9 Care and treatment of detained persons

9.1 Notwithstanding other requirements for medical attention as set out in this section, detainees who are held for more than 96 hours must be visited by an appropriate healthcare professional at least once every 24 hours.

9.2 Nothing in this section prevents the police from calling an appropriate healthcare professional, to examine a detainee for the purposes of obtaining evidence relating to any offence in which the detainee is suspected of being involved. See Note 9A.

9.3 If a complaint is made by, or on behalf of, a detainee about their treatment since their arrest, or it comes to notice that a detainee may have been treated improperly, a report must be made as soon as practicable to an officer of inspector rank or above not connected with the investigation. If the matter concerns a possible assault or the possibility of the unnecessary or unreasonable use of force, an appropriate healthcare professional must also be called as soon as practicable.

9.4 Detainees should be visited at least every hour. If no reasonably foreseeable risk was identified in a risk assessment, see paragraphs 3.6 to 3.10, there is no need to wake a sleeping detainee. Those suspected of being under the influence of drink or drugs or both or of having swallowed drugs, see Note 9C, or whose level of consciousness causes concern must, subject to any clinical directions given by the appropriate healthcare professional, see paragraph 9.15:

be visited and roused at least every half hour;

have their condition assessed as in Annex H;

and clinical treatment arranged if appropriate.

9.4A As soon as practicable after arrival at the police station, each detainee must be given an opportunity to speak in private with a member of the custody staff who if they wish may be of the same sex as the detainee (see paragraph 1.17(c)), about any matter concerning the detainee’s personal needs relating to their health, hygiene and welfare that might affect or concern them whilst in custody. If the detainee wishes to take this opportunity, the necessary arrangements shall be made as soon as practicable. In the case of a juvenile or vulnerable person, the appropriate adult must be involved in accordance with paragraph 3.17 and in the case of a girl under 18, see paragraph [3.21A]. (See Note 9CB).

9.4 B Each female detainee aged 18 or over shall be asked in private if possible and at the earliest opportunity, if they require or are likely to require any menstrual products whilst they are in custody. They must also be told that they will be provided free of charge and that replacement products are available. At the custody officer’s discretion, detainees may have menstrual products supplied by their family or friends at their expense (see Note 9CC). For girls under 18, see paragraph 3.21A.

See Notes 9B, 9C and 9G

9.5 When arrangements are made to secure clinical attention for a detainee, the custody officer must make sure all relevant information which might assist in the treatment of the detainee’s condition is made available to the responsible healthcare professional. This applies whether or not the healthcare professional asks for such information. Any officer or police staff with relevant information must inform the custody officer as soon as practicable.

9.6 The custody officer must make sure a detainee receives appropriate clinical attention as soon as reasonably practicable if the person:

(a) appears to be suffering from physical illness; or

(b) is injured; or

(c) appears to be suffering from a mental disorder; or

(d) appears to need clinical attention

9.7 This applies even if the detainee makes no request for clinical attention and whether or not they have already received clinical attention elsewhere. If the need for attention appears urgent, e.g. when indicated as in Annex H, the nearest available healthcare professional or an ambulance must be called immediately.

9.8 The custody officer must also consider the need for clinical attention as set out in Note 9C in relation to those suffering the effects of alcohol or drugs.

9.9 If it appears to the custody officer, or they are told, that a person brought to a station under arrest may be suffering from an infectious disease or condition, the custody officer must take reasonable steps to safeguard the health of the detainee and others at the station. In deciding what action to take, advice must be sought from an appropriate healthcare professional. See Note 9D. The custody officer has discretion to isolate the person and their property until clinical directions have been obtained.

9.10 If a detainee requests a clinical examination, an appropriate healthcare professional must be called as soon as practicable to assess the detainee’s clinical needs. If a safe and appropriate care plan cannot be provided, the appropriate healthcare professional’s advice must be sought. The detainee may also be examined by a medical practitioner of their choice at their expense.

9.11 If a detainee is required to take or apply any medication in compliance with clinical directions prescribed before their detention, the custody officer must consult the appropriate healthcare professional before the use of the medication. Subject to the restrictions in paragraph 9.12, the custody officer is responsible for the safekeeping of any medication and for making sure the detainee is given the opportunity to take or apply prescribed or approved medication. Any such consultation and its outcome shall be noted in the custody record.

9.12 No police officer may administer or supervise the self-administration of medically prescribed controlled drugs of the types and forms listed in the Misuse of Drugs Regulations 2001, Schedule 2 or 3. A detainee may only self-administer such drugs under the personal supervision of the registered medical practitioner authorising their use or other appropriate healthcare professional. The custody officer may supervise the self-administration of, or authorise other custody staff to supervise the self-administration of, drugs listed in Schedule 4 or 5 if the officer has consulted the appropriate healthcare professional authorising their use and both are satisfied self-administration will not expose the detainee, police officers or anyone else to the risk of harm or injury.

