Operational efficiency of health care in police custody suites: comparison of nursing and medical provision

Abstract

This paper is a report of a study to examine the operational impact of a police custody nursing service on healthcare delivery in one police service in the north of England. Medical practitioners, trained specifically for the role of forensic medical examiner, have traditionally provided forensic and custodial medical services. However, there is a trend for police authorities in the United Kingdom to replace forensic medical examiners with custody nurses. Restructuring health care in police custody suites to a multidisciplinary team approach is a practical response to the challenges faced by an overburdened service. However, very few evaluations of the impact of a nursing addition to forensic medical services have been published. One nursing service was evaluated by comparing performance indicators over a 6-months period with retrospective data from records of the traditional forensic medical examiner service. Data were extracted from 9,000 calls made by the police for medical assistance across five police stations, and analysed for response and consultation times. Five custody nurses, 20 custody officers and six forensic medical examiners were also interviewed, and the study was conducted in 2003. In comparison to the traditional service, nurses demonstrated faster response times, comparable consultation times, and were perceived by custody staff as more approachable than their medical colleagues in providing handover information. As nurses take on the roles previously performed by medical colleagues, so it will become increasingly important to define role boundaries and assess the impact on the quality of care of detainees.