Delivering person-centred care in police custody
From seeing a detainee who has collapsed in a cell to assessing someone’s fitness to be interviewed for murder, it's all in a day's work for police custody nurse Matt Peel.
From seeing a detainee who has collapsed in a cell to assessing someone’s fitness to be interviewed for murder, it's all in a day's work for police custody nurse Matt Peel
The custody nurse role was introduced in 2003 following changes to legislation which allowed nurses and paramedics to care for people in police custody. Prior to this, the work was solely done by doctors.
The role of the custody nurse has developed significantly over the past 14 years, with nurses now undertaking the majority – in some areas up to 99% – of the work.
I have worked as a police custody nurse in West Yorkshire Police’s custody suites for five years. Initially I was employed by a private company, but following a successful tender by Leeds Community Healthcare NHS Trust I now work for the NHS.
My background is in acute medical, critical care and emergency department nursing, experience which is ideally suited for police custody work. Experience of mental health settings is also very helpful, as many detainees have mental health problems.
People seen in police custody are often vulnerable, with chaotic lives, often deprived of healthcare services. Due to the varied nature of the work, induction courses must be thorough and followed up with supervised practice. They should include:
- Drug and alcohol withdrawal/intoxication
- Management of long-term conditions
- Overview of mental health conditions
- Introduction to the Police and Criminal Evidence Act
- Introduction to forensic science, particularly forensic evidence collection.
Custody nurses have dual responsibility. As well as having a therapeutic responsibility towards the detainee, we are independent clinical assessors for the police, advising on an individual’s fitness for detention or interview. These assessments are particularly important as errors can lead to harm or miscarriages of justice.
A major aspect of the role is ensuring that detainees remain safe while in custody, and maintaining their rights. This includes ensuring that prescribed medication is continued, managing minor illnesses or injuries, and setting an appropriate care plan for the police to follow, preventing deaths in custody.
A unique aspect of the role, which requires meticulous attention to detail, is forensic sampling. Custody nurses prepare samples and collect forensic evidence on suspects accused of serious offences, such as sexual offences, murder and serious assaults.
There is no typical day at work. I can go from seeing a detainee who has collapsed in a cell and needs immediate treatment, to assessing someone’s fitness to be interviewed for murder.
Custody nurses work autonomously and usually alone, so as well as having confidence in your clinical skills and reasoning, you need to be able to make decisions which can be unpopular, such as refusing to authorise a detainee’s medication or recommending an appropriate adult.
At times, the role can be open to intense scrutiny. In the event of a death in custody, for example, there will likely be an Independent Police Complaints Commission investigation and a coroner’s inquest, where the custody nurse will be required to provide detailed statements, interviews or testimony.
I am passionate about ensuring that detainees receive a high standard of person-centred care, and making every contact count. It is also satisfying knowing that forensic samples I have taken have helped the police in their investigations and assisted courts in reaching their verdict.
Matt Peel is a police custody nurse with Leeds Community Healthcare NHS Trust, working in the West Yorkshire police force’s custody suites