2026

Noted (AI summary) • Operational reminders have been issued reminding Custody Officers to ensure medical requests are made. • A new protocol for 'case finding' was implemented in November 2025, where the HCP on duty runs through the custody whiteboard with the Grip Sergeant and checks if there are any detainees who may have unmet medical needs.

Noted (AI summary) • The Shared Care Protocol (SCP) includes a section that explains how methotrexate doses should be managed once a hospital specialist has started treatment. • The protocol states that methotrexate should be prescribed at 7.5–25 mg once weekly according to hospital instructions, with an initial dose of 5–15 mg once weekly, titrated upwards by 2.5–5 mg every 2–6 weeks according to response, with a typical maintenance dose up to 20 mg per week, and in some circumstances up to 25 mg per week. • The protocol also specifies that only 2.5 mg tablets should be prescribed, which is a recognised national safety measure intended to minimise the risk of dosing errors with methotrexate.

Noted (AI summary) • Department officials made enquiries with the Care Quality Commission (CQC), North Northamptonshire Council (NNC), and the Chair of the Northamptonshire Safeguarding Adults Board (NSAB) to gain insight into why Mrs. Fenwick was not referred to Speech and Language Therapy (SALT) and any follow-up actions. • The Department of Health and Social Care launched the Adult Social Care Learning and Development Support Scheme (LDSS) in September 2024, providing funding for care staff to undertake relevant courses and qualifications.

Noted (AI summary) • A common, local protocol for managing those suspected to be under the influence of illicit substances (UTI) at HMP Bedford has been agreed and implemented with the Prison Governor and Head of Safety. • The protocol clearly articulates the roles, responsibilities, and expectations of both healthcare and prison staff in the identification, assessment, and management of those suspected to be UTI. • The protocol makes it clear when prison staff should escalate to healthcare staff and states that healthcare staff are responsible for taking the lead on • HMP Bedford and NHFT carried out a joint review of the UTI policies and protocols in place, resulting in the removal of any previous conflicting guidance and implementation of a single UTI protocol. • The updated protocol has been issued to all prison and healthcare staff through structured briefings, written notices, daily meeting updates, and daily checks. • A newly appointed substance misuse lead carries out daily assurance and visits all suspected UTI cases, ensuring consistency between operational and healthcare colleagues and consistent adherence to the UTI protocol.