HMICS raises concerns over disparity in police custody healthcare

HM Inspectorate of Constabulary in Scotland (HMICS) and Healthcare Improvement Scotland (HIS) carried out a detailed review of the two main police custody centres for the Argyll and West Dunbartonshire police division.

The area’s biggest police custody centre – with 29 operational cells – is based within Clydebank police station, with healthcare provided by the Glasgow City Health and Social Care Partnership (HSCP) on behalf of NHS Greater Glasgow and Clyde.

The area’s second busiest custody centre – with seven cells – is within Oban Police Station, with Argyll and Bute Health and Social Care Partnership (HSCP) providing the healthcare on behalf of NHS Highland.

HMICS inspectors – working jointly with HIS – have called on Argyll and Bute HSCP to take action in 14 areas relating to healthcare in the custody centre at the police station in Oban.

In contrast it made no direct healthcare-related recommendations for improvement to the Glasgow City HSCP regarding Clydebank police station.

HM Assistant Inspector of Constabulary in Scotland, Mark Hargreaves, said: “This inspection was carried out by HMICS and HIS to assess the treatment of, and conditions for, individuals detained at the custody centres.

“While we found the provision of healthcare services at Clydebank to be generally good, inspectors have made several recommendations for the improvement of healthcare provision at the Oban custody centre.”

Healthcare issues highlighted in the Oban custody centre included a lack of emergency equipment – such as oxygen and emergency medication – which if needed, would have to be brought to the police station by an on-call GP.

It was noted some healthcare practitioners were not able to access a specialist IT system for patients being held in police custody, meaning most medical consultations with detainees were being recorded on paper.

Products used to clean the healthcare room, cells and custody area did not comply with National Infection Prevention Control Manual guidance.

And patient records dating back to 2022 were not found to be stored securely, but rather kept in a cupboard that non-healthcare staff had access to.

One recommendation the HMICS report made for Argyll and Bute HSCP was that it should ensure an effective governance system was in place to provide oversight of healthcare delivery within the Oban police custody centre.

Another was to ensure that approved processes were in place to support the delivery of consistent evidence-based care, including the management of patients withdrawing from alcohol or other substances.

The report also said Naloxone kits – which can help save lives by reversing the effects of an opioid drug overdose – should be available for detainees to take home with them on their release, as they are from Clydebank.

The HMICS review noted there had been a seven per-cent increase in the number of detainees held at custody centres in Argyll and West Dunbartonshire over the past year.

In the period 2023/24, a total of 6,402 detainees had passed through the area’s custody centres – compared with 5,987 the year before.

Of these, 5,323 detainees were held in the Clydebank custody centre, and 468 in Oban.

The remainder had been held in custody centres across the divisional area – including Dunoon (206), Rothesay (124), Campbeltown (120), Lochgilphead (106), Bowmore (33), Tobermory (11), Craignure (9) and Tiree (2).

As part of their inspection, HMICS interviewed custody staff and healthcare practitioners working at the custody centres in Clydebank and Oban, and detainees being held there at the time of their visit.

Inspectors also examined a sample of 563 custody records from detainees held in custody centres across Argyll and West Dunbartonshire in March 2024.

Aside from healthcare issues, the HMICS report made four other recommendations in relation to the custody centres in Clydebank and Oban.

They related to the repair and maintenance of the police buildings; introducing an effective quality assurance and audit process in relation to custody standards; and ensuring staffing arrangements at each custody centre fully met the desired needs.

Inspectors noted that on one occasion when a staffing issue arose, a person arrested in Oban on a Friday had to be transferred to Clydebank the following day, then returned to Oban for court on the Monday.

Mr Hargreaves said: “This equates to a round trip of roughly 170 miles, on an A class road, in the back of a police van.

“While we recognise that such instances are not commonplace, efforts should be made to avoid this wherever possible.”

The report also repeated concerns made following recent HMICS inspections of custody centres in two other police division areas, relating to incongruence between risk assessments and the corresponding care plans and observation levels put in place.

Mr Hargreaves said: “This report, similar to recent inspection reports on Fife and Ayrshire, highlights our concerns regarding a lack of consistency in the recording of information on the Police Scotland National Custody System.

“While some aspects of custody centre operations were recorded well, such as hand-over records, the recording of information relating to criminal justice decisions and care plans was found to be lacking.

“Despite raising this issue on several occasions, we found disparities, in some cases, between the risk assessments undertaken and the corresponding care plans put in place.”

The ‘HMICS Custody Inspection Report – Argyll and West Dunbartonshire’ makes 18 recommendations for Police Scotland and the NHS.

It also listed a further four areas where it would like to see improvements made.

Mr Hargreaves added: “Police custody has been subject to considerable scrutiny by HMICS since Police Scotland was established, and HMICS have published several custody inspection reports.

“Police Scotland has made progress in implementing previous recommendations and improvement actions in respect of custody services and is actively working to address those that remain outstanding.”