1. Memorandum from the Home Office
DEATHS IN POLICE CUSTODY
INTRODUCTION
1. The Home Office welcomes the Joint Committee's
inquiry into this complex area and offers its full co-operation
and participation. Any death in police custody is a tragedy and
police forces across the country are taking a whole range of actions
to ensure that such deaths are kept to a minimum. The Human Rights
Act has incorporated the provisions of the European Convention
of Human Rights into UK law and the Home Office is committed to
its principles and requirements and is determined to ensure that
all those held in police custody are as safe as possible. Reducing
all types of death in police custody, but especially suicide and
self-harm, is a key objective and a great deal of work has been
and continues to be done in this area.
2. The Home Office publishes annual statistical
bulletins to record deaths in police custody or those that follow
any kind of contact with the police. Copies of bulletins for the
years 1999-2000, 2000-01, 2001-02 and 2002-03 are attached as
background briefing.[1]
Prior to April 2002, deaths in police custody were broken down
as:
Category A—where the deceased was in any
type of police detention or hospital having been arrested for
an offence;
Category B—this category was defined as
where the deceased was otherwise in the hands of the police or
death resulted from the actions of a police officer in the purported
execution of his duty.
3. With effect from 1 April 2002 the Home
Office introduced new and broadened categories covering all deaths
of members of the public during or following police contact. This
was done because it is considered important to record all deaths
that follow contact with the police, however minimal. The categories
are as follows:
CATEGORY 1
Fatal road traffic accidents involving the police
This definition covers all deaths of members
of the public resulting from road traffic incidents involving
the police, both where the person who dies is in a vehicle and
where they are on foot.
CATEGORY 2
Fatal shooting incidents involving the police
This definition covers circumstances where police
fire the fatal shots.
CATEGORY 3
Deaths in or following custody
This definition covers the deaths of persons
who have been arrested or otherwise detained by the police. It
also includes deaths occurring whilst a person is being arrested
or taken into detention. The death may have taken place on police,
private or medical premises, in a public place or in a police
or other vehicle.
CATEGORY 4
Deaths during or following other types of contact
with the police
This definition covers circumstances where the
person dies during or after some form of contact with the police
which did not amount to detention and there is a link between
that contact and the death.
DEATHS IN
POLICE CUSTODY—2002-03
4. The Home Office has not yet published
the statistics bulletin on deaths for 2002-03—this will
be done in the autumn. The bulletin will be made available to
the Select Committee as soon as it is published.
Q1. What are the main causes of deaths in
police custody? Are there any common factors? Are there particular
aspects of conditions of detention, or the treatment of detainees,
or the cultural background of detainees that contribute to?
— Suicide and self-harm in custody?
— Other deaths or injuries in custody?
The table below sets out the main causes and
numbers of deaths in police custody since 1999:
| Year | Alcohol/
Drugs
| Road
Traffic
Accidents |
Shootings | Suicides
| Natural
Causes | Restraint
| Misc | Total |
| 1999-2000 | 15 (3) | 22
| 3 | 11 (3) | 5 (3)
| 2 | 12 | 70 |
| 2000-01 | 12 (4) | 16
| 2 | 5 (2) | 5 (1)
| — | 12 | 52
|
| 2001-02 | 11 (2) | 34
| 4 | 4 (1) | 9 (1)
| 2 | 6 | 70 |
| 2002-03 | 13 (2) | 40
| 3 | 11 (2) | 11 (1)
| 2 | 19 | 104 |
| | |
| | | |
| |
The figures in brackets refer to deaths which occurred in
police stations.
Deaths during or following contact with the police—statistics
for 2002-03
Although the statistics for 2002-03 appear to have risen
(from 70 in 2001-02 to 104 this year) they are not really comparable.
Prior to April 2002, there were only two categories to record
deaths—those that occurred where the person was detained
in police custody, and where the deceased was otherwise in the
hands of the police. If the previous definitions had been used,
the total for 2002-03 would be 77.
With effect from 1 April 2002, the Home Office introduced
revised categories covering deaths in police custody—deaths
of members of the public during or following police contact. This
was done to ensure that all relevant deaths involving any form
of contact with the police were included in the statistics; and
to draw a clear distinction between those where there was direct
contact with the police and those where it was less obvious.
Suicide/self harm deaths
In 1999, of the 14 suicides all were male and 13 were white.
Three people hanged themselves in police cells and the rest committed
suicide following some other form of contact with the police.
In 2000, all suicides were white males and two people hanged
themselves in police cells.
In 2001, all suicides were white males and all deaths occurred
outside police detention, but following some form of contact with
the police.
In 2002, two white males hanged themselves in police stations.
Nine white males, one black male and one white female committed
suicide following some other form of contact with the police.
Age seems to have no bearing on those who commit suicide—ages
range between 17 and 60.
