Watch-house detainee emergency healthcare

In the acute phase of police detention, health concerns can emerge for detainees, especially around drug dependence, mental health conditions, and physical injury. In addition are system complexities including crowding.

In the event of an infectious disease outbreak (such as COVID-19), crowded conditions amongst a population with greater underlying burden of disease than the general population creates significant public health and economic concern. Furthermore, access to resources and expertise to manage health concerns in this environment can be challenging, especially in rural areas.

Researchers will interview key stakeholders involved with the care delivery and decision making of detainees, to identify innovative strategies to delivering healthcare in watch-house settings. This research will consider the decision making processes and costs associated with the delivery of healthcare in police watch-houses that may reduce the need for transfer to hospital emergency departments or reduce the potential for deaths in custody.

This research addresses the World Health Organisation’s (WHO) recommendation to understand how evidence-based health services can be provided for those requiring treatment, care and illness prevention whilst in police custody. It also identifies ways in which the need for expensive hospital stays can be minimised.

The expected impact of this research is the capability to identify and inform joined-up approaches so that cost-effective, safe, quality emergency care can be provided to detainees in police watch-house settings.

Delivering emergency care in the watch house: an outcomes analysis.

Increasingly, prisoners are requiring transfer to and assessment in the ED; some for illnesses that may be treated in the custodial environment with an appropriately trained health care professional. Optimising how health care is delivered in the watch house environment was the focus of this study, following recommendations in a recent (2012) Inquiry following the death of Herbert John Mitchell.

This study is underpinned by recommendations from deaths in custody, the literature and anecdotal experience. The study will provide a comprehensive outcomes evaluation of a 66 day trial of a model where emergency nurses were posted to the local watch house for an 8hr late shift and a 10hr night shift to supplement domiciliary nursing services to provide 24hr nursing presence in the watch house. This model of enabling experienced emergency nurses the opportunity to work within an 'out of hospital environment' but with the support from medical colleagues has not to our knowledge been trialed elsewhere and is therefore innovative.

The impact expected from this study is on the prisoners, health care staff and police staff working in this model. We expect the following main outcomes: less transfers of prisoners to ED from the watch house and a cost effective model.