Last month, SPF was invited to attend the Police Federation of England and Wales’s National Custody Seminar. As an experienced Custody Sergeant, Steve Clark, Depute Secretary of the East Area, was asked to attend and he compiled the following report on his observations.
“The seminar opened with current statistics that are available in England and Wales (E&W) that 75% of police officers surveyed do not want to work in custody and 20% of officers who currently work in custody want out.
Chief Constable Nick Ephgrave (NPCC lead for Custody and Criminal Justice) was the first speaker and spoke about the NPCC Custody Strategy which included: –
- Training – looking at virtual reality training to deliver national standard training.
- Risk Assessment – new tool to be introduced that incorporates a continual process in an effort to try and predict outcomes – involves a quick yes/no process.
- Technology – to introduce new technology wherever possible.
- Voluntary Attendance – this has become increasingly popular in E&W and includes interviewing suspects out with the custody environment.
CC Ephgrave also spoke about the Independent Review into Deaths and Serious Incidents in Custody. This review was commissioned by the then Home Secretary (Theresa May) in 2015. The review is now complete and there is a draft report – not yet published, although believed to be published imminently – later this month or October.
Statistic was quoted that 900,000 custodies per year across E&W, of which 40-60% have mental/medical issues.
CC Ephgrave provided an insight into current work being carried out regarding detainees under restraint. A campaign to raise awareness within policing has/is being put together and is titled –
“60 seconds to save a life”.
The main points within the campaign message are:-
• 2 intervention points – 1st – at arrest and at initial restraint.
2nd – upon arrival at a custody centre.
• Take 60 seconds at both above stages
• Consider any red flags – Has there been any extreme restraint?
Are drugs/alcohol present?
Are there mental health issues present?
Is it a case of acute behavioural disorder (ABD)? – recognised in E&W that ABD can be associated with an underlying medical reason and as such someone exhibiting ABD should be dealt with as a medical emergency *.
• Are you dealing with a Prisoner or a Patient? – Acknowledgement that it can be both – make a decision which takes priority?
• If the decision is Patient the call an ambulance / summon medical assistance immediately.
*ABD generated some spontaneous discussion at the seminar with various delegates and speakers becoming involved, including medical professionals. It was highlighted that the Royal College of Emergency Medicine have issued guidance (Guidelines for the Management of Excited Delirium / Acute Behavioural Disturbance (ABD)) that ABD is a recognised medical condition and that the sedation of such custodies in a hospital environments often the preferred form of treatment, rather than being subject to any form of physical restraint, including within a police custody suite. The aforementioned guidance was issued in relation to deaths in custody. The clear message from those who spoke on this subject was to encourage Forces to liaise with their local NHS providers and establish a clear MOU regarding custodies who present with ABD and/or excited delirium.
The second speaker was Che Donald from PFEW. Che highlighted the on-going PFEW ‘Protect the Protectors’ campaign. He specifically mentioned: –
• Taser and Body Worn Video (BWV) – to be a wider roll-out across England and Wales;
• Spit / bite guards – not all Police Forces in E&W have issued and use these, apparently due to adverse media/public reaction, although numbers have increased in recent months and now sits at 24 out of 43 Forces. PFEW hope that all Forces will eventually use/issue them; and
• Police drivers – PFEW attempting to use political influence to seek legislative changes to the Road Traffic Act to afford police officers with a level of protection when responding to emergency calls and using blue lights and sirens.
There was an input from the Independent Police Complaints Commission (IPCC) – effectively the equivalent of our PIRC. Early next year (date tbc) the IPCC are to change their name to the Independent Office for Police Conduct (IOPC).
A professor from the University of Wales and a medical colleague delivered a presentation on ‘Custody Early Warning Score’ (CEWS) and associated technological advances that are aimed at making police custody a safer environment for all. In terms of technology the presentation included the following: –
• Wristband monitoring (similar to a fitbit) – can monitor the heart, movement, sleep patterns etc. Wearable life sign monitoring is apparently available in the worldwide marketplace at costs as low as $10.00 per unit;
• Portable chest monitors for heart issues/conditions; and
• Concussion – current research being undertaken in the sporting world whereby ipads/tablets are being used to monitor eye movement and test reaction times that can then diagnose symptoms of concussion.
During the presentation it was explained that the NHS are now using a clinically proven monitoring / triage process called ‘NEWS’, which stands for National Early Warning Score. NEWS monitors the following: –
• Respiratory rate;
• Oxygen saturation;
• Blood pressure;
• Pulse rate; and
• Level of consciousness.
Each of above has a score, which is then added together to give a total result, which is then used as part of the on-going assessment of patients. NEWS has been proven to be a valuable tool that can highlight patients who are deteriorating or require medical attention.