Road traffic accidents
People killed in road traffic accidents were almost exclusively
white males and approximately 90% were under the age of 30, with
many of those under the age of 25. Almost all these deaths were
due to police cars pursuing vehicles that were either suspected
of being stolen or being driven in an erratic manner. In 2002-03,
we started recording any death that followed some sort of contact
with the police. We have therefore included eight deaths that
occurred to either pedestrians or other drivers while the police
were pursuing people committing road traffic offences.
Alcohol/drug-related deaths
People who suffer alcohol related deaths tend to be white
males over the age of 35, and although they have died after some
form of contact with the police, there is usually a history of
alcohol abuse, which has largely contributed to their deaths.
The main cause of drug-related deaths in police custody is
ingestion of controlled substances following arrest. Again, these
tend to be white males, although usually under the age of 35.
Since 1999, eight people from an ethnic minority background
have died as a result of either alcohol or drugs; and five women
have died as a result of ingesting drugs.
Fatal shootings by police
Since 1 April 1999, 12 people have been fatally shot by the
police. All were males, and 10 were white. Ages ranged between
19 and 62. In all cases, before the police fired the fatal shot,
they challenged the individual to disarm.
Five of the shootings arose after domestic incidents, where
people had threatened a member of their family with either a gun
(real or fake) or a knife. Two of these incidents developed into
siege situations.
Five incidents concerned people armed with firearms in town
centres and threatening others. One person was diagnosed with
schizophrenia. In another incident, plain clothes police attempted
to arrest two drug dealers, one of whom shot at the police. Police
returned fire, killing the marksman. In another case, police were
informed that the deceased was armed. When challenged, he threatened
police with a handgun and was shot.
Deaths from natural causes
Every death from natural causes (except three) that has occurred
since 1 April 1999 has been of older white males. One black male
in his fifties died of heart failure. One black male of 23 and
one white male of 26 died in custody, but all the others were
over the age of 45 and almost all died of heart attacks following
arrest. Six deaths occurred in police stations.
Use of restraints
Since 1999, six deaths have occurred where the use of restraints
was a primary factor. Three of these were white males over the
age of 40. One had a history of mental disorder and was restrained
to prevent his aggressive behaviour towards members of the public;
four were restrained because of their aggressive behaviour towards
the police or members of their families and the public. The sixth
person who died whilst being restrained was an Asian male of 26
who was restrained for causing a disturbance.
Other people have died whilst in restraints, but this was
not the primary cause of death. In the majority of cases, they
were restrained due to their violent behaviour caused by drugs,
and it was drug overdoses that caused their deaths.
Miscellaneous deaths
This category covers accidental deaths (other than road accidents)
and misadventure.
Q2. What practical steps have already been taken, and
what further steps need to be taken to prevent:
— Suicide and self-harm in custody?
— Other deaths or injuries in custody?
In May 2003, the Police Leadership and Powers Unit of the
Home Office wrote to all Chief Officers, setting out the key initiatives
that could be taken to reduce the numbers of deaths in police
custody. The letter was intended to raise forces' awareness of
the additional measures they could take or procedures they could
adopt. These are set out below.
ORGANISATION OF
CUSTODY FACILITIES
A number of forces already concentrate custody facilities
at a smaller number of police stations where superior provision
for detention and care is available. This is certainly a positive
development in terms of reducing deaths in custody and merits
wider consideration.
Some forces are also creating a custody specialism with its
own management and command structures. This also deserves further
attention as a means of increasing the professionalism, knowledge
and skills of those responsible for the custody of detainees.
A number of forces now operate custody user groups where officers
involved in this area of work can share experience, learning and
skills amongst themselves and with other professionals involved
in the custody environment. This is an excellent way of spreading
good practice, particularly in relation to critical issues linked
to deaths in custody.
CUSTODY OFFICER
TRAINING
CENTREX provide a national custody officer training programme
which is reviewed and updated every six months. Many forces now
use this programme or have amended their existing courses in light
of the national programme. Many forces provide two or three weeks
training before officers are appointed to custody duties and refresher
training is becoming much more common. Input into the central
framework comes from bodies such as the ACPO Medical Working Group.
The key areas regarding deaths in custody are: risk assessment,
adequate checking on vulnerable prisoners, first aid, liaison
with medical personnel, searching, hazard awareness, record keeping,
and conflict resolution. It is imperative that all new custody
staff are trained appropriately (and given refresher training
as necessary). Forces need to be proactive in seeking custody
staff's views on where they would benefit from additional training
on deaths related issues.
A number of forces have introduced additional training for
operational officers in the searching of detainees in order to
identify and remove all possible ligatures or items which could
be used to cause self harm.
The Metropolitan Police have produced a training video which
gives various scenarios which could lead to a death in custody,
whether in cells or otherwise. This is used by a number of forces
as part of their custody officer-training package. Another video,
"Their lives in your hands", has been produced by South
Wales Police. This analyses a death by suicide in custody and
includes open input by the custody officer on duty at the time.
