key priorities and act on them. That has always been a core argument for the new approach embodied in the SONAR Data Portal.

Visualisation of Data makes a Difference

The SONAR Data Portal translates healthcare data into visualisations, which are much easier for users to assess and rectify.   Again, this helps managers, clinicians and admin staff understand performance and see where improvement is required.

What we have started is only the beginning, when it comes to data analysis, the quality of that data and how we utilise that data further in data forecasting for the healthcare provider and Commissioner is our end objective. 

Accurate collection of healthcare data, and the secure, yet easily accessible presentation of it, may not be the most glamorous element of healthcare in Criminal Justice, yet improving data quality within Prison Healthcare is paramount and plays an integral role in ensuring the well-being of patients and the efficacy of commissioned healthcare services.

I look forward to updating you further in the New Year on the implementation and roll out of the SONAR Data Portal. 

SONAR – World AIDS Day, 1 December 2023

The discovery of new and better treatment for HIV / AIDS is one of the great health service successes of the last forty years. Clinicians and scientists have discovered how to diagnose the disease quickly and to treat it with new drug therapies (diagnosis of patients as HIV positive can be carried out by a simple test costing £20, with 100 per cent reliability).

As a result, the number of new HIV diagnoses among men has fallen from 4,155 in 2013 to 2,430 in 2022. At the same time, the number of people who are able to live with the disease has risen. The most recent survey showed that an estimated 105,200 people were estimated to be living with HIV infection in the UK in 2019, 94 per cent of which were diagnosed.

There is more to do: the rates of transmissions among heterosexual men and among women have not fallen as fast as those for gay men, for example. Leading AIDS charities are campaigning for routine tests for patients attending A&E across the country, following a successful pilot in London, Manchester, Brighton and Blackpool.

The overall goal, as set out by government, is to end new transmissions of HIV in England by 2030. Providers of health information systems in prisons and other settings, such as SONAR, can help to achieve it.

The cohort of users that SONAR supports is at high risk of contracting the virus. Drug users are heavily over-represented in prisons. Nearly 30,000 adults received treatment for drug problems in prisons in 2020-21.

In 2018, the Health Select Committee received evidence that prevalence of HIV and hepatitis C was higher among male prisoners than in the whole population, and substantially higher among female prisoners.

SONAR’s specialized interface for health staff aims to make it easy for health professionals to input data on, for example, HIV testing and treatment. Because of the ability to connect to health data in other settings, and in the NHS, prison staff will have full knowledge of prisoners’ medical history and medication needs.

It will prevent examples where individuals have suffered harm due to failure act on a person’s medical status, as in the case of Thoko Shiri who died as a prisoner at HMP Chelmsford having failed to receive HIV medication. Through the SONAR Release Portal, it will ensure that health authorities are aware of an individual’s full medical history post-release.

SONAR aims to provide the right information at the right time. In the case of HIV / AIDS, it will contribute to an historic and ongoing improvement in people’s lives through better healthcare.

References

• HIV diagnoses: New HIV diagnoses, AIDS, deaths and people in care in England data tables, UK Health Security Agency, October 2023

• People living with HIV: House of Commons library, July 2023

• Department of Health AIDS action plan (December 2021) and update (June 2023).

• People receiving drug treatment in prison: Alcohol and drug treatment in secure settings 2020-21, Office for Health Improvement and Disparities, 27 January 2022

• Evidence to Health Select Committee: Revolving Doors Agency, 2019

• Case of Thoko Shiri, Leigh Day solicitors, June 2022

SONAR Data Portal

I have already written about SONAR’s ability to join up healthcare information across criminal justice settings. The quality of healthcare information is also crucial.

The SONAR Data Portal – Which went live in a custodial setting for the first time last week – is designed to help managers identify problems in their data, as well as support their decision-making.

Coroners’ reports regularly highlight the harm that can arise from poor collection and entry of data. In one example, healthcare professionals in a police custody suite did not enter the correct level of risk on the electronic custody record, and were not sure of the meaning of the grade of risk:

““During the course of the evidence, it became apparent that the HCPs were not using objective and/or consistent criteria to assess the risk of [redacted], meaning that (a) the grade of risk assigned to AF was inconsistent and/ or inaccurate and (b) no one else knew what was meant by the grade of risk recorded in the electronic custody record. (2) Further, none of the HCPs who gave evidence used the criteria described in the online training materials.”

In another example, an offender did not receive a mental health screening within 48 hours, which was the procedure. The offender was also logged under different names, so that his information was incomplete:

“For example, according to the mental health team, multiple prison stays, under different names meant that Mr Kunarathnam's records were not easy to find. Records were kept but often not shared with others at the correct time.”

Last week, a new NHS England review of health and social care in women’s prisons recommended that prisons collect a wider range of data so that managers and researchers can better understand whether different groups of women experience services differently.

The SONAR Data Portal responds to all of these concerns. In terms of data quality, it will flag up data errors in existing criminal justice healthcare records systems. It will identify gaps in offender health records – for example, records which do not have NHS numbers.

For managers, it will generate reports on performance against KPIs, allowing managers to identify necessary improvements in services. And it will support joined-up thinking around resettlement and rehabilitation. For example, it could flag prisons which have a high number of offenders without a registered abode, and therefore a need for housing support.

Excellent healthcare information in criminal justice is not only joined-up but also accurate and actionable. I hope the SONAR Data Portal is a good way to achieve this.