Recommendation - College of Policing, March 2026

The IOPC recommends that the College of Policing revises its Authorised Professional Practice (APP) in relation to detention and custody, to ensure that it gives clear and consistent guidance to police forces on how the outcomes of Healthcare Professional (HCP) assessments are communicated to custody officers.

This recommendation follows a review of a complaint made by a person who had been in police custody. Approximately two hours after the complainant had been booked into custody, a medical assessment was carried out by a HCP. 

The HCP assessed that the complainant was not fit to be detained and that they should be transferred to hospital. However, although the HCP’s assessment was recorded on the custody log, the complainant was not transferred to hospital and remained in custody for a further 24 hours. There was no evidence as to whether the HCP communicated their assessment verbally.

In the section ‘Detainee care – monitoring, observing and engaging’ of the detention and custody APP, it states that “the HCP’s recommendations should be given both verbally to the custody officer and in writing.” However, in the section ‘Response, arrest and detention – fitness for detention’ of the same APP, it states that “After examining a detainee, the HCP should record any clinical findings relevant to their custodial healthcare and directions in the custody record.” This leaves room for doubt as to whether a HCP should communicate the outcome of an assessment to the custody officer both verbally and in writing, or whether an entry on the custody log alone is sufficient.

APP is the official guidance for policing, which officers and staff are expected to take into account when carrying out their duties. Forces are expected to support their officers and staff to implement APP (or to justify where local policy or guidance does not comply with APP), so it is vital the guidance is clear and consistent about what is expected.

Accepted

We acknowledge that there is an inconsistency in the language used within the Authorised Professional Practice (APP) regarding the communication of Healthcare Professional (HCP) assessments.

While we consider it unlikely that this inconsistency would materially affect outcomes in a live operational context, where communication between HCPs and custody officers would ordinarily be expected as a matter of routine practice in the ongoing management of detainee care, we recognise that, when considered retrospectively, the wording may give rise to ambiguity.

In particular, the relevant section does not explicitly restate the requirement to record the assessment in writing alongside providing a verbal update to the custody officer, which may be interpreted as an omission rather than an implicit expectation.

As discussed with IOPC, we also advised that the College of Policing does not have jurisdiction over, nor contractual arrangements with, healthcare providers operating within custody. As such, it cannot directly compel HCPs to take specific actions. We have therefore encouraged the IOPC to make reasonable enquiries with healthcare providers commissioned to deliver custody healthcare, as they are better placed to influence clinical practice.

The IOPC recommendation does not specify a preferred form of wording. In order to avoid any ongoing ambiguity, we propose to amend the APP to make expectations explicit and consistent.

We propose that the relevant section is amended to state that:

“The outcomes of any HCP assessment, including decisions regarding fitness for detention, should be communicated both verbally to the custody officer as soon as practicable, and recorded in writing within the custody record.”

This will be reflected at both sections within the APP.