Animation as a Medium

Animation as a Medium to Help Clinicians Understand the Secondary Healthcare Experiences of Prisoners

Authors

Surrey Heartlands Health and Care Partnership (in partnership with UCL Collaborative Centre for Inclusion Health),

Stockley, Rich (contact)

Situation

The authors state that hospital staff are often not aware of the issues that are faced by prisoners accessing secondary care.

NHS England acknowledges that prisoners have both poorer access to healthcare services and poorer health.

Educating staff and clinicians about the issues faced by prisoners is seen as the way forward to changes in practices and services for prisoners.

There are difficulties involved in this due to negative preconceptions and work pressures.

The designers engaged directly with the prisoners, prison clinicians, hospital staff, a prison charity, ex-prisoners and also with a animation company to create the tool.

Relevance

This is the original research that inspired me to want to be involved in this project. I thought we should include it as part of our case studies.

Very similar to our groups project but we would be using secondary research rather than engaging directly with prisoners and using the concerns and factors related to our personas to inform the design of the tool.

Task

To create a digital storytelling tool namely a five minute animation Stories from the inside: Hospital care for people in prisons, the researchers carried out qualitative research with a range of prisoners in five prisoners in South-East England. The designers engaged directly with the prisoners, prison clinicians, hospital staff, a prison charity, ex-prisoners and also with a animation company to create the tool and create the aims.

The aims are as follows:

• Whether this animated film can transform hospital clinicians’ and medical student’s knowledge and attitudes towards offenders

• How this film may influence hospital staff behaviour

• What aspects of the animation affect its ability to achieve these impacts

The research received full ethical approvals from both National Health Service Research Ethics Committee (NHS REC) and Her Majesty’s Prison & Probation Service National Research Committee (HMPPS NRC) and therefore followed very rigorous and repeatable qualitative research methodology.

Very qualitative to establish what the impact of the animation is/was.

Actions

The misperceptions of hospital staff were established first by interviewing a range of staff and clinicians and understanding their attitudes towards patients who are prisoners.

Small focus groups were held with prisoners (n =5) and interview data (n =17) from prisoners about their healthcare experiences.

Systematic thematic analysis took place. Re-interviewing of prisoners took place using the themes to guide the interviews. This was seven hours and then the animation team developed a five minute soundtrack using the audio which mirrored the themes.

Results

Five major challenges were identified:

(1) Security overriding healthcare need or experience;

(2) Security creating public humiliation and fear;

(3) Difficulties relating to the prison officer’s role in medical consultations;

(4) Delayed access due to prison regime and transport requirements;

(5) Inability of patients to manage their own healthcare.

The animation highlights these issues and the prisoners describe in their own words some of the changes that can be made.

Upon screening staff have indicated that it dispelled misconceptions about prisoners as patients and gave good guidance about workable changes.

The next steps are to roll out large scale evaluations in acute Trust settings. This was halted due to COVID-19.

The animation seems to have been well received. There are plans to disseminate the animation further from Pubic Health England, Royal Colleges and other organisations. Seminars will be given using the animation as a base to junior doctors. They want to show the video to the public by installing an interactive arts-based installation within the grounds of the University College London campus.

Reflections

There is no indication given of how difficult it was to distil the seven hours of audio into five minutes.

Really innovative to use the voices of prisoners for the video.

Animation is very powerful and interesting how the full faces of the prisoners are always in the shadow.

It really is very innovative to use a digital story in this way and despite its short length it is very impactful.

The video needs to have captions it does not have them on the Vimeo link and also a need to think about the different languages.

For our project it gives a great insight into key themes that we need to include in our story e.g. drugs that are prohibited in prisons, patients are patients so need to be treated that way.

References

Edge, C., Stockley, R., Walsh, M., Decodts, F., Perryman, B., Lenneskog, M., Kyungdon Lee, T. and Black, G. (2019) Using qualitative data to produce an animated clinical engagement tool: secondary health-care experiences of people in prison, The Lancet, [online] Available at: https://linkinghub.elsevier.com/retrieve/pii/S014067361932834X (Accessed 5 June 2021).

University College London (2020) Prisoners experience inequality of healthcare in hospitals, UCL News, [online] Available at: https://www.ucl.ac.uk/news/2020/jun/prisoners-experience-inequality-healthcare-hospitals (Accessed 5 June 2021).