APPENDIX A
MPS DEATHS IN CUSTODY GROUP
INTRODUCTION
In November 2002 the Metropolitan Police created
the Department of Criminal Justice headed by Commander Alan Given.
The Department's remit was to bring together the various strands
of criminal justice work that were taking place across several
departments and ensure a unified and corporate approach to delivering
on key Government targets around narrowing the justice gap and
bringing more offences to justice.
At the time the Dept of Criminal Justice was
formed, the MPS' Property Services Department (PSD) reported the
findings of a survey they had commissioned of MPS custody suites
to ascertain if they were fit for purpose and what action the
MPS needed to take to ensure that detainees were held in the safest
possible environment. The results of the survey highlighted areas
where improvements were required. As a result of this Commander
Given formed the Death in Custody Group.
THE DEATH
IN CUSTODY
GROUP
At the first meeting, initial discussions focused
on implementing a high-level programme of work to eradicate potential
ligature points from cells and refurbish cell wickets. Prioritisation
of work was undertaken using analysis supplied by the Dept of
Professional Standards (DPS), into the number of instances of
self-harm or attempted self-harm by detainees. The demographic
make up and political sensibilities of local communities were
also considered as part of an intelligence led approach as the
MPS was concerned to ensure that its policy of improvements within
cell areas impacted on members of all community groups who may
come into police custody. This programme of work continues and
costs approximately £6,000 per cell.
Responsibility for preventing deaths in police
custody had previously been led by DPS. It was however decided
to use the Death in Custody forum as an opportunity to adopt a
holistic approach to the whole issue of prisoner safety and prisoner
care. It was therefore, formally agreed that the Dept of Criminal
Justice would take responsibility for ensuring the safety of detainees
whilst being held in custody suites. Should a death in custody
occur at any other stage of a detainee's interaction with police
eg in the back of a prison van, it would be investigated by DPS/Police
Complaints Authority (PCA) and follow up action would be directed
to the most appropriate department.
Membership
In order to take forward this new area of work,
it was agreed that the group should meet on a monthly basis and
membership was drawn from the following groups and departments:
— Department of Criminal Justice;
— Directorate of Training;
— Occupational Heath Branch;
— Dept of Information and Technology;
— Dept of Legal Services;
— Linguistic and Forensic Medical Services
branch; and
— a Forensic Medical Examiner (FME)/HM
Coroner.
In addition to permanent members, the group
also seeks expert advice from other organisations with an interest
in preventing deaths in custody. An example of this is the recently
(accepted) invitation to the Police Complaints Authority to sit
as members of a small working sub-group, considering the best
methods of deployment and monitoring of CCTV in custody suites.
AREAS OF
RESPONSIBILITY
In addition to overseeing the cell improvement
plan, the group takes responsibility for the following areas:
General building improvement works
— In addition to the work to replace
cell wickets and remove potential ligature points, the Death in
Custody Group is also overseeing the general upgrade of cells.
This includes replacing doors and benches and improving toilet
areas.
Scope training requirements for custody staff
and gaolers at both an initial and refresher level. This includes:
— conducting training needs analysis;
— liaison with Directorate of Training
as to course design and methods of delivery; and
— reviewing the content of courses
to ensure they reflect current policy and new thinking.
Act as a conduit for new legislation and policy
that effects operations within custody suites.
— The Dept of Criminal Justice has
a dedicated policy unit, a representative of which sits on the
Death in Custody Group. The policy office scopes new legislation
and proposes new policies and methods of operation within custody
suites. A current example of their work is the formation of a
sub-group to look at the development of a "Detainee Welfare
Folder", which would contain all the relevant documentation,
including risk assessments, relating to a detainee's welfare and
a record of any medical care he/she receives whilst in custody.
Oversee the installation and upgrading of CCTV
in custody suites and developing corporate operating procedures
and policy.
— As mentioned above a sub-group has
been formed to develop proposals in this area and will produce
a policy covering the usage of monitors; how they will be viewed;
ergonomic factors; integrity and security.
Consider the lessons to be learned from DPS
inspections and investigations, near misses (incidents where a
detainee has tried to commit suicide or self-harm but fail), recommendations
from HM Coroners.
— Occupational Health branch have responsibility
for collating details of "near misses" and the findings
from these and the other sources mentioned above are debated at
the Death in Custody meeting and taken into account when training
is planned. The Dept of Criminal Justice holds monthly meetings
with Criminal Justice Unit (CJU) managers who are based on boroughs
and in most cases have responsibility for managing their custody
suites. Lessons learned, best practice and details of new policy
are promulgated to them and they have the responsibility for cascading
this information to custody staff.
Work is also ongoing into developing an intranet
site containing useful information and best practices which all
MPS staff can access.
