Custody Nurse Practitioners in the Metropolitan Police

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Custody Nurse Practitionersin the Metropolitan
Police

• Karen Swinson Custody Care Consultant,
  Metropolitan Police

16th September 2009
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Healthcare Professionals in Custody

• Previous Provision
• Forensic Medical Examiners Predominantly local
  GPs
• The need for change
• Inefficiencies in previous service provisions
• Audit Commission
• PCA Report
• Home Office Working Group
• PA Support

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Healthcare Professionals in Custody

• A health care professional means a clinically
  qualified person working within the scope of
  practice as determined by their relevant
  professional body.
• PACE Act 1984 Code of Practice C
• Primarily these clinicians are
• Forensic Medical Examiners - General Medical
  Council
• Nurses - Nursing and Midwifery Council
• Paramedics - Paramedics Board of the Health
  Professions Council

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Healthcare Practitioners and Police together
reducing the risk of death in Custody

• Improved Training
• Professionally recognised qualifications
• Role specific
• Professional recognition and support and
  registration
• Royal College of Physicians - Faculty of Forensic
  and Legal Medicine
• Royal College of Nursing Criminal Justice Forum
• Council for the Registration of Forensic
  Practitioners Both Physicians and Nurses

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Examinations
Medicines via PGD for substance misusers 16.5
Drug Related 15
Alcohol Related 11
Medical Conditions 14
Head Injury 4
Verification of death 2
Forensic Samples / EBAs 4.5
Minor Injury21
Mental Health 12
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Factors which increase vulnerability of persons
detained in Police Custody

• Chaotic lifestyles poor physical health
• Packers and Stuffers
• Poor / inaccurate historians motivation
• Violence Restraint
• Volume V Constant Supervision
• High proportion of those detained have misused
  drugs / alcohol concentrated risk
• Custody Sergeant responsible for health and
  welfare PACE
• Minimal training for officers (difference
  between rousing and checking)
• PACE requirements 8 hours interrupted sleep, 24
  hour total detention
• Searches intimate or non intimate
• Drug Operations
• Zero tolerance Policing
• Local hospital and Ambulance policies

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The Changing Future

• Examination demand increase
• Changing offender profile
• Accountability and transparency demands on Police
  Forces
• Target and performance measurement
• Variation in service provision, contracted,
  employed, outsourced
• Offender Health Strategy proposals Department
  of Health
• Custody Inspections by Her Majestys Inspectorate
  of Prisons (HMIP)

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• For more information on this exciting role come
  and see our stand number 12 in the Gallery Hall