The Queensland prison system is comprised of 14 correctional centres. Unlike most Australian jurisdictions there is no centralised health service for Queensland’s correctional centres. In the Queensland model, prison health services are the responsibility of the local hospital and health service (HHS), translating to variation in hepatitis C treatment uptake across the state, and a range of unique models of care.

 

The 2021 Queensland Prison Forum was representative of the Queensland custodial health workforce including those currently working at the respective correctional centres and/or providing in-service. The Forum was attended by 50 participants. Of the 50 participants who attended the Forum 46% (n = 23) had not registered to attend the 2020 Forum; reflecting the continuous shift in staffing of the custodial health workforce. The highest proportion of attendees were classified as Nurse (60%), followed by Other (26%) and then Medical Officer (6%). Noting that Other included professions in the areas of academia, policy, public health, health promotion, harm reduction, government, and project management.

 

The Forum was a mixture of didactic presentations and group discussions outlining developments, progress, challenges and future directions for hepatitis C care within Queensland custodial settings. Key areas of interest raised by participants related to adherence to medication, self-administration of medication, reinfection, management of patients with cirrhosis, point of care testing and other advances in diagnostics, patient recordkeeping, financial and resourcing constraints, harm reduction strategies, health promotion, peer education and support, and transition of care to community.

 

The objective of the Forum was to bring together health professionals working in Queensland prisons and those providing in-reach or telehealth services, to discuss progress in HCV treatment programs and opportunities to strengthen care during transition to community. 93.6% of the Forum attendees who responded to the post-evaluation indicated the objective was mostly or entirely met. Additionally, 93.6% of the Forum attendees who responded to the post-evaluation indicated that their overall learning needs were mostly or entirely met.

 

An outcome from the Forum was the development of seven recommendations to support the Queensland custodial health workforce, see outlined below:

  1. Continue to advocate for the development of a model to deliver safer injecting practices in Queensland custodial settings to reduce ongoing risk of injecting related harms and infections due to unsafe injecting practices in prisons.
  2. Collaborate and involve community-led initiatives to enhance prisoner health outcomes within custodial settings, including peer support, harm reduction education and health promotion.
  3. Progress and expand opioid substitution therapy within Queensland custodial settings and before prisoner release into community, including buprenorphine injection for subcutaneous use.
  4. Establish a state-wide approach to testing, treatment and management of hepatitis C across Queensland custodial settings.
  5. Continue to advocate for an electronic health record to enhance hepatitis C testing and treatment access and continuity of care within and between custodial settings community, including patient history and pathology results.
  6. Scale-up hepatitis C support services for patients upon release, ensuring effective transition from prison to community, and the opportunity to connect with peer support upon release.
  7. Promote and scale up hepatitis C point of care testing programs and micro-elimination strategies.