Custody-nursing pilot
In addition to the work of the Dept of Criminal
Justice, the Metropolitan Police custody-nursing pilot started
in July 2001 at Charing Cross Police Station. The evolution of
the MPS custody nurse scheme has been incremental to ensure a
safe environment for all concerned, and has received the backing
of the Association of Police Surgeons. The changes to the PACE
Codes of Practice enable custody nurses to undertake certain medical
tasks that were previously the sole responsibility of the FMEs.
A Psychiatric Nurse is available to support and advise custody
staff and detainees on an on-call basis between 9am-9pm. Outside
these hours the nurses and the custody officers rely on the duty
Mental Health Social Worker.
Research conducted thus far indicates that detainees
will often provide custody nurses with information about themselves
that they are reluctant to impart to custody staff, and this information
is of considerable value, both in identifying if a prisoner is
ill and also if they may be pre-disposed to self-harm.
The MPA approved the scheme to be a permanent
feature in October 2002. A decision to roll out the custody nurse
programme further will be taken once the nurses' extended working
practices have been evaluated and balanced against other factors,
including cost effectiveness.
Drugs Mules
Earlier in the year, Commander Given chaired
a small working group looking into the issues surrounding "drug
mules" and what action police could, and should, take when
such individuals are arrested to ensure everything possible is
done to preserve of life. Expert opinion was sought from consultants
and nurses who were able to provide relevant information as to
the type of medical intervention required, the circumstances under
which they could act, ie a person who has swallowed a cachet of
drugs or inserted it into their body is not regarded by the medical
profession as ill, but rather as being in a particular condition.
Therefore unless the drugs get into the system no medical treatment
is required.
HM Customs and Excise invariably detain drugs
mules however, under PACE they have no legal authority to charge,
bail or detain prisoners after charge (this includes transporting
detainees to court from police stations). This is why their prisoners
pass into police care and control. As a direct result of the meetings
a protocol was drawn up between the police and HMCE, which set
out the roles and responsibilities of both organisations. The
ultimate aim of the protocol is to reduce as far as possible the
amount of time drugs mules spend in police custody, and ensure
they have access to FMEs who will be able to risk assess their
condition.
CONCLUSION
The formal structure and multi discipline approach
of the Death in Custody Group has raised the profile of improving
the safety of detainees in custody suites. There are regular clear
lines of communication to CJU Managers and on to operational officers
working in custody suites which enables the promulgation of relevant
information in a direct and timely manner. The Group supports
and influences funding necessary to improve custody suites and
install and upgrade CCTV. Issues are debated and decisions are
made in a constructive way. The range and experience of members
of the group, particularly HM Coroner and Legal Services, ensures
that issues take into account human rights, diversity legislation,
health and safety and the expectations of external colleagues
and agencies.
DEATHS IN IMMIGRATION DETENTION
Since 1989 there have been five deaths of persons
held in Immigration Service detention centres (now known as removal
centres). In all but one of the cases, death was self-inflicted[2].
Coroners' inquest verdicts in the cases concerned have been either
suicide, death by misadventure or "open". Central records
of incidents of self-harm are not maintained.
With such a relatively small number of deaths
in immigration detention compared to the total number of individuals
likely to have been detained over the same period it is difficult
to establish statistical trends. However, to the extent that common
themes emerge in the individual cases concerned, it appears that
incidents of self-inflicted death have preceded the proposed or
potential removal of the person concerned from the UK. This is
also a common theme in incidents of actual or attempted self-harm
involving immigration detainees, which for the most part appear
to be designed to delay or prevent removal.
To the extent that it is possible to do so where
very little may be known about the individuals concerned, the
Immigration Service will, amongst other risks or special needs,
identify whether a person who is being detained is likely to present
a risk of suicide or self-harm and this information will be passed
to the detaining agency.
Under the Detention Centre Rules 2001, Detainee
Custody Officers are required to be alert to the particular anxieties
to which detainees may be subject and the sensitivity that this
will require, especially when handling issues of cultural diversity.
Within removal centres there are a range of measures in place
to prevent suicide and self-harm, and all centres are required
to comply with an Operating Standard on suicide and self-harm
prevention. Specific measures include:
— all staff receive suicide awareness
training, refreshed annually;
— display of notices to detainees and
visitors in relevant languages about informing staff where they
have concerns about a detainee;
— Suicide Prevention Committees which
meet monthly and involve detainees;
— all staff receive training in emergency
first aid; and
— systems for paying particular attention
to detainees on their first night in detention and in cases where
removal directions are known to the detainee or immediately prior
to removal.
The death of an immigration detainee would be
subject to a number of separate investigations. The centre operator
would carry out an internal investigation and the Immigration
Service would conduct its own investigation.
In all cases, the police would be called in
to investigate the incident and there would, of course, be a Coroner's
inquest.
18 September 2003
2 The single exception is the apparent murder in May
2003 of a female detainee by her partner. The cause remains under
investigation by the police. Back
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