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Efficient Government Fund Application
Stage 1 Application - Expression of Interest
Part 1: summary table
Bid Number (for EG use) | |
Lead Bidder | Fife Constabulary per Superintendent Martin Birrell
01592 418406 martin.birrell@fife.pnn.police.uk |
Brief description of the aims of the project | Offering a place of safety with the intention of improving the health of a vulnerable group in society through early intervention. The development of a process which channels this group to an appropriate facility thus freeing up the services of the police, health service accident and emergency staff and other agencies. The facility aim will be to provide short term health care but also look to offer longer-term intervention |
Clear description of what the EGF money would be used to buy | The money would be used to partly fund a purpose built facility offering a place of safety and a detoxification centre aimed at improving health. Funding for both the full capital and running costs is a matter that requires further investigation by all partners involved in this project. It is understood that the Efficient Government Scheme does not cater for this element. |
Partners to the project likely to commit resources | The main partners are, NHS Fife, Fife Constabulary, Fife Drug & Alcohol Action Team, Fife Council Housing Service, Fife Alcohol Support Service, Kingdom Housing Association, Social Work |
Names of other organisations with whom the project has been discussed (to assist the introductions process) | Criminal Justice Service and support agencies such as Fife Intensive Rehabilitation & Substance misuse Team (F.I.R.S.T) |
Evidence that suggested approach has been deployed successfully elsewhere | There are two other places of safety established in Scotland the first is Albyn House, Aberdeen which has been run successfully for many years and has good partnership working including Social Work, Local Government, Police, Health Service and various Voluntary Sector Alcohol Services. As a result of this facility Grampian Police do not require to detain such persons in police cells. The second place is Beechwood House, Inverness that was founded by the Church of Scotland with similar partner arrangements to Albyn House. Both properties have a designated area where people detected by the Police for being drunk & incapable are taken. They are monitored in a safe environment until fit to leave. The clients are then given the opportunity to move on to the hostel/rehabilitation accommodation attached where they can stay and receive support and rehabilitation for their alcohol and related problems. |
Are there any restrictions to enlargement of the project (i.e. number of partners) | No |
Benefits projected from the project | Currently in Fife, persons who have consumed excessive amounts of alcohol and are found in a public place incapable of looking after themselves, invariably find themselves in the custody of Fife Constabulary and in some cases attending the accident and emergency unit. Dealing with this client group is time consuming and commits resources that could be better deployed elsewhere. Studies have shown that the monitoring of this client group by police and hospital staff is not always appropriate and that there are more suitable means of care. The benefits to be enjoyed include the following - Availability of higher degree of care
- Holistic approach to care
- Freeing up of resources in the emergency services
- Reduced number of deaths in police custody
- Reduced demand on the Procurator Fiscal
- Freeing up of court time
- Medical intervention and the offer of longer term treatment
- Longer term savings to the Health Service
A recent fatal accident inquiry involving a person who had been held in police custody, albeit suffering from substance misuse, ran for 10 court days. It involved 17 police witnesses and a significant number of civilian witnesses. A further FAI concerning a death in custody which did involve alcohol abuse will take place later this year. Deaths in custody are thankfully rare however. Such a facility would remove the risk of death in police custody. Numbers for the care of this client group in hospitals are not recorded in a format which allows any estimate of costs to be made. |
Benefits projected from the project (cont) | Savings can also be made to the Criminal Justice System. In 2004 177 people were reported to the Procurator Fiscal service for being Drunk & Incapable. By establishing a designated place these people would no longer come to the attention of the criminal justice service. Full details of Fiscal reporting is available in part 2 of this document. |
Estimated financial projections | Total | 2004/5 | 2005/6 | 2006/7 | 2007/8 |
Overall projected costs | £1,053,864 | _ _ _ _ _ _ | £35,950 | £423,120 | £594,794 |
Estimated projected benefits: The above capital figures submitted correspond to the attached Chartered Surveyor's report as amended by projected spend on specialist equipment. The capital projections have been phased over the 3 financial years 2005/06, 2006/07 and 2007/08. This is in line with the expected completion date of the build being by 31 March 2008. The estimated projected benefits do not feature in the financial years 2005/06, 2006/07 and 2007/08 as a consequence of the anticipated completion date of the building being by 31 March 2008. It is projected that the estimated projected benefits for the police will be in excess of £110k year on year. Working papers to substantiate the anticipated benefits figures, if required, are available for review. At this point no cognisance has been taken of the estimated projected benefits for the NHS, Court or Procurator Fiscal services or of Force Medical Examiner cost savings which are expected to be considerable when combined. |
Is a pilot required - see guidance notes | No |
Additionally: why is EG funding required | To contribute to initial setting up costs of the designated place. |
Does this project complementary in anyway to other EG work | No |
Is "stage 2 development funding" requested | Yes |
Part 2: Narrative bid
In the calendar year 2004 Fife Constabulary dealt with some 484 cases of persons being drunk and incapable of looking after themselves, this number does not include the number of people detected but taken home to the care of a suitable adult. Many of the people detected are repeat offenders, with one person arrested 55 times within this year. In the majority of these cases it resulted in these persons being arrested and spending a number of hours in police custody. In most cases no attempt is made to assist the individual beyond his or her stay in custody and indeed the only purpose in keeping an individual incarcerated is in terms of their immediate safety. Consequently any opportunity to intervene medically or in a social sense is usually lost.
