‘Wide variation’ in custodial healthcare poses challenges for Police Scotland

A new report has found a “wide variation” in the healthcare provided to people in police custody – with concerns raised that this could be leading to officers making decisions “without the benefit of clinical advice”.

Craig Naylor, HM Chief Inspector of Constabulary in Scotland, spoke about the “challenges” for police as a result of the “variability of healthcare”.

His comments came after a joint review of healthcare facilities in police custody carried out by HM Inspectorate of Constabulary in Scotland and Healthcare Improvement Scotland.

That report told how “there is wide variation across Scotland in access to healthcare provided to people in police custody”.

It found: “People requiring healthcare in custody did not receive the same timely access to healthcare services, and the range of services available varied.”

With evidence suggesting offenders can have “multiple and complex health issues such as mental and physical health problems”, the report highlighted a “lack of equity” in terms of the services provided.

The “speed of access to a healthcare profession” can be dependent on geographical location, it added, with “inconsistent self-set targets for people in custody to access healthcare” ranging from one to four hours.

The report has now recommended that the Scottish Government, NHS boards and health and social care partnerships introduce “nationally agreed waiting time standards for the assessment and treatment of individuals detained in police custody centres to ensure equity of access to healthcare across Scotland”.

Mr Naylor said: “The variability of healthcare raises challenges for Police Scotland. Gaps in healthcare within a custody centre can result in staff having to make decisions about a person’s healthcare needs – such as whether they require hospital treatment – without the benefit of clinical advice.

“We hope this report and the subsequent inspections will help ensure that those in police custody get the care they need.”

There have been 14 deaths in police custody since April 1 2014, the report said, though it also noted data released under Freedom of Information showed a total of 122 deaths of people after police contact or while in custody from April 1 2014 to August 3 2021.

Lynsey Cleland, quality assurance director at Healthcare Improvement Scotland, said: “Evidence suggests that people who have offended, or who are at risk of offending, frequently experience multiple and complex health issues such as mental and physical health problems, learning disabilities and substance use, and are at increased risk of premature morbidity.

“It is vital that people’s health needs are met in the custody setting and that help with routes into treatment or other support is available for those who need it.

“We believe that this report and the future inspections will help ensure greater consistency in care for people across the country.”

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