He describes how the incident affected him, his colleagues and
family.
RISK ASSESSMENT
AND INFORMATION
Prisoner risk assessment has historically been a difficult
issue within the police service, but many forces are making rapid
strides to improve their procedures and ensure that structured
processes are in place to assess and document specific risks presented
by detainees coming into custody. It is encouraging to see that
all forces have responded to Home Office Circular 32/2000 that
relates to prisoner risk assessment, including the Prisoner Escort
Record form. The responses vary from introducing a formal written
risk assessment process to amending previously used systems.
Home Office Circular 28/2002, "Learning the lessons
from adverse incidents", highlighted a case where a detainee
was returned to his cell without having his trainers removed and
subsequently hanged himself with his shoe laces. It was suggested
that laces were not always removed due to the requirement for
proportionality under the Human Rights Act. However, under Article
2 of the European Convention on Human Rights "Everyone's
right to life shall be protected by the law", and the police
must have the highest regard for this. It is worth re-inforcing
that items such as shoelaces and belts that can most easily be
used for self-harm should always be removed, especially where
there are grounds for believing that someone may be a suicide
risk. There is no legal obstacle under the Human Rights Act to
doing this.
Many forces have a local index of detainees who have "self
harmed" whilst in custody. These are normally computerised
and many form part of the custody handling system. Those that
form part of the custody handling systems are configured so that
the warning notice appears on the screen whenever that person
is being booked in.
Some forces have introduced written guidelines for custody
officers, which advise on identification of risks to ensure that
additional supervision is given where appropriate. Other forces
have introduced written briefing instructions to custody staff
who are given the duty of constantly monitoring any detainee who
presents a high risk.
Some forces have piloted a system whereby details of incidents
relating to individuals which take place in prisons, which would
assist and inform future risk assessments of that individual are
communicated to the local force. The force then evaluates the
information and, where appropriate, it is placed on the PNC. The
ACPO Prison Intelligence Group is currently evaluating this system.
One force is considering introducing a policy whereby all
detainees who are suspected of having swallowed drugs or are suspected
of being "mules" would be taken directly to hospital.
This form of action is subject to the police surgeon's decision
on what course of action to take if there is a perceived immediate
risk.
USE OF
CCTV TO MONITOR
(VULNERABLE) DETAINEES
IN CUSTODY
SUITES
Many forces have CCTV (including sound) at their custody
reception points and CCTV (vision only) in all corridors, entrances,
exits etc. Some have installed CCTV cameras in a limited number
of cells suitable for vulnerable persons. The effective use of
CCTV equipped cells for vulnerable prisoners presupposes early
and accurate identification of such persons by custody staff but
the use of CCTV does not remove the need for effective monitoring
and checking. There is considerable scope for these systems to
reduce the overall level of risk and all forces are encouraged
to consider how they can most usefully be applied.
DESIGNING OUT
SUICIDE/SELF
HARM RISKS
FROM CELLS
The Home Office Building and Estate Management Unit (BEMU)
is a source of expertise in the area of designing out flaws in
custody suites (including cells) and police station specifications.
General guidance on making police cells safer was included in
Home Office Circular 28/2002, "Learning the Lessons from
Adverse Incidents".
All new cells in all forces are constructed in accordance
with the Home Office design guide. Some forces have instigated
periodic custody unit inspection by officers from other custody
units. In this way, familiarity with cells is alleviated in the
identification of possible ligature points. Most forces have replaced
the old "T" shaped cell door handles with anti-ligature
handles. All forces have local instructions which state that cells
hatches should be kept closed at all times. Some have attached
a notice to the outside of each cell door reminding staff of this
instruction.
Where forces have a totally computerised system, many have
been designed or amended to give reminders that the maximum time
since a detainee was last checked is almost complete. This can
be set according to the instructions of the custody officer following
the risk assessment.
The cells in some forces are regularly searched by experts
to ensure that any dangerous objects, which have been missed at
a time the detainee was searched and are later secreted in a cell,
are safely removed.
Many forces provide ligature cutters on cell key rings, or
at various places throughout the custody units, or as a personal
issue to all custody staff. Some forces use a restraint belt to
prevent self-harm and suicide attempts by detainees who have been
identified as presenting a high risk.
ENCOURAGING THE
USE OF
INNOVATIVE NEW
TECHNOLOGY
Some forces have been trialing a life signs monitoring system
which uses low power microwave transceivers to detect movement
within custody cells. Progressive warnings are sounded if an occupant's
breathing becomes very low or ceases altogether. The system is
currently being assessed. Early indications are favourable and
a further letter will be sent to police forces shortly.
There are also broader design and technology issues to take
account of in establishing good practice. For example, to reduce
self harm some forces supply safer unbreakable plastic cutlery
for use by detainees while the majority of forces only supply
unbreakable spoons to detainees irrespective of the meal being
provided.
