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Tender to Undertake a Study on the Prevalence of Drug Use, including Intravenous Drug Use, and Blood Borne Viruses among the Irish Prisoner Population

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Commission

The National Advisory Committee on Drugs (NACD) wishes to commission a study to estimate the prevalence of drug use, including intravenous drug use, among the prisoner population in Ireland in order to determine the need for drug treatment and harm reduction (including needle exchange) services in Irish prisons.  

The objectives of the study are:

• To describe the nature, extent and pattern of consumption for different drugs among the prisoner population when in the community and when in prison ;
• To describe methods of drug use, including intravenous drug use, among the prisoner population;
• To estimate the prevalence of blood-borne viruses among the prisoner population and to identify associated risk behaviours;
• To measure the uptake of individual drug treatment and harm reduction interventions (including hepatitis B vaccination) when in the community and when in prison.

The study will be jointly funded by the NACD and the Irish Prison Service.

Background

The National Advisory Committee on Drugs (NACD) was established in July 2000 to advise the Government in relation to the prevalence, prevention, treatment/rehabilitation and consequences of problem drug use in Ireland, based on the analysis of research findings and information. The Committee oversees the delivery of a work programme on the extent, nature, causes and effects of drug use in Ireland. The research and information actions for which the NACD has lead responsibility are set out in the National Drugs Strategy (interim) 2009-2016, which is available on www.pobail.ie.

The mission of the Irish Prison Service is to provide safe, secure and humane custody for people who are sent to prison. The Irish Prison Service currently has an average of 4,000 prisoners in custody at any one time and had 13,557 committals in 2008 which comprised of 10,928 persons. It is anticipated that this figure will be exceeded when data becomes available for 2009. All prisoners committed to prison receive a health screen and medical assessment from appropriately qualified staff.    Information on healthcare provision to prisoners is set out in the appendix.

Background Information

A Steering Group, set up under the aegis of the former National Drug Strategy Team, carried out an assessment of the need for prison-based needle exchange in Ireland in 2009. A copy of the report is attached. The report’s primary conclusions were that prison needle exchange constitutes a viable and effective means of addressing the remaining drug problem and its associated health risks within Irish prisons but that there is no up to date information on the prevalence of drug use including intravenous drug use in Irish prison settings.  The Steering Group therefore recommended that research into the prevalence of drug use, including intravenous drug use, and Blood Borne viruses among prisoners should be carried out before consideration is given to introducing needle exchange into a prison setting.   

The Brief

Against this background, the NACD is seeking to establish the prevalence of drug use, including intravenous drug use, and blood borne viruses among the prisoner population.  The project will involve:

• an approach to surveying prison entrants (committals) and a cross-section of prison inmates (remand and sentenced) during particular time periods*;
• the development of a representative sampling strategy and the calculation of an adequate sample size;
• the identification of appropriate methods to collect and test biological samples for drug-related blood-borne viruses, of note, these methods should have high specificity and sensitivity but be acceptable to the survey population;
• the design of an appropriate anonymous questionnaire and a system to link the questionnaire with the biological sample;
• the obtaining of ethical approval from the prison research ethics committee;
• the organisation of the completion of this questionnaire by a high proportion of the selected sample ;
•  the accurate entry and validation of data;
• analysis of data (using appropriate statistical methods) to answer the questions set out in the study objectives;
• the presentation of the full study methods, findings and their implications in a written report and oral presentation to the NACD.

* Note: It is intended to validate the self reported drug results through the screening of saliva for drug metabolites.

Survey mode

To address objective 1, it will be necessary to ensure that the questionnaire instruments adhere to the EMCDDA protocol for General Population Surveys on drug use; the methods for these surveys were adapted for Ireland
(http://www.nacd.ie/publications/NACD_IpsosMORI-Technical-report-Final-23-May-08.pdf).   Data relating to drug prevalence on a lifetime, last year (recent) and last month (current) basis will be required on all drug types as set out in Tables 1.1. to 1.3  from  the 2006/2007 Drug Prevalence Survey. (http://www.nacd.ie/publications/44598NACDConfidenceTables3.pdf).
When addressing objectives 2 and 3, the study should be guided by the protocol for the EMCDDA key indicator on drug related infectious diseases (http://www.emcdda.europa.eu/html.cfm/index65537EN.html).This key indicator collects data on the extent of infectious diseases — primarily HIV, hepatitis C and hepatitis B infection — among people who inject drugs.  Assessment of the uptake of needle exchange and other harm reduction options, including methadone treatment, drug fee options and counselling, will be a core objective of the study; the Irish prison services will provide you with a list of current treatment and harm reduction services. The potential contractors will be expected to obtain ethical approval in their proposal.  Copy of prison ethics application is included as an additional document on eTenders.