In a recent report by Best & Kefas results suggested that vulnerable populations, particularly those with gross alcohol intoxication, are not cared for adequately in police custody. It was reported that 86% of deaths in Police custody were linked to recent alcohol consumption or chronic alcohol abuse, in 81% of the head injury deaths in police care the deceased was suspected of intoxication. Alcohol toxicity can be fatal and often alcoholics require supervised care and even resuscitation, which is very difficult to do in a custody environment.
It has long been argued that in most cases it is probably inappropriate to detain such people in police cells although clearly, there is exiting legislation which allows this and in the absence of any other place of safety, there is generally no alternative.
A number of studies have been undertaken which highlight the high level of risk such custodies pose. Due to their intoxicated state and in many cases, the additional medical complications caused by perhaps a long history of alcohol abuse, it is not unknown for further complications to arise out of their condition; thankfully however that remains a relatively rare occurrence however.
What this highlights is that despite best efforts, the police service is not always equipped to deal with individuals who are intoxicated. Apart from the issue of lack of facilities and medical skills, there is also an issue of cost associated with detaining this number of custodies. It is accepted that there is a need to find a place of safety for vulnerable people and the police service must continue to be involved in that process where necessary.
Similarly, significant numbers of persons are referred to Accident and Emergency Departments resulting in highly skilled staff caring for individuals who have consumed too much alcohol.
As mentioned in the benefits projected from the project, the following chart shows the number of reports sent to the Procurator Fiscal in 2004 in relation to persons detected for being drunk & incapable. If there were an alternative place of safety for individuals to be taken to this would help reduce the number of reports sent to the Procurator Fiscal service making savings for the Police, Procurator Fiscal and Court System.
| Cupar | Kirkcaldy | Dunfermline | Total |
|---|
No Proceedings | 16 | 64 | 53 | 133 |
|---|
Accepted not guilty | - | 14 | 4 | 18 |
|---|
Admonished | - | 10 | 2 | 12 |
|---|
Fines | 3 | 6 | 2 | 11 |
|---|
Probation order | - | 2 | - | 2 |
|---|
Warning Letter | - | 1 | - | 1 |
|---|
Total reported to pf | 19 | 97 | 61 | 177 |
|---|
Beyond the immediate care issue is the opportunity to improve the health of the individuals involved and the possibility of further long-term savings for the many agencies involved. It is proposed that the issue of alternative places of safety be explored further to assess the most appropriate means of caring for persons under the influence of alcohol.
Over a number of months discussions have taken place with various partners and at a variety of forums. There is broad support to further explore the potential for examining alternative means of caring for people who come to our attention in this condition. Additionally, this proposal supports the Scottish Executive plan for Action on Alcohol Problems.
In the first instance the main partners at this preliminary stage are the health service and the police. Other agencies such as social work department housing departments and others voluntary sector agencies have also been spoken to with high levels of interest expressed.
It is hoped that this bid will be supported to allow joint work to be funded and to explore the options further. It is only through this further work that the various partners would be able to make a proper assessment of the benefits that may accrue from the project and at that stage consider whether or not to progress matters and what priority they may give such a project.