CEWS and ‘CEWS Lite’ are a direct result of NEWS and are a streamlined version that is deemed suitable and achievable within the custody environment. CEWS Lite monitors the following: –
• Pulse rate;
• Blood pressure;
• Pupil size; and
• Custody behaviour.
CEWS has been used within the UK Border Agency (UKBA) for some time and it is currently being trialled within Devon & Cornwall Police at Plymouth.
The next topic was Mental Health & Policing. The Mental Health Act 1983 – only for E&W – stipulates that there are to be no children (under 18yrs) at a police station as a place of safety. Likewise is states that police stations are not to be used for adults either, unless in exceptional circumstances (not defined).
It was explained that there have been big improvements in some Forces across E&W in this regard, with some Forces not holding any MH custodies within their custody suites during the past 12 months – West Midlands Police were given as an example. The Forces have apparently achieved this through effective multi-agency/partnership working, with A&E and other designated places of safety being utilised. It was recognised however that there were occasions that police officers were required to maintain a presence to support NHS/Local Authority colleagues.
It was acknowledged that there remains a vast variation across E&W in terms of Forces use and interpretation of criminal -v- MH powers re detention/arrest.
Day 2 of the seminar started with a presentation from the Chief Executive of the Independent Custody Visiting Association (ICVA) which covers virtually all of the UK, including Scotland. ICVA are seeking to move from carbonated paper records to an electronic version.
This was followed by a presentation re ‘Legal Highs’ or the new official term New Psychoactive Substances (NPS). Highlighted the dangers of Fentanyl – very dangerous in powder form if airborne and can be absorbed through the skin if handled. The presentation included a section on drugs packing / swallowing, with information provided that indicated that x-rays are effectively a waste of time as they are too inconclusive. CT scans (multiple x-rays) are far more effective and accurate, however they are expensive.
The final presentation of the seminar involved a lawyer from Slater Gordon Lawyers and she spoke about custody investigations and emerging issues. She concentrated on a case study involving the death of a custody in England in 2012 and highlighted some of the main issues that arose from the investigation into the case, which included: –
• The lack of information and quality of information provided by arresting officers to custody staff to enable a full and effective risk assessment. The case study and investigation resulted in criticism regarding the lack of information passed to custody staff in relation to the prior restraint of the prisoner before he entered the custody environment;
• There was criticism of the decision to take the prisoner straight to a cell, with no attempt made to process him at the charge bar;
• The use of the Emergency Response Belt (ERB) was highlighted – it was used to try and prevent the prisoner from biting officers/staff – he was placed face down onto the belt and conveyed to the cell – it would appear that this further restricted his breathing and was a contributory factor in his death;
• Breathing – how do you assess a custodies ability to breathe?;
• The prisoner in question did not have a history of offending and was not known to the police. It subsequently transpired that he had a history of poor mental health which was a major factor in his behaviour and why he came to the attention of the police on the occasion of his death. The police officers dealing with him on the day, including custody staff were not sighted on his mental health;
• The question of what should be recorded on a custodies record in relation to a critical incident was discussed. It was highlighted in the case study, that when it became clear that the prisoner was very unwell and he was taken to hospital by ambulance the custody sergeant updated the custody system and prisoner record with information regarding his restraint and time spent within the custody suite. This information obviously becomes part of the investigation and is evidence. The lawyer explained ‘perception distortion’ – a recognised issue and one that can affect people involved in serious incidents and there perception/recollection of events. She queried the appropriateness of making notes/updating systems immediately at the point of a critical incident..? And questioned if that is the best time for an individual (custody sgt) to make a record of an account of an incident. She appreciated the need to update systems timeously and accurately, however on occasions where the matter looks so serious, she questioned the need and appropriateness of such updates. She mentioned the procedures involved with Post Incident Procedures (PIP) and was in favour of staff being treated in a similar manner.
Other Points of note:
• E&W they have a policy that custodies are entitled to 8hrs uninterrupted rest, particularly during the night. This is apparently a default position and is dependent on the risk assessment and associated care plan. If a custody presents a low risk then regular checks will be made, but only via the opening of the cell hatch to observe breathing/movement and no verbal response is required;
• Extensive use and increasing use of voluntary attendance in E&W, where suspects are invited to attend at a police station at a mutually convenient time/date. This even applies to suspects who are traced at locus, e.g. shoplifters apprehended by security staff….etc. This practice appears to be generally popular with police officers who work both within and out-with custody; and finally
• Attendance at the seminar highlighted that there are many similarities in terms of the issues faced in custody in E&W and those encountered in Scotland.”
SPF will now now discuss the points raised with Police Scotland with a view to shaping custody practices and procedures that ensure the safety and care of all concerned.