POLICING THE
MENTALLY ILL
There are currently several strands of work focused on improving
police practice in relation to mentally ill individuals. Together
with the Department of Health and ACPO, the Home Office is considering
the development of national protocols covering the interaction
between the police and health services in dealing with the mentally
ill, and significant progress will be made in 2003-04. The
Department of Health envisages a two-year project regarding this
development. The revision of the PACE Codes of Practice
has further strengthened protections for mentally ill detainees,
particularly in terms of assessing their vulnerabilities and fitness
for interview. In addition, the review of the Mental Health Act
that is underway recognises that police cells are not generally
appropriate places for assessing whether a person needs medical
treatment.
PROVISION OF
MEDICAL SERVICES
AT POLICE
STATIONS
The quality of medical services at police stations is inextricably
bound up with the delivery of the police surgeon service. The
Home Office Working Group on Police Surgeons made a number of
recommendations about the organisation of the service and connected
issues such as training, accreditation and the delivery of care.
Linked to that, there is scope to improve the availability and
timeliness of medical services by enabling a wider range of healthcare
professionals such as nurses to take a broader role in the custody
suite.
The intention is to move towards a position where there is
a significantly greater role for registered healthcare professionals
within custody suites, but where they work in partnership with
police surgeons, and police surgeons retain clearly defined responsibilities
to intervene where their broader skills are likely to be required.
As well as improving the standard and delivery of clinical treatment
for detainees, the introduction of nurses and other healthcare
professionals to police custody suites is seen as a key initiative
in helping to reduce the number of deaths in police custody.
Increasing the range of custody healthcare professionals
is expected to result in increased flexibility, improvements in
response times and the opportunity for best value efficiencies
in the way healthcare is delivered in custody suites.
Some forces have reviewed their provision of police surgeon
services and have brought in new requirements regarding their
training in forensic medicine and medical jurisprudence. There
are some police surgeons who refuse to prescribe drugs to detainees
within their first 6-12 hours of detention so that there is no
possibility of overdose caused by the detainee's consumption of
drugs prior to arrest. The national guidance on "Substance
Misuse Detainees in Police Custody: Guidelines for Clinical Management"
provides well documented information in regard to this, and stresses
the importance of when a police surgeon should/should not administer
drugs to a detainee.
The ability to read the handwriting of medical staff is crucial
to the risk assessment process and some forces ask the custody
officer to check the custody record entries of police surgeons
to check legibility before the surgeon leaves the unit.
THE POLICE
AND CRIMINAL
EVIDENCE ACT
1984—CODES OF
PRACTICE
— The Codes of Practice deal with contact between
the police and the public. They regulate police powers and procedures
in the investigation of crime and set down safeguards and protections
for members of the public.
— The Codes are subject to regular review and measures
currently proposed in the Criminal Justice Bill look to speed
up and make more effective the process by which the Codes can
be updated.
— It is essential that the Codes are relevant, effective
and accurate to the needs of the public and the investigation
of crime, and that they ensure there is a high level of protection
and safeguards for people in police custody.
— The latest revisions of the PACE Codes of Practice
were issued on 1 April 2003. This revision includes a new section
on identifying needs for urgent health care intervention. If a
person fails to meet the following criteria, an appropriate health
care professional or an ambulance must be called.
— Rousabilty—can the detainee be woken?
— Response to questions—can they give appropriate
answers to basic simple questions?
— Response to commands—can they respond appropriately
to simple commands?
— Custody Officers are reminded to take into account
the possibility or presence of other illnesses, injury or mental
condition, as a person who is drowsy and smells of alcohol may
also have the following:
— Drug intoxication or overdose;
METROPOLITAN POLICE
SERVICE DEATHS
IN CUSTODY
GROUP
The Metropolitan Police Service (MPS) has instigated a Deaths
in Custody Group to consider how best to ensure the safety of
detainees and the attached summary at Appendix A shows how the
MPS is developing best practice in this area, including improved
cell design, widening the range of healthcare professionals involved
in the treatment of detainees, and involving other agencies to
ensure detainees receive appropriate care in police custody.
INITIATIVES TO
REDUCE ALCOHOL/DRUG-RELATED
DEATHS
There has been recognition for many years that people who
are incapable through drink or drugs would usually be better and
more safely cared for in dedicated facilities than at a police
station. Intoxication, whether through alcohol or drugs, remains
a significant factor in some deaths in custody. It also places
a severe burden on the police who have to deal with severely intoxicated
people who might be better cared for elsewhere. Recent Home Office
research studies have indicated that alcohol/drugs are a factor
in almost a third of arrests and have recommended a number of
approaches related to the care and management of intoxicated detainees
in custody suites, including the provision of alternative settings
for the care and treatment of those who are incapable through
drink or drugs.
