A new report has highlighted the impact of a shortage of prison nurses and other healthcare workers on people in police custody.
This report, published by Newcastle University and led by sociology lecturer Dr Gethin Rees, called for improvements to the provision of healthcare workers, such as nurses, in custody environments.
“It was the weirdest thing of being physically and emotionally exhausted”
Custody healthcare professional
Researchers spoke with detained people and police staff and analysed custody logs to inform the study, titled Equivalence in Police Custody.
Despite it being common practice for a healthcare professional, normally a paramedic or a nurse, to be “embedded” in a custody suite, the report found that there were “many times” when this was not the case.
The reasons for this, the report said, ranged from sickness, holidays and difficulties recruiting and retaining them.
As well as this, researchers noted how “troubling” it was to find out that, in some cases, the decision to not embed a healthcare professional in each custody area was “increasingly strategic in order to reduce costs”, with virtual consultations replacing someone being present on site.
As a result, people who are detained experience delays to assessments, medication and treatments, with waiting times, in some cases, of more than two hours, the report warned.
One person, identified as Jim, told the study: “I can live with not having food for a couple of hours, but you can’t live with not having your medication when you’re due it.”
A healthcare professional named Marie spoke to researchers about the impact the poor arrangements were having on the workforce.
She said that, in one instance, another healthcare professional had called in sick at short notice, meaning she had to cover for them despite the fact she was based in a different town.
“My shift just went in like an instant,” she said.
“When I came out, it was the weirdest thing of being physically and emotionally exhausted. I ended up having to take a little nap, on my way back.
“But because it was my nightshift, by the time I’d driven home, I was then still tired and shattered and all these other things, with a bit of adrenalin still running through me, and I still couldn’t sleep properly after.”
The report noted that there was a “postcode lottery” for access to medication, due to variations as to whether staff have prescribing qualifications.
As well as this, the report found examples where custody staff would record that they believed medical issues being disclosed by detainees were “untrue” or “exaggerated”, and that this gave the impression that some staff saw detained people as “an inconvenience”.
It found that medications for the treatment of conditions including epilepsy, cancer, diabetes and others were being withheld.
It also noted contrasts between the way non-clinical and clinical staff would refer to detainees: at one location in Sunderland, a healthcare professional noted that a detained person was “alcohol dependent”, while the non-clinical staff member wrote “alcoholic”.
The report said, in general, the language used in custody logs “conveyed a level of disrespect” towards detainees and that their medical issues were treated with “scepticism”.
This, the report noted, extended to detainees with drug dependencies who were suffering from withdrawal symptoms, and it found other examples where detained people were not given the proper care.
The report issued seven recommendations to improve care for detained people:
Embed healthcare professionals “properly” in custody suites and provide “proper” resourcing of them;
Sign up all healthcare professionals to a standardised medication list;
Remind all healthcare professionals that there is no six-hour detention minimum before medicating;
All staff working in custody should approach health concerns of detainees with “curiosity”, not scepticism;
Ensure methadone is accessible to all on a rehabilitation treatment programme;
Recognise alcohol and drug dependent people in custody as vulnerable adults;
Make sure detained people are properly referred to support services.
Report author Dr Rees said: “Healthcare provision in police custody at the present time does not meet the standards of ‘availability, accessibility, acceptability and good quality’ adapted from the Universal Declaration of Human Rights.
“We have provided recommendations that will assist healthcare provider companies and the police to meet these minimum standards.”
