Services that Manage the Care Needs of Drunk - Scottish Government

4.24 It is worth noting that other studies have shown that a large proportion of the
work of forensic medical examiners involves intoxicated detainees, and much
of this work is related to assessing individuals for their fitness to be detained.
If an FME considers an arrestee fit to be detained, they usually request that
custody staff make frequent checks — eg, in some cases, every 15 minutes —
to ensure the well-being of the detainee. 118
4.25 Traditionally, forensic and medical services to detainees in police custody have
been provided on an on-call basis by medical practitioners (usually part-time
GPs with special training in forensic medicine). However, in recent years,
there has been a growing trend (in the UK and elsewhere) to restructure
services so that initial medical contacts are made by custody nurses.
The role of forensic medical examiners and custody nurses in managing the
care needs of intoxicated arrestees
4.26 There have been two UK studies which have specifically investigated the role
of the FME in addressing alcohol-related problems of drunken detainees in
police custody – through screening and brief interventions. 119 However,
neither of these studies looked specifically at the effectiveness of using FMEs
to manage the care needs of drunk and incapable people in police custody.
4.27 Nevertheless, there were a few messages from these studies which are
relevant to the aims of this review:
• First, a large part of the job of an FME involves assessing the fitness of
alcohol-related detainees to be in custody.
• Second, one of the reasons for this may be that custody sergeants feel a
certain level of anxiety about this group, who represent one of the most
common groups to die in police custody.
• Third, although FMEs generally feel confident about caring for the needs of
alcohol-related detainees, they question whether it should be part of their
role to screen people for alcohol problems or to deliver brief interventions,
and they question the effectiveness of such interventions being delivered in
the context of a police cell when an individual is intoxicated.
4.28 Four studies were identified which examined the role of custody suite nurses.
However, none of these studies concerned the specific role of nurses in
meeting the needs of alcohol-related detainees. One of the studies was not
relevant at all to the purposes of this review as it primarily concerned an
exploration of the roles and boundaries of practice among custody nurses. 120
4.29 The main purpose of three of the studies (two in Melbourne, Australia and one
in the north of England) was to evaluate the impact of providing nursing care in
118
Deehan et al, 2002; Best et al, 2002.
119
Deehan et al, 1998; Best et al, 2002.
120
Gannon, 2002.
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