Arrest referral and diversion pilots have an extremely important
contribution to make in improving the framework within which intoxicated
detainees are handled and we are giving serious consideration
to the use of alcohol treatment centres as an alternative to police
custody for intoxicated detainees. At present only a minority
of forces have dedicated alcohol referral schemes for those in
police custody and even fewer forces are seeking to divert intoxicated
people to alternative treatment facilities. Historically there
have been examples of good practice, for example the St Anne's
Centre in Leeds, and arrest referral and diversion schemes at
Holborn and Watford will offer an opportunity in the short term
to evaluate innovative best practice.
There is scope for broader action in this area across the
police service, particularly in terms of pilot projects. Some
forces have established policies of taking the grossly intoxicated
and communication incapable arrestee to hospital for assessment
or at least to have them assessed immediately by the police surgeon
before detention for any length of time is contemplated.
In May 2003, the Police Complaints Authority (PCA) published
a report into drug-related deaths in police custody.
The report highlights the need for improvements in police
training to raise awareness of the risks associated with substance
misuse and also highlights the need for improvements in the medical
support services available to assist police officers. The report
cites more systematic screening of substance misuse problems by
custody staff or the availability of trained custody nurses equipped
to deal with substance misusing populations as possible mechanisms
for managing the risks associated with substance misuse detainees.
The report also highlights the need to improve the training of
Forensic Medical Examiners (FMEs) in the areas of alcohol, drugs,
mental health and dual diagnosis and to address the complex funding
issues affecting the delivery of the FME service in some areas
of England and Wales.
We are already addressing the issues highlighted in the PCA
Report:
The revised PACE Codes of Practice permit healthcare professionals
in custody suites and a current survey of forces has indicated
that at least 11 forces are already using nurses in their custody
suites, whilst a further nine forces are actively considering
this option. The policy intention behind the revisions to Code
C is to increase the scope for widening the range of healthcare
professionals involved in the treatment of detainees in custody
suites. The revisions are intended to result in increased flexibility,
improvements in response times and the opportunity for best value
efficiencies in the way healthcare is delivered in custody suites.
— Annex H of the revised PACE Code of Practice C
provides an observation list for custody officers to follow for
detainees with known risks, including drug intoxication.
— We issued guidance to police forces about detainee
risk assessment in Home Office Circular 32/2000. This circular
sets out minimum standards for risk assessment procedures to be
applied to all detainees coming into police custody and covers
the key risk factors including drug/alcohol and mental health
issues.
— Drug testing of detainees is currently being piloted
in certain police areas in England and Wales under provisions
introduced by the Criminal Justice and Court Services Act 2000.
These allow, in certain circumstances, for the taking of saliva
samples from persons in police detention, and at other points
in the criminal justice system, to test for the presence of specified
Class A drugs (heroin and cocaine/crack). From 1 April 2003 drug
testing in police custody is being extended to 30 Basic Command
Units and will assist in targeting those arrestees who were not
picked up or engaged at the initial booking-in stage.
— We set up an Advisory Forum on Police Surgeons
in April 2002, which not only provides a national oversight and
monitoring of the police surgeon service but is also tasked with
facilitating the professional development of the service. Its
programme of work includes developing and monitoring centres of
excellence for training police surgeons and overseeing assessment,
training and accreditation procedures.
— First aid training is included in mandatory training
for probationer police officers and national occupational standards
have been developed for Custody Officers.
"EXCITED DELIRIUM"
SYNDROME
A delirium is characterised by a severe disturbance in the
level of consciousness and a change in mental status over a relatively
short period of time. There is a reduced clarity of awareness
of their environment. The ability to focus, sustain or shift attention
is impaired. The individual's attention wanders and is easily
distracted by other stimuli. The individual is almost certainly
disoriented and may not know what year it is, where they are,
what they are doing and the impact of their behaviour. Perceptual
disturbances are common and the person may hallucinate. A delirium
is the result of a serious and potentially life threatening medical
condition. Potential causes include infection, head trauma, fever,
and adverse reactions to medications or overdose of illegal drugs
such as cocaine and methamphetamines. Any person who is delirious
requires prompt medical evaluation and treatment.
The delirious person is likely to manifest an acute behavioural
disturbance. These individuals can appear normal until they are
questioned, challenged or confronted. When confronted or frightened
these individuals can become oppositional, defiant, angry, paranoid
and aggressive. Further confrontation, threats and use of force
will almost certainly result in further aggression and even violence.
Attempting to restrain and control these individuals can be difficult
because they frequently possess unusual strength, pain insensitivity
and instinctive resistance to any use of force. As many as five
to eight people may be required to restrain one delirious adult.
The Police Complaints Authority (PCA) recommend the following
training for police officers to help them differentiate between
intoxication and excited delirium syndrome:
— Learn how to recognise the signs of delirium or
the initial symptoms;
— Obtain immediate medical consultation and attention
for any person who may suffer from a delirium;
— Do not excite, confront or agitate individuals
who are delirious;
— Contain rather than restrain when the individual
is not dangerous to self or others;
— Avoid the use of force unless individual is dangerous
to self or others;
— Use the lowest level of force necessary as well
as a method of restraint that will not cause asphyxiation; and
— Be cautious and aware of potential side effects
of medication.
