Correctional institutions in the Module stating that the medical examination is to be conducted at the earliest possible time (within 24 hours). No such note is currently contained in the Module. The NPM recommends that the justice administration create the technical prerequisites for this. XX  A health examination upon arrival must consist of a full-body examination, including disrobement. XX  At the health examination upon arrival, inmates should be expressly informed of the option of a blood test. The refusal by an inmate to undergo a blood test should be documented in the Electronic Patient Record Module. XX  In the case of a transfer (e.g. due to a transfer to a different prison or a classification), a medical examination must also be performed within 24 hours. XX  The automatic inclusion of newly admitted inmates on the doctor’s appointment list in the Electronic Patient Record Module should also contain a note that the medical examination should be performed within 24 hours. 2.5.5.5 Presence of prison guards during medical examinations The question of which persons should be present in the doctor’s office during a medical treatment or examination is closely linked to the question of the scope and timing of the health examination upon arrival. NPM made a recommendation in early 2017 The NPM made a recommendation to the Federal Minister on this matter in early 2017 (see NPM Report 2016, pp. 99 et seq.), which demanded that only trained medical and nursing staff should be utilised in the infirmaries and doctor’s offices of correctional institutions. These persons may not perform any supervisory functions with respect to inmates. The presence of prison guards during a medical examination or treatment should be the absolute exception and only at the request of the doctor. Even in these cases, confidentiality must be protected to the maximum extent through technical or structural precautions (e.g. screens, glass partitions, headphones). Thus far, this recommendation has not been followed. According to the Federal Ministry, there is a need for additional permanent positions in the nursing service. In addition, the Federal Ministry believes that the confidentiality of examinations has been adequately guaranteed because prison guards are subject to official confidentiality. International criticism 126 The NPM cannot agree with this argument. An atmosphere of trust is a necessary component of the “doctor-patient relationship”. Respect for privacy and confidentiality are fundamental rights of every patient. This means that discussions with doctors, examinations and treatments should not be conducted in the presence of third parties. In the course of its visits, the CPT has already criticised the inadequacy or total lack of confidentiality during