Joint review of police custody recommendations

During the course of 2022, HMICS and HIS collaborated on a baseline review of the provision of healthcare services to police custody centres across Scotland. A report outlining our findings and recommendations was published in January 2023. We used learning from the review to develop a framework to inspect healthcare provision within police custody, and to devise a methodology for the joint inspection of police custody centres. The framework draws on national standards, human rights principles and expected healthcare equivalence across centres.

 Thereafter, we commenced a programme of joint custody inspections and, to date, have published ten custody inspection reports and two progress reports. The findings from these can be found on our website. We have also published a revised version of our custody inspection framework, which can be found here. It outlines the quality indicators that form the basis of our inspection of custody centre operations.

 The baseline review provided an important starting point for understanding healthcare delivery within police custody centres, however, the findings set out in this report are primarily drawn from our published joint inspection reports and our examination of progress made on recommendations during this review. Where relevant, reference is made to recommendations from the baseline review to demonstrate progress and to highlight areas where further improvement is required.

As outlined in our custody inspection reports, progress has been made against several recommendations; however, a number of thematic issues have persisted. This review highlights ongoing challenges relating to the custody operating model, the ageing custody estate, staffing and workforce planning, and operational practices associated with the supervision of vulnerable detainees, including children and those assessed as high risk. While we recognise that many of these pressures are exacerbated by financial constraints and the increasing vulnerability of the custody population, we consider that further action is required at pace to progress outstanding recommendations and secure sustained improvement.

In respect of healthcare provision, our inspections identified meaningful, though variable, progress across police custody centres. Areas where improvements had been identified include clinical governance, infection prevention and control, equipment and medicines management, and staff training. A number of NHS boards and Health and Social Care Partnerships (HSCP) have demonstrated effective implementation of national recommendations, with emerging examples of strengthened practice identified through inspection.

 However, inspection findings also highlighted ongoing challenges. These included limitations in digital systems, delays in access to secondary mental health services, variation in the delivery of Medication Assisted Treatment (MAT), and inconsistencies in clinical governance arrangements, staff training and supervision. While improvements in staff training were identified through inspection, variation in access, consistency and supervision continued to present a challenge across services.

Overall, the joint inspection programme has contributed to measurable improvement, strengthened assurance, and enhanced national understanding of risks, good practice, and areas requiring further development across police custody. Notwithstanding this progress, the pace of change in some key areas remains limited. Continued inspection focus will be required to monitor progress; however, it is essential that Police Scotland’s custody division and NHS boards maintain momentum and deliver the sustained improvement necessary to achieve consistent, safe and rights-based custody services and healthcare provision.

Craig Naylor
His Majesty’s Chief Inspector of Constabulary

Eddie Docherty
Director of Quality Assurance and Regulation
Healthcare Improvement Scotland

August 2026