SAFER USE
OF RESTRAINTS
A conference entitled "Safer Restraint Conference—Health,
Prison and Police", organised by the Police Complaints Authority,
took place on 17 April 2002. The conference focused on the management
of acute violent incidents and provided an opportunity for best
practice in the three services to be disseminated and new methods
of restraint to be discussed, in order to reduce the risk of deaths
within the custodial services.
We have held discussions via a cross-government group with
colleagues from the Department of Health (mental health branch,
prison health care, NHS Executive and the National Institute for
Mental Health) on police, health service interface issues relating
to the management of potentially violent behaviour and the use
of restraint. The group is working to produce joint guidance on
local inter-agency protocols and to develop accredited training
in order to reduce the incidence of deaths involving the use of
inappropriate restraint techniques.
The ACPO/Centrex Personal Safety Manual of Guidance should
form the basis of all restraint training for police officers.
Civilian support staff that come into contact, or have dealings
with persons who are detained in police custody, such as Detention
Officers should also receive training based on this manual. The
content of this manual was extensively researched in terms of
the legality of all the technique and tactics contained within
the manual, and the medical implications. Recent cases were considered
during this research process. The manual contains specific sections
on restraints, and control techniques. The section on medical
implications includes information on positional asphyxia, excited
delirium, and dealing with persons who may be effected by alcohol,
drugs, or mental illness.
There is a section on Custody Skills that provides guidance
on cell extraction and insertion, and tactics to assist in the
safe taking of fingerprints and DNA samples by force when appropriate.
Other sections contain information and guidance on communication
skills to assist in the diffusion of potentially violent situations
without the use of force.
The manual is the subject of an annual review and maintenance
cycle that should ensure that it remains a live and valid document.
This process will take account of emerging cases that may impact
upon use of force issues, including persons in police custody.
ACPO gives recommendations in respect of the amount of training
that police officers should receive in Personal Safety. However,
Chief Constables make the final decision as to how much time will
be allocated to Personal Safety training for their officers. Unfortunately
this varies a great deal from force to force, from as little as
four hours annually up to four days annually. Obviously the amount
of training received has a direct impact upon the effectiveness
of personal safety training, which will affect all use of force
issues, including those in custody areas. This of course can compromise
both police officers and subjects alike.
The police service shares a certain amount of common ground
with the prison and mental health services with regard to restraint.
It too views the use of force as a last resort. Indeed, ACPO
guidance makes clear that: "Before resorting to the use of
force, police officers should use all other methods to achieve
the desired outcome of a situation."
It is also clear from the legal standpoint that officers'
use of force should be reasonable, necessary and proportionate
and that each individual is accountable to the law for his or
her actions. The police service shares the same focus on the human
rights aspects of the issue and the view that no death in these
circumstances is acceptable.
It uses many of the same control and restraint techniques
used in the prison and mental health services. And it is working
both on its own and with them to continually review these techniques,
learn lessons from experience and find alternatives wherever possible.
On the other hand, the context in which the police operate
is very different to that of the other two services.
The nature of their role as an emergency service means that
they are often dealing with crises and unpredictable circumstances.
They are usually the first port of call, often the first to arrive
and accept the responsibility to act as gatekeepers, dealing perhaps
with medical or mental health emergencies until other agencies
arrive.
The environment in which potentially violent incidents unfold
is not controlled in the same way as it is in either prison or
mental health settings. The events are spontaneous, the dynamics
unknown and officers usually have very little time to assess a
situation and plan a response. The challenges they face are particularly
difficult when the behaviour of those they confront is affected
either by mental illness, psychiatric disorder or by the consumption
of drugs or alcohol.
Moreover, officers may have conflicting priorities. At the
same time as they have a duty of care towards the individual,
they are also required to protect the public—and themselves—from
harm.
In some instances then, restraint will be necessary but the
police service is striving to make it a safer option by following
five main steps:
1. Informed by a working group on self-defence and restraint,
ACPO establish clear national policy; individual forces set their
policies within this framework.
2. Best practice and procedures are set out in a personal
safety manual, the national guidance for all forces and officers.
3. Training is based on the manual and supplemented by
first aid training.
4. Equipment is tested, approved and recommended to support
best practice, tactics and procedures.
5. Use of force is continually monitored and best practice
and procedures reviewed and reformed as necessary in order to
continue to minimise risk.
Training is the key to turning policy into action on the
ground. Beyond the fundamental principle that they must always
act within the law, officers are taught conflict resolution. The
model moves through a structured approach to threat assessment
that enables officers to choose an appropriate response including
a level of force. They are also taught to continually reassess
the threat so that they can de-escalate or escalate the use of
force as necessary.
