Recommendation - Essex Police, December 2023

The IOPC recommends that Essex Police should take steps, in partnership with relevant stakeholders, to ensure healthcare services in police custody best meet the needs of detainees. In particular, Essex Police must make sure detainees have access to and receive appropriate clinical attention as soon as reasonably practicable if they appear to be suffering from physical or mental illness, are injured, or appear to need clinical attention.

This follows a review of a local death or serious injury investigation into a near miss in custody where a detainee who required medical attention suffered a seizure. The detainee was seen by a healthcare professional shortly after being booked into custody because he had disclosed he was taking methadone and had asthma. The healthcare professional recorded that a review was required later that day for a drug withdrawal assessment and/or to administer methadone. Prior to this review being due, the detainee was taken to hospital after it was suspected that he had injured his arm. The detainee was returned to custody later that day and custody staff requested that a healthcare professional assess him. The detainee began complaining of pain from his injury and the medical review became overdue. Several requests to the third-party healthcare provider were made but the custody sergeant was reportedly advised that, due to staffing issues, no medical practitioner could be provided regardless of the risk or clinical need. In the early hours of the next day, the detainee informed custody staff that he was starting to experience seizures and he was taken to hospital. The detainee in this case did not receive appropriate clinical attention in a reasonable timeframe, which is not in line with Code C of PACE, and could have had far more serious consequences.

Authorised Professional Practice on Detention and Custody states forces must develop an appropriate healthcare model in consultation with health commissioners and other key stakeholders that best meet the needs of detainees based on a regular needs assessment. Agencies and individuals providing this service must have the legal authority, qualifications, experience, capability, and capacity to deliver a continuous quality service within set timeframes. Forces should monitor their healthcare provision to ensure quality of service and effectiveness. In HMICFRS’s last inspection of custody facilities in Essex Police it found there were instances of long waits for a healthcare professional. HMICFRS noted the following area for improvement: healthcare professionals should see detainees promptly, and within a timescale that supports their health and well-being and does not unnecessarily hinder custody processes.

Accepted:

In Essex, healthcare is provided by EPUT (NHS) who supply approved mental health practitioners for custody and a private company contracted through EPUT called Castle Rock Group (CRG) who supply the qualified HCP medics embedded in the suites. 

I meet on a regular basis with representatives from these organisations to discuss resourcing, complaints and any other issues that arise between us and our partners. This is a two-way process in which issues from both the police and the medical side are aired and addressed regularly.

 Urgent matters don’t wait for the scheduled monthly meet-up and the reps of EPUT and CRG can and do contact Custody Management at short notice to discuss matters. Likewise, custody managers are in Teams and email contact with both EPUT and CRG on an almost daily basis to deal with any staffing shortages which can potentially cause significant logistical problems for the police and concerning gaps in medical provision for detainees. 

All persons coming into Essex Custody are asked a series of risk assessment questions during the booking-in procedure. During this process, the sergeant or detention officer may form the opinion that the detainee needs medical assessment, in which case this is arranged at the earliest practical time.  

Alternatively, the detainee may themselves request to see a medic and this is catered for in the same timely manner.

In Essex, all juveniles, all detainees assessed as vulnerable, and all females are automatically seen by an HCP within the suite regardless of whether a visible medical need is apparent or not. 

Likewise, anyone having just been to hospital or seen by an ambulance immediately prior to arrival in custody is seen by a medic. There are protocols around road traffic collisions in which potential high-speed collisions are assessed by the custody sergeant via radio comms with the officers on scene to triage whether a person under arrest should be brought to the station or first go to a hospital.

 The detainee is continually assessed throughout their time in custody via routine cell visits, s.40 PACE reviews by Inspectors and during custody sergeant handovers. If a detainees’ health appears to have deteriorated during their time in custody, then referral to the HCP is always considered.  

Essex Custody is one of the safest and best run custodies in the country and am confident that processes we already have in place meet the recommendation.