Additional documentation

The following additional documentation is provided:

• A copy of the ROI Population Study Questionnaire for 2010/2011 is included as an additional document on eTenders;
• A copy of the reports prepared for the Minister for Justice, Equality and Law Reform (Parts 1 and II) on Hepatitis B, Hepatitis C and HIV in Irish Prisoners: Prevalence and Risk.

http://www.drugsandalcohol.ie/5110/3/Long_Prevalence_risk_prisoners.pdf
http://www.drugsandalcohol.ie/5015/3/Long_prevalence_risk_prisoners_part_1.pdf

Research Advisory Group

The Research Advisory Group (RAG) comprising representatives from the NACD, the Irish Prison Service, the Health Research Board, the Office of the Minister for Drugs and other interested parties have been invited to oversee the project.  The successful bidder will be expected to report to this RAG on progress during the research. Close collaboration with the Research Advisory Group is expected during the lifetime of this research project to enable the early identification and resolution of design or other research difficulties.

Timescale of the project.

The survey of inmates (sentenced and remand) should be carried out between
November 2010 and December 2010 or sooner depending on speed of access to interviewees and the survey of entrants should be carried out between February 2011 and March 2011.
 

REQUIREMENTS

Tenders must submit a written proposal detailing the following;

• Research methodology to be employed and justification of outputs (please be guided by bullet points set out in the brief);
• Project management from conception to completion with clear milestones;
• Personnel involved their credentials and qualifications;
• Track Record in this field;
• Description of administrative and technical costs.

Evaluation of the submissions will be based on the following criteria and on the basis of the following scores:

Research methodology (35)

Understanding of the issues involved;
Understanding of the work involved;
Feasibility of the approach suggested;
Methods to ensure confidentiality.

Project management (40)

Ability to deliver key outputs on time;
Clarity in description of milestones;
Track record in this field;
Qualifications and capacity of personnel.

Value for Money (25)

A full and detailed breakdown of fees and costs (excluding VAT) is required. Tenderers should indicate the estimated number of person/days for completing the work.  The NACD reserves the right to reject any or all of the proposals submitted and will not be obliged to accept the lowest or any tender.

DATA PROTECTION AND INTELLECTUAL PROPERTY
Researchers/contractors must comply with data protection legislation. The successful bidder will be expected to demonstrate steps they will take to protect and store the data from corruption, infiltration and technical damage. The Intellectual Property issues are dealt with in the sample contract which is on the NACD website. Submission of a tender proposal will be taken as acceptance of these terms.

FINANCIAL DETAILS
The researcher must set out a description and justification for the costs of implementing the brief. A separate financial report will also be required on completion of the project before final payment is made.

NACD CONTRACT
A copy of the NACD contract is available to download from the NACD website.

A FREEDOM OF INFORMATION DECLARATION
A Freedom of Information Declaration must be completed and returned with the tender. This is available to download from the NACD website.

CLOSING DATE FOR SUBMISSIONS
Five copies of the tender together with a signed Freedom of Information Declaration (form attached) and an up-to-date Tax Clearance Certificate should be sent to the NACD offices, and include a short CV of those leading and managing this study, no later than
3.00pm, Monday, 12th July 2010.
Tenders will not be accepted by email.
Please mark your envelope ‘Prison Study’ Tender and address to:
The Secretary
NACD
1st Floor
Dún Aimhirgin
43-49 Mespil Road
Dublin 4
Ireland
Tel: 00 353 1 647 3240
Fax 00 353 1 647 3150
Email: info@nacd.ie; Web: www.nacd.ie

Appendix

Healthcare provision in Prisons

Primary care is the model of care through which healthcare is delivered; it is the linchpin of the prison healthcare system. The effectiveness of this system is crucial to the provision of secondary and tertiary care. The Irish Prison Service (IPS) is working towards a service that is structured and organised in a way that delivers maximum outcomes for patients.

The main domains of care apart from Primary Care would fall into the following categories Chronic Disease Management, Mental Health and Drug Treatment.  

The service is currently provided by a mix of part-time and full-time doctors , who attend the various prisons for varying periods of time commensurate with the numbers and needs of the prisons population. The service is heavily dependant on support from Nurses and Medical Orderlies. The service is provided using a Multidisciplinary model and intra-disciplinary working processes. The IPS is working towards having a structure that will offer, from appropriately competent staff, a system to ensure systematic review of all patients.    
The IPS has developed a   set of basic Healthcare Standards, which represent an outline of practical provision of care at institutional level, the aim of which is to achieve a consistent approach to the delivery of service across fourteen prison locations,   providing a benchmark for such provision. The Standards set out the processes for assessment, primary care intervention, treatment and specialist service engagement. The Healthcare Standards are based on best international guidance in the delivery of prison healthcare. 
The IPS provided substitution treatment for some 2424 prisoners in 2009 of whom 266 were new to treatment.
Drug rehabilitation programmes for prisoners involve a significant multidimensional input by a diverse range of general and specialist services provided both by the IPS and visiting statutory and non-statutory organisations. The IPS has committed significant investment in recent years to respond to addiction issues in the prison system. The most significant recent development has been the awarding of a contract for the provision of addiction counselling services to Merchants Quay Ireland. Addiction counselling services are now available in prisons and places of detention where prisoners require such a service. The addiction counselling service delivers approximately 1,500 prisoner contacts per month. Feed back on this service from clients is very positive.