TAYSIDE PATHFINDER PILOT The provision of Healthcare and

TAYSIDE PATHFINDER PILOT The provision of Healthcare and Forensic Medical Services within Tayside Police Custody Settings Sally Patrick 7 th September 2011

PATHFINDER PILOT • JANUARY 2009: COMMENCEMENT OF PARTNERSHIP BETWEEN, NHS TAYSIDE, TAYSIDE POLICE, AND THE UNIVERSITY OF DUNDEE FUNDED BY TAYSIDE POLICE AND THE SCOTTISH GOVERNMENT

STAFFING FORENSIC NURSES • 10 NURSES (9. 8 WTE )WORKING 24/7 – 365 DAYS PER YEAR • 6 RGN 3 RMN 1 RGN/RMN • 1 NURSE 0730 -1830 HRS • 2 NURSES 1830 -0730 WEEKENDS AND PUBLIC HOLIDAYS

FORENSIC PHYSICIANS • 3 FULL TIME SENIOR LECTURERS EMPLOYED FOR BOTH CLINICAL FORENSIC MEDICINE AND FORENSIC PATHOLOGY MONDAY-FRIDAY 0800 -1800 HRS FRIDAY NIGHT AND SATURDAY 0800 -1800 HRS • 6 LOCAL GPS EMPLOYED ON A SESSIONAL BASIS TO COVER REMAINING SHIFTS

‘GATEKEEPERS TO SERVICE’ FORENSIC NURSES ARE THE PRIMARY POINT OF CONTACT FOR THE POLICE, PROCURATORS FISCAL, PAEDIATRICIANS, SOCIAL WORK DEPARTMENT, HM PRISON

PROTOCOLS • OPIATE AND ALCOHOL WITHDRAWAL PROTOCOLS • 27 PATIENT GROUP DIRECTIONS • CONTINUED SUPPLY OF METHADONE FOR DETAINEES ALREADY ENROLLED ON METHADONE PROGRAMME • REFERRAL PROTOCOLS TO SEXUAL HEALTH SERVICE AND WRASAC (WOMENS RAPE AND SEXUAL ASSAULT CENTRE)

CLINICAL FORENSIC EXAMINATIONS AIM TO INCREASE THE QUALITY OF CLINICAL FORENSIC EXAMINATIONSNAND DOCUMENTATION OF INJURIES TO THE LEVEL THAT IS PROVIDED IN FORENSIC PATHOLOGY

NHS TAYSIDE INTRANET LINKS • ECS(EMERGENCY CARE SUMMARY) • Mi. Di. S (MENTAL HEALTH DATABASE) • LONG TERM CONDITIONS • CENTRAL VISION • CHI look up • VISION - Virtual Practice

1 APRIL 2010 - 31 MARCH 2011 FORENSIC NURSES • Total number of patients: • Total number of consults: - drug issue - alcohol and drug - mental health - medication 2705 8550 1548 365 1951 107 10165

1 April 2010 – 31 March 2011 FORENSIC PHYSICIANS • Total number of callouts : 768 • 2009 -2010: 902 • 2008 > 4000 callouts • Fitness to plead: 188 • Fitness to detain: 51 • Paediatric examinations: 73 • Sexual Assault Victim: 50 • Sexual Assault Suspect: 39 • Physical Assault Victim: 16 • Physical Assault Suspect: 26 • Suspicious Deaths: 118 • Section 4 RTA bloods: 37 • Intimate Search: 25

EDUCATION AND TRAINING • OCTOBER 2009 – GRADUATE CERTIFICATE IN FORENSIC NURSING • OCTOBER 2010 – GRADUATE DIPLOMA IN FORENSIC NURSING • ONGOING DEVELOPMENT OF TRAINING COURSE FOR GPs WORKING AS FORENSIC PHYSICIANS

EVALUATION • 2 YEAR EVALUATION OF SERVICE FUNDED BY ACPOS COMMENCED NOVEMBER 2009. • INTERIM REPORT DECEMBER 2010 • FINAL REPORT DUE DECEMBER 2011 University of Dundee and Scottish Institute for Policing Research

PROGRESS SO FAR……… • May 2009 – agreement from Crown Office Procurator Fiscal Service for nurses to commence venepuncture for section 5 RTA • September 2009 – nurses commenced assisting Forensic Physicians with physical and sexual assault examinations • April 2010 – Nurses commence Fitness to Release examinations • June 2010 – following training in Alcohol Brief Interventions nurses commenced • May 2011 – SARN Sexual Assault Referral Network

A&E ATTENDANCES 2009 2010 Reduction of 12% in total numbers 2008 Reduction of 40% in Dundee Reduction of 13% in total numbers 2009 Reduction of 16% in Perth