9.13 When appropriate healthcare professionals administer drugs or authorise the use of other medications, or consult with the custody officer about allowing self administration of drugs listed in Schedule 4 or 5, it must be within current medicines legislation and the scope of practice as determined by their relevant regulatory body.

9.14 If a detainee has in their possession, or claims to need, medication relating to a heart condition, diabetes, epilepsy or a condition of comparable potential seriousness then, even though paragraph 9.6 may not apply, the advice of the appropriate healthcare professional must be obtained.

9.15 Whenever the appropriate healthcare professional is called in accordance with this section to examine or treat a detainee, the custody officer shall ask for their opinion about:

any risks or problems which police need to take into account when making decisions about the detainee’s continued detention;

when to carry out an interview if applicable; and

the need for safeguards.

9.16 When clinical directions are given by the appropriate healthcare professional, whether orally or in writing, and the custody officer has any doubts or is in any way uncertain about any aspect of the directions, the custody officer shall ask for clarification. It is particularly important that directions concerning the frequency of visits are clear, precise and capable of being implemented. See Note 9E.

9.17 A record must be made in the custody record of:

(a) the arrangements made for an examination by an appropriate healthcare professional under paragraph 9.3 and of any complaint reported under that paragraph together with any relevant remarks by the custody officer;

(b) any arrangements made in accordance with paragraph 9.6;

(c) any request for a clinical examination under paragraph 9.10 and any arrangements made in response;

(d) the injury, ailment, condition or other reason which made it necessary to make the arrangements in (a) to (c); See Note 9F

(e) any clinical directions and advice, including any further clarifications, given to police by a healthcare professional concerning the care and treatment of the detainee in connection with any of the arrangements made in (a) to (c); See Notes 9D and 9E

(f) if applicable, the responses received when attempting to rouse a person using the procedure in Annex H. See Note 9G.

9.18 If a healthcare professional does not record their clinical findings in the custody record, the record must show where they are recorded. See Note 9F. However, information which is necessary to custody staff to ensure the effective ongoing care and well being of the detainee must be recorded openly in the custody record, see paragraph 3.8 and Annex G, paragraph 7.

9.19 Subject to the requirements of Section 4, the custody record shall include:

a record of all medication a detainee has in their possession on arrival at the police station;

a note of any such medication they claim to need but do not have with them.

9A A ‘healthcare professional’ means a clinically qualified person working within the scope of practice as determined by their relevant statutory regulatory body. Whether a healthcare professional is ‘appropriate’ depends on the circumstances of the duties they carry out at the time.

9B Whenever possible detained juveniles and vulnerable persons should be visited more frequently.

9C A detainee who appears drunk or behaves abnormally may be suffering from illness, the effects of drugs or may have sustained injury, particularly a head injury which is not apparent. A detainee needing or dependent on certain drugs, including alcohol, may experience harmful effects within a short time of being deprived of their supply. In these circumstances, when there is any doubt, police should always act urgently to call an appropriate healthcare professional or an ambulance. Paragraph 9.6 does not apply to minor ailments or injuries which do not need attention. However, all such ailments or injuries must be recorded in the custody record and any doubt must be resolved in favour of calling the appropriate healthcare professional.

9CB Matters concerning personal needs to which paragraph 9.4A applies include any requirement for menstrual products incontinence products and colostomy appliances, where these needs have not previously been identified (see paragraph 3.5(c)). It also enables adult women to speak in private to a female officer about their requirements for menstrual products if they decline to respond to the more direct enquiry envisaged under paragraph 9.4B. This contact should be facilitated at any time, where possible.

9CC Detailed guidance for police officers and staff concerning menstruating female detainees in police custody is included in the College of Policing Authorised Professional Practice (APP).

9D It is important to respect a person’s right to privacy and information about their health must be kept confidential and only disclosed with their consent or in accordance with clinical advice when it is necessary to protect the detainee’s health or that of others who come into contact with them.

9E The custody officer should always seek to clarify directions that the detainee requires constant observation or supervision and should ask the appropriate healthcare professional to explain precisely what action needs to be taken to implement such directions.

9F Paragraphs 9.17 and 9.18 do not require any information about the cause of any injury, ailment or condition to be recorded on the custody record if it appears capable of providing evidence of an offence.

9G The purpose of recording a person’s responses when attempting to rouse them using the procedure in Annex H is to enable any change in the individual’s consciousness level to be noted and clinical treatment arranged if appropriate.