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Working as a female prison GP: Dr Helen Bramwell

Dr Helen Bramwell, lead GP for HMP YOI Swinfen Hall, tells us about the rewards and challenges of being a prison GP.

I wasn’t looking for a new job but something made me check the job adverts one lazy Sunday afternoon in October 2018, and to my surprise something sparked my interest.

General Practice was getting tougher to cope with and it was hard to maintain a decent work-life balance. I had been a community GP for 17 years having worked in salaried, locum and partnership positions. Every job change felt like going out of the frying pan and into the fire with increased stress, paperwork and longer hours. That’s when I found Care UK.

Not an obvious career change

The job role was for a salaried lead GP based at HMYOI Swinfen Hall which is a category C male prison for 18-28 year olds. A prison GP job was not an obvious career change for me, and for many members of my family and friends it was a decision that left them feeling concerned and as if I was more than a little crazy. However, those who knew me well knew that I had the skills and enthusiasm to rise to the challenge.

My first visit to Swinfen Hall filled me with trepidation and I admit to feeling a little apprehensive on seeing my first group of prisoners milling around in the waiting room in the healthcare department. However, all my fears were allayed on meeting the team I would be working with.

The healthcare team, comprising the head of healthcare, nursing manager, pharmacy technicians and a nursing team, were instantly supportive, welcoming and helpful in settling me in and making me feel safe, secure and part of the team. Due to daily meetings and discussions with staff regarding patients, any problems, concerns or risks could be assessed and safety measures put in place.

I see patients on my own but if there are any concerns regarding risk, a member of the healthcare team or a prison officer if needed, will be present during the consultation. This has only occurred on a handful of occasions in the past eight months since I started working there.

Communication and consultation skills are key to success

A wise prison GP (Dr Pat Staite) said to me on my first day that it all depends on how you talk to the prisoners and how you treat them, and if you get this right you will not have too many problems. He was right!

Years of honing my communication and consultation skills have stood me in very good stead. I risk assess every patient as they walk towards my door and generally a smile and a friendly “good morning” sets the tone as it does out in the community. The patients have often had very troubled and difficult backgrounds with many of them being ‘looked after children’ themselves in the past. Listening to them and providing empathy and compassion has reaped many rewards, and the compliments and gratitude that I have received from the patients has increased my job satisfaction more than I ever thought possible.

Don’t get me wrong, the job is filled with challenges both medically and practically, and the systems are still a little behind the community but are catching up with time.

Quality of care is of utmost importance and the multidisciplinary team working means that I have daily access to mental health nurses, substance misuse workers and learning disability nurses, as well as the weekly involvement of a psychiatrist. This is important due to the higher proportion of patients with ADHD, autism and learning disabilities and personality disorders. However, there are plenty of typical primary care mental health issues and also plenty of pathology despite the young and narrow population group of the prison.

More time to get to know patients

Working in a prison environment means adapting to their regime but sometimes this can be a positive. When fewer patients are brought down for your surgery, it means you can take a little bit more time to assess and get to really know your patients. A great sense of satisfaction was also had in preventing a couple of trips to A&E by managing to remove foreign bodies from ears, saving the prison both time and money and improving care for the patient.

I would highly recommend my job to any GP who welcomes a challenge, as this has given me a new dimension to a career that I love but in a very supportive environment with excellent training and finally an improvement in my work-life balance.

Care UK is currently recruiting for a range of prison GP roles including:

This article was sponsored by Care UK.

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