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Introduction
1. The current system for providing medical services to people in police custody in Scotland has evolved in a rather ad hoc, often non-standard fashion. This may have been acceptable many years ago, when forensic medical services were just developing, but it is clearly not suitable in today's challenging environment. We are therefore grateful to ACPOS, and in particular to Deputy Chief Constable George Graham of Dumfries and Galloway Constabulary, for bringing this matter to our attention.
2. This report is intended to stimulate improvement and contribute to continuing debate on the manner in which these services are provided. It makes a number of recommendations on the basis of identified good practice, and seeks to contribute to wider discussion about how and by whom such services should be provided. The inspection was carried out by Superintendent Brian Muir (seconded from Lothian and Borders Police) and Chief Inspector Graeme Galloway (seconded from Dumfries and Galloway Constabulary), supported by our senior research officer Dr Emma Fossey, and directed by the then Assistant Inspector of Constabulary, Malcolm R Dickson QPM. We anticipate that the main body of the report will be of interest to all readers, while the annex containing evidence and good practice should be of use to those responding to our findings and to custody practitioners generally. Interested parties are welcome to contact us on any aspect of the report or to obtain further detail.
3. The inspection examined the following key areas:
- Existing provision of medical services for people in custody in Scotland.
- Force plans for improving provision in the future - both in terms of the cover provided and the manner in which it is sourced.
- Examples of good practice in other police forces in the UK.
- Examples of good practice in other organisations with a responsibility for the care and custody of individuals. To this end we liaised with Social Services, the voluntary sector and the Scottish Prison Service, as well as with HM Inspectorate of Prisons, all of whom were extremely important sources of advice and instruction.
4. The question of responsibility for supplying these medical services. A large number of police forces across the UK are taking the opportunity to re-assess their approach. Several now use companies from the private sector, while the possibility of moving to a position where the National Health Service assumes responsibility is also actively being explored.
5. In identifying these key areas cognisance was taken of the Scottish Government's five strategic objectives, two of which we felt were particularly pertinent to this review:
- Healthier - help people to sustain and improve their health, especially in disadvantaged communities, ensuring better, local and faster access to health care; and
- Safer & Stronger - help local communities to flourish, becoming stronger, safer places to live, offering improved opportunities and a better quality of life.
6. In order to establish the current position and enable all interested parties to contribute to the debate, we presented each of the eight Scottish forces and British Transport Police ( BTP) with a series of focused questions. As is standard practice in our inspections, we also sought the views of ACPOS as well as the various force staff associations - the Association of Scottish Police Superintendents ( ASPS), the Scottish Police Federation ( SPF) and UNISON. The evidence provided and the opinions expressed are summarised in Annex A. It proved very difficult to obtain uniform statistical information across the country, and while we are grateful to forces for their efforts in this respect, it is revealing that there is as yet no common system to provide these data. This matter is considered later in the report.
7. In any inspection of this sort it is clearly beneficial to liaise with as many sources of information and advice as possible, in order to apply more rigour to our examination of current practices, obtain views and comments, and identify possible areas for improvement. With this in mind, we consulted a wide range of individuals and organisations. These included, in no particular order: the Police and Community Safety Directorate and Public Health and Wellbeing Directorate of the Scottish Government; ACPOS health/medical services reference group; Crown Office and Procurator Fiscal Service ( COPFS); individual forensic medical examiners ( FMEs); Scottish Independent Custody Visitors; ACPOS National Custody Forum; Her Majesty's Inspectorate of Constabulary (for England, Wales and Northern Ireland); Cumbria Constabulary; Humberside Police; Metropolitan Police; Sussex Police; the Scottish Prison Service ( SPS), HM Inspectorate of Prisons and private providers. As a result, a great deal of relevant information and advice was obtained and is reflected throughout the key issues section of this document and in the annex.
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