At one end of the continuum of force, an officer's presence
is often enough to defuse a situation. ACPO guidance emphasises
the importance of good communication. Officers' training in verbal
de-escalation techniques is underpinned by many of the same elements
found in prison and mental health services training—body
language interpretation, cultural awareness and an understanding
of certain medical conditions, particularly associated with acute
behavioural disturbance or the consumption of drugs or alcohol.
It is important that officers do not make any assumptions and
thereby overestimate the threat.
Where communication, negotiation and the threat of using
equipment such as CS spray fail, containment of the individual
is the next option. Ultimately, at the other end of the continuum
of course, is the use of force. The challenge is to ensure that
130,000 officers dealing with 1.25 million acts of restraint a
year apply that restraint properly and safely.
The police service is responding to criticism and striving
to minimise risk, continually evaluating techniques and keep officers'
training up to date in terms of best practice and the human rights
context. The personal safety manual, for example, devotes a chapter
to acute behavioural disturbance, its possible causes and implications
and the signs and symptoms to identify risk factors. Positional
asphyxia and the dangers that neck holds carry inherent risks
and are not acceptable.
Officers' equipment is also kept up to date and comes into
use only after it has been subjected to rigorous medical scrutiny
and evaluation. The police service continues to look for safer
alternatives including less lethal alternatives to firearms.
Ultimately, there is an understanding that public scrutiny
and public confidence are vital to policing by consent and that
the police must exercise force ethically, lawfully, restraining
someone in the prone position for too long are covered in similar
detail. The manual also clearly states proportionally and with
sensitivity if they are to retain that consent.
POLICE PURSUITS
— Everything should be done to minimise the risk
of accidents involving police vehicles. The police fully recognise
that and are aware of the need to maintain a balance between,
on the one hand, responding promptly to emergencies, which may
entail the apprehension of offenders, and, on the other, ensuring
the safety of the public.
— In the late 90s following several high profile
fatalities and police officers being convicted of serious driving
offences, ACPO began a general review of police driver training.
The resulting report "Police Pursuit Driver Training"
by Rodney Lind, ACC of Wiltshire at the time, was issued in September
1998. It provided 33 recommendations for chief officers to consider.
— Measures are in place, or are in the process of
being implemented, which are intended to reduce the need for high
speed chases involving the police.
— There is a nationally agreed ACPO Pursuit Code
of Practice.
— Work is going forward on a national basis to implement
recommendations from the Lind report on police pursuit driver
training.
— ACPO recognises that the police service has a
fundamental duty to equip officers with the necessary training.
In December 2000 they launched their new police driver-training
course, introducing a universal standard for driving in England
and Wales. An essential element of the course is that officers
recognise the need to give priority to public safety above all
other considerations such as attending an incident or apprehending
a suspect.
— It is already policy to consider continuously
the consequences of a pursuit and whether to break it off.
— Operational measures to avoid pursuits or curtail
them include the use of helicopters, the early deployment of tyre
deflation devises across the carriageway and tactical pursuit
and containment in which a number of police vehicles are deployed
in a planned manner to box in the target vehicle and bring it
safely to a halt.
— It is right that the police should be able to
pursue suspects and respond to emergency situations without being
restricted to speed limits. Accordingly, when it is operationally
necessary, the police have statutory exemption from speed limits
and general compliance with red traffic signals. However, these
statutory exemptions do not remove the need for police drivers
to exercise the greatest care.
— The police have statutory exemption from speed
limits and general compliance with red traffic signals. For the
first, Section 87 of the Road Traffic Regulation Act 1984 states
that no statutory provision imposing a speed limit on motor vehicles
applies to any vehicle when it is being used for fire brigade,
ambulance or police purposes, if observance of the limit would
hinder the vehicle in its purpose. The corresponding provision
for red traffic light signals is set out in section 33(1)(b) of
the Traffic Signs Regulations and General Directions 1994.
Q3. What has been done to foster a greater "human
rights culture" in prisons and detention facilities? What
more could be done? Would a human rights approach to conditions
of detention and management of detention facilities contribute
to the prevention of deaths in custody?
(i) What has been done to foster a "greater human
rights culture" in detention facilities?
— The Police Skills and Standards Organisation has
developed national occupational standards and accredited training
for custody officers in police stations. A key area of training
is human rights which includes the right to privacy and the right
to life.
— It is Home Office policy to ensure that persons
detained in police custody receive quality clinical treatment
in a timely manner when required, as our main concern is to ensure
the safety and well-being of both detainees and police custody
staff.
— Our aim is to reduce deaths in police custody
by improving the quality of healthcare provided in police custody
suites. This includes reducing the time taken to administer medication
when required as part of an individual's clinical treatment.
— Our objective is the development of multidisciplinary
clinical teams within police custody suites that parallel similar
developments in NHS primary care. This would ensure that the standard
of healthcare provision in police custody suites mirrors that
in the wider healthcare community.
