Joint review of police custody finds limited progress on nurse-led healthcare provision

Speaking on Thursday (July 24) following the publication of the joint Criminal Justice Inspection Northern Ireland (CJI) and Regulation and Quality Improvement Authority (RQIA) review, CJI Chief Inspector Jacqui Durkin and RQIA chief executive Briege Donaghy said significant improvements were required on some critical issues.

“Police custody is often an adult or child’s first experience of detention. It can be a daunting experience for anyone but particularly for those who have mental health or addiction issues, are neurodiverse, or those who need access to physical or mental health care,” said Ms Durkin.

“When the joint inspection team reported on police custody in 2020, a 24/7 custody nurse practitioner scheme was being piloted to meet the needs of men, women, and children in detention in Musgrave Custody Suite in Belfast.

Inspectors recommended the Police Service of Northern Ireland (PSNI), and Belfast Health and Social Care Trust (BHSCT) should collaborate to implement this model across Northern Ireland.”

Ms Donaghy said: “At the time of fieldwork for the follow-up review in autumn 2024, -inspectors found that while the service had been expanded to Antrim and the new Waterside Custody Suite, it was not available in the other three custody suites in operation where the healthcare needs of detainees were being met by on call forensic medical officers.

“Inspectors found that where the nurse-led service was in place, the health needs of detainees in police custody were identified more promptly, and subsequent care and treatment was delivered in a timely manner.”

Ms Durkin also highlighted the importance of ensuring timely access to health care professionals to enable medical samples to be taken for evidential purposes.

“No one should be able to avoid detection and prosecution for driving under the influence of any substance for want of a timely sample being taken by an appropriate health care professional,” said the Chief Inspector.

“The ambition for and proven benefits of this nurse-led service model has not been sufficiently progressed and this needs to be resolved as soon as possible. The PSNI needs to have a consistent, quality health service model for all custody suites across Northern Ireland not one that is geographically dependent.

Ms Donaghy added: “We expect that by the time the next full police custody inspection is undertaken, the nurse-led service will be operational ensuring that all detainees across Northern Ireland will have access to timely and appropriate care, regardless of their location.”

The CJI Chief Inspector also expressed her concern at the pace of change to address remand, bail and custody arrangements for children and young people in Northern Ireland.

“Inspectors recognise there were 718 less children detained in 2023/24 than in 2018/19 and I welcome the progress made by the Department of Justice in tabling this long-awaited draft legislation to address alternatives to custody for children and young people.  However, I remain concerned that ‘Looked After’ children who are in the care of the State, are disproportionately represented and are more likely to be detained in custody because they cannot access timely social work support, go back to their children’s home or find alternative accommodation,” said Ms Durkin.

Reflecting on the limited progress since the last inspection, Ms Durkin and Ms Donaghy highlighted that while some areas for improvement had been achieved and there was evidence of steps taken to address recommendations, the majority of strategic and operational recommendations remained only partially achieved or not achieved at all.

“Detainees who inspectors spoke to during this follow-up review were in the main, positive about their treatment reporting that they felt safe, well treated and that their needs in custody were addressed,” they said.

Ms Durkin said while the size and age of the custody suites inspectors visited varied, there was a regular schedule of refurbishment in place and in the majority of cases, the cells, facilities and communal areas were clean and risks to detainees and staff were mitigated appropriately.

“We also witnessed respectful interactions between staff and detainees with some positive feedback on the caring approach of some staff,” said Ms Durkin.

The Chief Inspector also highlighted wider on-going issues between the PSNI and the Northern Ireland Prison Service relating to detainee transport from police custody suites to prison following virtual court appearances.

“While I acknowledge the resource implications involved, the withdrawal of police officers from response and other front-line policing duties to transport detainees from police custody to prison is at best non-sensical in today’s operating environment. Debates about funding, resources and security need a solution,” Ms Durkin said.

Looking to the future, Ms Durkin and Ms Donaghy said: “CJI and the RQIA will continue to undertake regular inspections of police and monitor places of detention as members of the UK National Preventive Mechanism.

“The outstanding recommendations and areas for improvement highlighted in this follow-up review will be examined again through a future inspection, consistent with the combined inspection approach of CJI and RQIA.

“In the interim, we urge the Department of Justice, the PSNI and Department of Health to work in partnership to progress the full implementation of recommendations and identified required improvements.”

Assistant Chief Constable Anthony McNally said: “We are committed to continually reviewing how we can improve policing and note the CJINI observations in respect of areas for improvement including expanding custody healthcare led by nurse practitioners.

“This has been introduced in Musgrave, Antrim and the new custody suite at Waterside, as part of our wider modernisation and improvement of regional custody provision across Northern Ireland.

“At times, we deal with detainees whose needs are complex, and may be under the influence of alcohol or drugs, or may be experiencing a mental health crisis. It’s crucial our custody provision is fit-for-purpose and can continue to meet health and safety requirements while, at the same time, enable an efficient criminal justice process. We will continue to seek funding to allow transformative change, but we remain within a challenging financial context.

“We will now take time to consider the recommendations in detail. The PSNI is working collaboratively with our multi-agency partners to deliver a transformed custody healthcare service.”