A need for clinical governance

While guidance on safe detention provides valuable information for police forces, custody sergeants and managers, there is little to govern or set standards for medical provision in custody. Speaking to Police Professional, Gary Green from G4S Forensic Medical Services, champions the cause of clinical governance.

The Association of Chief Police Officers’ (ACPO) Guidance on The Safer Detention & Handling of Persons in Police Custody confers a statutory responsibility on chief officers to ensure that detainees have access to appropriate healthcare in a timely and effective manner.

The Guidance states: “Forces should determine the most appropriate model of healthcare provision, taking account of quality of service provision and best value.” However, it fails to define what those standards should be.

The Care Quality Commission – the body responsible for auditing NHS Trusts – does not have a remit for custody, Gary Green, Business Director for G4S Forensic Medical Services, believes it is time this changed to ensure all suppliers invest in standards to the same level.

“There is a need for clear standards to ensure the safety of everyone in custody and to maintain public confidence in the police.

“Value for money is important but priority must always be the safety of detainees. However, nationally, regulation of medical services in police custody doesn’t exist.”

The clinical competence of healthcare professionals remains the domain of bodies such as the Nursing and Midwifery Council and the General Medical Council, but G4S sees clinical governance in custody as unregulated; relying on a referral to a governing body after an event is closing the stable door after the horse has bolted. G4S’ clinical governance panel ensures systems used in the NHS are replicated into this environment to avoid negative incidents in the first place, says Mr Green.

For instance, maintaining records is a core component of medical provision in custody and audits are conducted regularly by G4S to ensure paperwork is completed to required standards. The company maintains its own safes within custody suites to hold medication and confidential medical notes, secure from the police, in line with patient confidentiality legislation.

“Sharing of information and accountability to board level is what is missing in this market. Through the implementation of clinical governance, the quality of patient care can be made consistent.

“Why should patient care in custody be any different to the NHS or prisons? It shouldn’t be,” said G4S’ Emma Pearson.

G4S provides medical staff and facilities to prisons, patient transport and facilities management to the NHS and 11 police forces across the country. When the company began providing medical services into the custody environment, it attempted to establish a cross-supplier governance arrangement but when that failed due to competitive pressures, a consistent and robust arrangement was sought to ensure all its processes and procedures focused on safety and best practice.

Clinical Governance Panel

G4S recognised the need to implement its own system to manage how all its medical practitioners operate; ensuring safety of detainees, how to dispense drugs, administer treatment, ensure accurate reporting in fulfilling their medical duties.

Led by medical staff, G4S’ processes and procedures are now clearly defined and audited by external physicians and clinici