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Northern Ireland to introduce nurse-led police custody care model

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Specially trained nurses will be in place across all custody suites in Northern Ireland before the end of next year, police chiefs have said. 

The country is moving towards a nurse-led model of healthcare on the frontline of its justice system to deliver holistic support to often vulnerable detainees.

“It is a different specialty within nursing, but the core principles are still the same”

Linsey Sheerin

The first phase of the project started in October 2018 and saw nine nurses from Belfast Health and Social Care Trust recruited to work full-time at Musgrave Street station in Belfast.

The aim is for the other eight custody suites run by the Police Service of Northern Ireland (PSNI) to have followed suit by September 2020.

The nurses receive special training to gain the title of custody nurse practitioner (CNP).

Linsey Sheerin, a Belfast CNP, told Nursing Times the CNP role appealed to her because she wanted a challenge and an opportunity to improve the health and wellbeing of vulnerable people in her community.

She said of her role: “I think it is a different specialty within nursing, but the core principles of the job are still the same— caring for people, responding to emergencies and being an advocate for health.”

PSNI has a legal requirement to provide healthcare to those in custody and previously this was provided solely by physicians, called forensic medical officers (FMOs).

FMOs continue to work with the station on an on-call basis, but the nurses are inside the station full-time.

The role of the CNPs is to triage detainees in custody and assess, treat and refer them on to other healthcare providers when necessary, a PSNI spokesman said.

“Our nurses’ skills are highly effective in de-escalating difficult situations”

Bernie Owens 

Ms Sheerin, who comes from an emergency care background, said: “I think primarily we’re here to promote the health and wellbeing of people in custody and make sure that people are mentally and physically well enough to go through the interview process.”

She said she felt that the rest of the team working at the station— police officers, custody officers and FMOs— very much valued the skills the nurses brought. 

psni nurses two

psni nurses two

Source: Police Service of Northern Ireland

From left, Professor Charlotte McArdle, Northern Irish Chief Nursing Officer and PSNI Head of Reducing Offending and Safer Custody, Una Williamson

Bernie Owens, director of unscheduled and acute care Belfast Health and Social Care Trust and also a registered nurse, said: “Our nurses’ skills are highly effective in de-escalating difficult situations and they are working collaboratively with police officers, custody officers and with forensic medical officers to provide a holistic approach.

“This is joined-up working in a new setting within the Northern Ireland context and it is proving to be very effective,” she added.

According to the PSNI, 91% of detainees were examined by an FMO in 2017-18.

Since CNPs started working independently, 12% of detainees have been referred by the CNP to an FMO.

This has resulted in savings of £766,000, most of which will be reinvested in enhancing the provision of custody healthcare within PSNI.

Una Williamson, head of reducing offending and safer custody at PSNI, said the service implemented the new nurse-led model after a joint Criminal Justice Inspectorate and Regulation and Quality Improvement Agency report recommended it looked at alternative ways to deliver health assessment and care in custody.

“The aim is to ensure detainees have access to the same quality of care in custody as elsewhere and provide compassionate equality of care for all detainees, some of whom are marginalised by society due to vulnerabilities, such as homelessness, mental ill health, addiction, or by the nature of their offending,” Ms Williamson said.

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