Research led by Newcastle University, working with colleagues at Northumbria and Durham universities, found that healthcare provision in police custody is frequently denied to detainees as not enough nurses and other Healthcare Providers (HCPs) are available to cover custody suites, or practices are followed that prevent medications being issued.

It also found that there was a postcode lottery in terms of which medications HCPs were able to provide to detainees. This frequently leads to different levels of care being provided across Police Force areas.

The research also highlighted that Custody Officers were often sceptical or mistrustful about the legitimacy of detainees’ health conditions and their requests for medication.

Medications being withheld didn’t just include methadone and other opioid replacements, but also prescribed drugs for the treatment of epilepsy, cancer, mental health conditions and insulin for diabetes.  

Dr Gethin Rees, Senior Lecturer in Sociology, Newcastle University, 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.”    

The ‘Equivalence in Police Custody’ report presents the research findings and makes a number of recommendations to improve the standard of healthcare delivery in police custody.

Among the recommendations made, the researchers say that all Healthcare Providers should sign up to a standardised medication list and Patient Group Directive - a framework that allows healthcare professionals to administer medicines to patients who meet specific criteria, without the need for a prescription from a doctor. This would avoid divergent standards of care across Forces.  

One person who had lived experience of being detained in police custody without access to healthcare told the research team: “The healthcare in there is absolutely hopeless. You get arrested and you’re detained for 12 hours and you’re in a cell sick because the healthcare won’t help you.  They won’t give you methadone, let alone phone up the chemist and ask if this guy is on a script and if he is taking his methadone. They don’t provide you with anything like that, so they make you suffer in a cell, sweating, being sick, diarrhoea, and you just want to end your life.”

Following changes to the commissioning of healthcare in police custody in 2008, HCPs – mainly nurses and paramedics employed by private companies – became located, or embedded, within police custody suites for 12-hour shifts. However, due to challenges in recruiting and retaining staff in post and difficulties caused by HCP staff being on sick leave, there often is not an HCP embedded in a particular custody suite.

This has led to HCPs now being required to travel large distances between suites, and frequently reporting exhaustion – which increases both compassion fatigue and an inability to retain staff. The report recommends that HCPs are properly embedded in all custody suites.

Sherry Ralph, Chief Executive Officer, Independent Custody Visiting Association (ICVA), said: “ICVA welcomes this research and resultant report as an important publication shining a light into healthcare provision in police custody. Our volunteers and schemes reports echo the findings of the research, specifically pertaining to the availability of healthcare for those detained in police custody, reflecting varying arrangements across forces being in place, with gaps in coverage leading to sometimes long wait times for detainees to see a healthcare professional to discuss their needs. We are delighted to support recommendation one of the report and look forward to working with the researchers and stakeholders to determine next steps to see this integral function of police custody improved.”

The research team are also calling for Custody Teams, including HCPs, to adopt professional curiosity when listening to detainees’ accounts of their health needs, rather than the current risk-averse approach which often leads to scepticism and distrust.

They also recommend that detainees with drug and alcohol dependencies to be regarded by Custody Teams as Vulnerable people, and that an Appropriate Adult is provided to assist the detained person in preparing for the police interview.

The Equivalence in Police Custody’ report and animation can be viewed at https://research.ncl.ac.uk/equivalence-in-custody-healthcare/