Arresting ideas

Linda Davidson

What would Dr Theodore Dalrymple say? The cynical doyenne of custodial healthcare and columnist beloved of Spectator readers has had his patch invaded by paramedics, nurses …and technology.

Essex Medical and Forensic Services (EMFS), a medical service used by four police forces, has become the first UK early adopter customer for Microsoft Dynamics CRM version 3.

The company uses the software to underpin its business which involves mobilising health professionals – nurses, paramedics and doctors – to attend people detained in police custody.

EMFS’ outsourced service replaces the traditional role of police surgeons – GPs who take part in a rota to attend detainees. The work can involve anything from examining a rape victim to treating a suspected shoplifter who suffers an angina attack after the shock of being arrested. Many cases involve people who use drugs or are drunk.

Outsourcing 

The GPs’ new contract and reduced out-of-hours working prompted a re-think in some forces and a consortium covering Bedfordshire, Cambridgeshire, Essex and Suffolk decided to change to an outsourced service last year.

EMFS won the contract. The company was set up last year by medical director, Dr Adam Cutts, who served previously in the traditional police surgeon service, and business director, Steve Roberts. From a standing start EMFS now answers 200 calls a day from a contact centre in Essex and has 150 health professionals on its books.

Familiar hospital and GP systems were rejected because they were “so hospital or GP based”. For example, Roberts said, GP systems stored details of 10,000 different drugs whereas only 12 were used in a custody environment.

e-Business solution provider, Aspective, implemented Microsoft CRM version1.2 for EFMS in April 2004 with a view to moving the version 3.

Roberts explained: “We inherited a massive paper-based system and process. There was little overall visibility of rota staff. We needed to be able to see where everyone was to give the police a good estimate of our time of arrival.”

Version 3’s rota functionality was one of the key selling points along with improved customisation and savings on data entry time. Roberts says the upgrade was done within 24 hours and “all errors were within our domain.” A 25% efficiency gain in data entry speed and “massive” improvements in reporting have been achieved.

One hour time limit

The company is committed to fielding a health professional within one hour of call out (or two hours if this is agreed with the customer) round-the-clock. A smooth running routine is vital to meet these standards.

Call outs are triggered by a phone message from one of the 40 sites where detainees can be kept in custody. The system tells EFMS where the call is coming so, for example, call handlers can see whether it is coming from a sympathy suite where the victims of sexual offences are examined.

“We’d know it was coming from a sympathy suite and would get an agent with the right skills. We’ve got that capability in there,” says Roberts.

EFMS also has a pool of Section 12 approved doctors who can assess a person who appears to have mental health problems and determine whether they need psychiatric care.

Health professionals get details of the case over the phone and can, in extreme cases, tell the police to take the detainee straight to hospital. Otherwise they go along to the custody site and send a text message to confirm they have arrived.

Next steps

Paper records are made at the custody site and these are later scanned into the CRM system. Roberts says time could be saved with electronic recording and this is one of the company’s next planned steps.

The hope is that eventually all the information about detainees will be co-ordinated under the National Strategy for Police Information Systems (NSPIS) and that when the system is fully rolled out nationally, third party suppliers will be looked at.

There is no planned integration with records on the NHS Spine yet. EFMS tries to keep patients’ GPs informed but finds detainees often have no GP.

Feedback is encouraging with other police forces expressing interest in service. Roberts says: “We believe we now have a system that supports us for growth and we want to cover a large part of the country.”

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