1. Deaths in Custody Tom Milsom Associate Commissioner 1

2. IPCC role 2 Increase public confidence in the police complaints system in England & Wales Set standards for dealing with police complaints & monitor performance Independently investigate the most serious matters Provide a right of appeal in certain cases Ensure lessons learned throughout police service & others

3. Conduct or oversee investigations Consider appeals re: complaints in some cases Identify learning and ensure this is reflected in police guidance and training Produce annual statistics on deaths and research Work with others to ensure changes are implemented IPCC role in improving care of detainees 3

4. Police have a statutory duty to refer deaths and serious injuries to IPCC in all cases Cases meeting the mandatory referral criteria must also be referred Forces may also make voluntary referrals IPCC has power to call in cases IPCC investigations 4

5. Fatalities 04/05- 14/15 Category 2004 /05 2005 /06 2006 /07 2007 /08 2008 /09 2009 /10 2010 /11 2011 /12 2012 /13 2013 /14 2014 /15 Road traffic fatalities4448362440292619311214 Fatal shootings35153222001 Deaths in or following police custody3628272215172115 1117 Apparent suicides following custody^46404745565446396570~69 Other deaths following police contact*24402230353956472243~41

6. 17 people died in or following police custody 14 were men and 3 were women Ages ranged from 22- 57 15 were White, 1 was Asian, 1 was Black 8 people were identified as having mental health concerns 16 people were known to have a link to alcohol and or drugs. 6 pathologist stated that alcohol and drug toxicity or long term abuse contributing factor in cause of death. Deaths in or following police custody

7. 10 of the 17 people had been restrained by officers before their death Restraint Type of ForceNumber of fatalities Restraint only4 Restraint and incapacitant spray4 Restraint and Taser1 Restraint, Taser and police dog1 No restraint /use of force7

8. Eight people taken ill/ unwell in a police cell – three died in a police cell and five taken to hospital either died on arrival or sometime later. Four people were taken ill at the scene of arrest and died either at the scene or after having been taken to hospital. Three were taken ill, or concern was raised, while they were in a vehicle. Two men died following their release from police custody. Place

9. Those who should not be brought to custody Sectioned under 136 should be taken to a health based place of safety Drunk and Incapable should be taken to hospital With or have signs of head injury should be assessed medically Acute behaviour disorder/disturbance dealt with as a medical emergency Those who have swallowed drugs should be taken to hospital. Those who are under 18. Police custody not appropriate. 9

10. Everyone brought into custody should be risk assessed on ongoing basis. Arresting officer should provide information from the arrest –especially use of force. Increased risk that symptoms of serious illness or injury may go unnoticed in those who are known/familiar. During initial risk assessment questions should be asked in a manner to obtain information. National consistency needed – Dr McKinnion – evidence-based work – new screening tool to improve RA – pilot in MPS area successful.. Risk assessment 10

11. If no risk of self harm then detainees should be able to keep asthma and angina pumps/sprays. All items connected with meals and drinks must be removed from cells. Care of pregnant detainees. Appropriate adult for those with learning disabilities/difficulties - difficult in custody environment to disclose Managing risk 11

12. Custody officer is always ultimately responsible for those in their care If delegate tasks Should be assured suitable, trained and competent to fulfil task Should check it has been carried out and to the appropriate standard. Always a designated custody officer responsible for detainee Multiple Custody Officers Handovers should be conducted in front of CCTV – involve medical staff. If accepting responsibility for detainee should check the detainee and enter the cell and wake up. Custody officer 12

13. Checks and rousing need to be carried out at the frequency and standard expected. Rousing checks must adhere to Annex H of PACE Code C Conversation and responses should be recorded and physical stimuli carried out where no adequate verbal response received. Checks and rousing 13

14. Those who are drunk and incapable should not be in custody Those under the influence should be visited and roused, condition assessed as in Annex H and clinical treatment arranged if appropriate. Alcohol and drugs 14

15. Changes to Law linked to IPCC Investigation in relation to overnight accommodation for 17 yr olds. Remains issue of telling parents without consent Need to be clear what 17 year olds should be provided as still not being provided with their rights. Appropriate adults should be provided with information on role especially if parent. Consideration should be given to use of force, restraint and risk assessment and how these affect young people. Under 18’s 15

16. All use of force should be proportionate, lawful and only carried out for as long as is necessary. Alternatives should be used as far as possible. The correct equipment should be used Always someone who monitors vital signs Support the IAP common principles for safer restraint Prone restraint should be kept to a minimum to prevent positional asphyxia. Use of force 16

17. Taser should only be used in exceptional circumstances in custody All use of force should be recorded to determine whether being used disproportionately Searches – conducted where not overlooked Use of force and searches 17

18. PER forms – vital that risk is passed onto ongoing custodial providers Those escorting to hospital should be trained to be able to complete and understand PER form Pre release risk assessment and onward referral to appropriate services PER and pre-release 18

19. Continue to work with NPCC and College of Policing to ensure national recommendations are reflected in guidance Feed into HMIC/HMIP custody inspections New powers to require forces to respond to learning recommendations Working with PCCs to ensure recommendations are implemented Developing a briefing document for ICVs Implementation of recommendations 19

20. Learning the lessons 20 The IPCC publishes a regular bulletin to help the police service learn lessons from investigations and other operations of the police complaints and conduct system. Bulletin 23 covers custody

21. If you witness something – make a note, raise with custody sergeant or Inspector or other senior officer If very concerned report to PSD If IPCC involved – talk to us. We may approach you to provide an account If force have ignored/failed to implement one of your recommendations it will be tor the force to answer why Some Practicalities 21