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Results for police custody (uk)

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Author: de Viggiani, Nick

Title: Police Custody Healthcare: An Evaluation of an NHS Commissioned Pilot to Deliver a Police Custody Health Service in a Partnership Between Dorset Primary Care Trust and Dorset Police

Summary: This evaluation was sponsored by Dorset Primary Care Trust and the South West Strategic Health Authority to examine the local commissioning relationship established to provide police custody healthcare across Dorset's three 24/7 custody suites, located in Poole, Weymouth and Bournemouth. This initiative has the status of a national pilot, and the evaluation is expected to carry lessons for a wide range of audiences in and beyond Dorset. A police custody medical service has operated within Dorset for many years using General Practitioners contracted on a part-time basis as Forensic Physicians (previously referred to as Forensic Medical Examiners or Police Surgeons). Historically, this has been customary practice in the UK, where GPs have been contracted to the police on a part-time basis, although increasing numbers are specialising in forensic work and work as full-time Forensic Physicians, particularly since the establishment of the Faculty of Forensic and Legal Medicine in 2005. The switch to provision commissioned by the NHS was introduced to Dorset in 2008, as a Department of Health/Home Office national pilot. Its purpose was essentially to examine the efficacy of the NHS taking a strategic lead in commissioning police custody healthcare, and, more specifically, to pilot the transfer of commissioning and budgetary responsibility from Dorset Police to Dorset Primary Care Trust. Throughout this trial period, the service has continued to be contracted to an independent provider but is now governed by a partnership agreement between the NHS commissioner and Dorset Police, as the two lead organizations, and through a local partnership board. This shift to mainstream health provision likely reflects the following key areas of thinking: a) concern that a disproportionate number of people entering the criminal justice system present in police custody with significant complex health and social care problems, particularly involving mental illness and/or drug or alcohol dependency, and often require urgent treatment and care; b) perception that the former medical approach to police custody healthcare was inadequate in terms of addressing the complex needs of people entering the criminal justice system, particularly in preventing deaths in custody, a source of intensifying political and professional concern; c) successful reform of prison healthcare, with the shift of commissioning and provision to the NHS in 2006; and d) an emerging "offender pathway‟ health policy focus, led by the Department of Health, that is advocated by the Bradley Report, into which this Dorset pilot fed its experience, and which implies a continuous and integrated approach to the management of health and social needs of people who move through the criminal justice system, between community and custody settings. At the heart of this innovation is the principle of health and social care as a fundamental citizen right. Furthermore, the Audit Commission's 1998 review of the provision of forensic medical services to the police concluded that the service needed to be reformed for the following reasons: [1] difficulties recruiting Forensic Physicians; [2] variable standards of service around the country; [3] inadequate clinical facilities within some custody suites; [4] poor communication and feedback; [5] lack of formal contractual arrangements in some areas; and [5] lack of clear management structure and scrutiny. The service delivered through this pilot represents a shift from the more traditional forensic medical service to one led predominantly by custody nurses. In place of physicians on call, the pilot, as agreed between the NHS Commissioner and Dorset Police required a 24 hour, 7 day nurse presence in each custody suite. An innovative feature of the pilot was the aspiration to link constant nursing presence to a broad triage service, linking police custody detainees to a range of integrated community-based services to address alcohol and drug dependency and other mental and physical healthcare needs. The focus of the evaluation was to understand the commissioning relationship and its impact, given that the key innovative aspect of the Dorset scheme was the introduction of NHS commissioning via an NHS organization (a Primary Care Trust). This particular case of commissioning involves the NHS contracting services on the premises and in the area of action of another public sector service. All Primary Care Trusts are now required to operate as "commissioners‟ in procuring and developing health services, and they are held accountable for their effectiveness as commissioners.

Details: Bristol, UK: School of Health and Social Care, University of the West of England, 2010. 55p.

Source: Internet Resource: Accessed November 30, 2010 at: http://eprints.uwe.ac.uk/8253/1/PC_Evaluation_final.pdf

Year: 2010

Country: United Kingdom

URL: http://eprints.uwe.ac.uk/8253/1/PC_Evaluation_final.pdf

Shelf Number: 120318

Keywords:
Health Care
Medical Care
Mental Health Services
Police Custody (UK)