Tackling health inequalities through integrated care in English police custodies: an inclusion perspective and model of care
ISSN: 1476-9018
Article publication date: 19 December 2023
Issue publication date: 26 April 2024
Abstract
Purpose
The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health and social care legislation to employ historically underused services, such as police custody healthcare providers, in addressing health inequalities.
Design/methodology/approach
This research analyses the policy approaches to tackling health inequalities in the UK in the past 40 years with an emphasis on those experienced by the people detained in English police custodies. It analyses the current model of healthcare in police custody and proposes a novel integrated model of care and joint commissioning opportunities in funding it.
Findings
Policies to tackle health inequalities have largely failed, as they became entrenched. But recent changes in the health and social care legislation in England offer opportunities to address them by employing historically underused healthcare services, such as those operating in police custodies.
Research limitations/implications
The research does not touch upon ethical considerations related to the patient privacy aspect of integrated care. Interventions by and interactions with police custody healthcare providers would be visible to all professionals with access to the patient’s health record. As with all novel interventions or innovative models of care, the effectiveness of such clinical interventions remains to be established by further research. It opens a new line of research on quality improvement through integration of care and explores understudied aspects of joint commissioning of integrated care.
Practical implications
It offers health commissioners and public health leaders the opportunity to employ police custody healthcare services in reaching their population health management objectives and meeting their health inequalities objectives at local level. It also gives police and crime commissioners the opportunity to address the health drivers of criminal behaviour that overlap with health inequalities. It offers funding opportunities presented by jointly commissioning services at lower costs to both police and health commissioners alike. It improves the health outcomes of historically underserved populations by facilitating access to health and social care services and facilities.
Social implications
Reducing health inequalities and disparities in health outcomes can decrease the costs of the healthcare services over the long term and might contribute to reducing criminality by addressing inequities and some health drivers of criminal behaviour.
Originality/value
The paper explores understudied opportunities offered by the recent changes in health and social care legislation in England and includes underused resources to tackle health inequalities.
Keywords
Acknowledgements
The author would like to express his appreciation to Sergeant Mark Anstead and Sergeant Pete McKay from Sussex Police for their relentless efforts in continuously seeking to improving the safety of those detained in police custody. Quality improvement conversations with them were the foundation on which this entire paper sits.
The author would like to express his heartfelt gratitude to Breda Flaherty, Course Leader and Principal Lecturer at Brighton and Sussex Medical School for her academic support and guidance, expertise and encouragement. Her accommodating and inspiring professorship was invaluable in many ways in starting, continuing and completing this work.
The author is deeply grateful to Thomas Bird, Lead Senior Healthcare Professional, Sussex contract at Care & Custody for his clinical, managerial and commissioning expertise and feedback.
Finally, the author would like to thank his wife, Natalia Schimbator, for her unwavering, patient and accommodating support for the duration of this research and beyond it.
Citation
Picior, M. (2024), "Tackling health inequalities through integrated care in English police custodies: an inclusion perspective and model of care", Journal of Integrated Care, Vol. 32 No. 2, pp. 131-144. https://doi.org/10.1108/JICA-04-2023-0022
Publisher
:Emerald Publishing Limited
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