NHS GGC Police Custody Healthcare Colin Mac Donald

NHS GG&C Police Custody Healthcare Colin Mac. Donald – Service Manager & Grant Scott – Professional Nurse Advisor

The Police Custody Healthcare Service in NHS GG&C went live on 1 st April 2014. Replaced model of GPs directly employed by Police Scotland.

The service aims are to provide: • NHS standard healthcare in police custody settings • A seamless & sustainable service • An integrated system of care The service is supported by: • Robust clinical governance • A network of clinical support • National strategic groups

NHS GG&C have 10 Police Custody Suites where healthcare & forensic services are provided: Stewart St (18), London Rd (38), Govan (50), Cathcart (57), Greenock (57) , Clydebank (29), Baird St (36) , Maryhill (27), Paisley (24) & Partick (14) Total of 353 cells in PCS across NHS GG&C

The PC Healthcare model in GG&C is a Nurse led service with staff on duty 24 hours a day, 7 days a week. We are based at Govan Police Office and work peripatetically from there. Nursing staff triage all calls and allocate to the most appropriate clinician on duty. This model brings professional advantages through the wide range of clinical expertise amongst the medical and nursing team.

The current staffing levels are: • • • 1 Service Manager 0. 5 Professional Nurse Advisor 1 Senior Charge Nurse (Band 7) 19 Practitioner Nurses (Band 6) Forensic Physicians 1 Administrator (Band 4) Nursing staff in PCH Service come from a variety of backgrounds - ED's, Addictions, MH, Prisons & Homeless Healthcare PCH Service currently has 5 NMP and 15 PGD's in operation which resolve a lot of clinical activity in police custody settings relating to prescribing medication for common issues.

Statistical Information • Since starting on 1 st April 2014 healthcare calls received have been consistently been above 1, 600 per month. PCH Nurses have dealt with over 65% of all contacts since service commenced • Health Improvement work has been successful within this new healthcare area, examples being ABIs and Naloxone take home kits

PCH Service has direct liaison with key stakeholders including : • • Emergency Depts Mental Health Services - including OOH & CT Addiction Services Archway GP's Community Pharmacies Third sector agencies Staff have access to ECS, Clinical Portal and Pi. Ms/EMIS to ensure robust medical history can be obtained

Service Vision For Police Custody Healthcare • Development of closer joint working/ resource initiatives with Prison Healthcare • Support the development of nursing role within the service –NMP, ANP, Forensic duties. • Tele. Health • West Of Scotland Model

Mental Health Pathway for Police Custody Healthcare • The aim of this work is to provide guidance for staff from NHS GG&C Police Custody Healthcare service in the process for accessing appropriate Adult Mental Health Services for people who are assessed as requiring additional specialist MH input

Historically Poor outcomes for people in custody with MH needs: • No clear guidance around access to services. • Delays in assessment and treatment. • Inappropriate referrals to court CPN’s

Routine MH Referrals • IT Systems check • Assessment • Discussion with MH Services that person is known to or in their postcode area • The urgency of the referral is discussed and a response time is agreed. • Community Mental Health Teams in NHS GG&C aim to assess routine referrals within 4 weeks. This may be slightly longer if a medical or psychology appointment is necessary. ‘Soon’ referrals are seen within 5 working days.

Emergency MH Referrals • IT Systems check • Assessment • Discussion with MH Services that person is known to or in their postcode area • Liaise with Police colleagues re further assessment being required and practical arrangements of same

24 Hour access • Core hours – CMHT’s • Out of hours - Crisis Teams, OOH MH Services • Emergency Departments – Physical health checks and Psychiatric liaison service

Patient referred to Police Custody Healthcare Service by Police for assessment Mon - Friday - 9 am - 5 pm Check relevant IT systems from information as part of triage Allocation to most appropriate clinician for assessment Known to Mental Health Services Not known to Mental Health Services Contact service for information Patient assessed by Police Custody Nurse Signpost to local service/GP Input required from Mental Health Service No input required Discuss with FP Contact service to discuss and agree response time Routine referral Forward written referral *Out of Hours staff will assess in Police Custody Healthcare Suite Emergency Referral Soon Referral Police escort patient to agreed site and remain with patient until outcome agreed* Admit to Hospital Follow up CMHT/Crisis Return to Police Custody