— We have also introduced legislation to ensure
that detainees have access to independent custody visitors. They
are members of the local community who visit police stations unannounced
to check on the welfare of people in police custody. Custody visitors
are independent and impartial and interview detainees out of the
hearing of police officers, and their reports provide a vital
source of information on the environmental and welfare conditions
in which detainees are held.
— The Codes of Practice to the Police and Criminal
Evidence Act 1984 require that an appropriate adult should be
called following the detention by the police of a vulnerable person
(a juvenile or someone who is mentally vulnerable). This action
provides support for the individual, and safeguards their human
rights by providing an independent validation of the procedures
followed during the period in custody.
(ii) What more could be done? Would a human rights approach
to conditions of detention and management of detention facilities
contribute to the prevention of deaths in custody?
In their dealings with detainees, all police officers must
bear in mind that everyone has a fundamental right to life, and
there is a strong emphasis on that right in all aspects of custody
officer training and in the day-to-day care of detainees. However
there can be conflict between an individual's right to privacy
and their right to be protected from self-harm. Home Office Circular
28/2002, "Learning the lessons from adverse incidents",
highlighted a case where a detainee was returned to his cell without
having his trainers removed and subsequently hanged himself with
his shoe laces. It was suggested that laces were not always removed
due to the requirement for proportionality under the Human Rights
Act. However, under Article 2 of the European Convention on Human
Rights "Everyone's right to life shall be protected by the
law", and the police must have the highest regard for this.
It is worth re-inforcing that items such as shoelaces and belts
that can most easily be used for self-harm should always be removed,
especially where there are grounds for believing that someone
may be a suicide risk. There is no legal obstacle under the Human
Rights Act to doing this.
The Home Office already does a great deal to foster a human
rights culture in custody suites. Police follow an interventionist
approach, with regular checks and risk assessments made on mentally
vulnerable detainees, removing shoe laces and other items of clothing
that might provide ligatures etc. This attitude does raise issues
under the requirement for privacy under the Human Rights Act,
but there is a need to strike a balance to ensure that the fundamental
right to life is protected.
Q4. Are you satisfied that Article 2 ECHR requirements
of an effective, prompt and independent investigation of deaths
in custody, with effective participation by the next-of-kin, are
met by the current system?
In England and Wales, all deaths in custody (along with violent,
unnatural deaths and those with unknown causes) must be referred
to the Coroner. The Coroner may then conduct a post mortem, and
if not satisfied that the cause of death is natural, hold an inquest.
To meet ECHR we rely on a mixture of the availability of
the following processes: the police investigation, Police Complaints
Authority supervision of police investigations, the Coroner's
Inquest, the Courts, Judicial Review and the Crown Prosecution
Service.
Deaths that occur in the custody of the police are referred
to the Police Complaints Authority (PCA). The PCA may then supervise
a police investigation. Whether the PCA choose to involve themselves
or not, there will always be a police investigation and the involvement
of the Coroner.
Where there is a suggestion of criminal activity revealed
by the Coroner or an investigation report, this is forwarded to
the Crown Prosecution Service who will independently determine
if criminal charges should be brought against any individuals
or organisation.
While it is likely that requirements under Article 2 are
satisfied through the current arrangements, we have recognised
the need for improvements to be made. To achieve this, new provisions
within the Police Reform Act 2002 create a new system for the
handling of complaints and incidents of alleged misconduct by
members of the police service.
We are currently awaiting the decision of the House of Lords
in the case R v Secretary of State for the Home Department
ex parte Amin. It is hoped that this will provide a clear
indication as to the Government's investigatory obligations under
ECHR in the event of a death of a person in the care and responsibility
of State agents. Their Lordships are considering whether to uphold
the Court of Appeal decision that in this case the requirements
of Article 2 have already been met and an additional independent
inquiry need not be instituted.
How could the effective investigation of deaths in custody
be better ensured?
Under the new police complaints system all deaths in custody
will be referred to the IPCC and they will be able to investigate
these independently of the police.
Provisions in the Police Reform Act, 2002, are intended to
ensure that all investigations under the new system comply with
the procedural requirements of ECHR wherever these rights are
engaged. The IPCC will be able to determine what type of investigation
is appropriate for a particular incident, and they will be able
to choose to investigate a death themselves.
In comparison to the current system for PCA investigations
under the 1996 Act, there will be:
— greater involvement of the complainant in the
investigation of the complaint;
— greater openness in disclosing materials to the
complainant; the legislation will prevent class claims of public
interest immunity in respect of investigation reports;
— more effective powers to direct that disciplinary
charges be laid against police officers;
— and (in relation to IPCC investigations) greater
independence of the person carrying out the investigation.
This change will strengthen the range of remedies available
following a death in custody that engages ECHR Article 2.
The Coroner's system is currently being reviewed to determine
if improvements can be made.
Hazel Blears MP
Minister of State Home Office
18 September 2003
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