28 August 2015

Police – The New Health Workers?

Just by way of introduction, I have been invited to become the police special adviser on the NHS Alliance National Executive. I am a retired police officer with considerable experience in achieving health outcomes in disadvantaged neighbourhoods whilst working towards policing objectives. I am an honorary fellow at the University of Exeter Medical School and a Council of Europe “Expert” in the field of access to social rights.

NHS Alliance believes that primary care can have a role in addressing the social determinants of health in new ways and to do so we need partnerships beyond social care; with housing, fire services and now… the police.

We don’t have enough NHS resources so we need to build new relationships and work smarter. This series of blogs comprise summarised extracts from my book, Connecting with People (available on itunes, Amazon or from the publisher Kingsham Press) are intended to help you consider how that might be achieved.

In 2004, I became the Police Neighbourhood Sergeant for Camborne in Cornwall. The first problem was that we didn’t know how to do neighbourhood policing and everyone that did had retired. So, we did more of what we knew how to do; knocking down doors, arresting people for drugs and theft offences and not really having any social impact at all.

Then came the seminal moment, which led to my police team working with the health service and making social and health impacts on the neighbourhoods. I attended a local strategic partnership meeting convened to discuss how the partnership’s executives could be trained in aspects of “deprivation”. Following an intriguing presentation on the relationship between regeneration and learning, the facilitator asked, “Can we take it that all of us understand what deprivation means?” The group collectively agreed that it could except for Hazel Stuteley OBE, a community nurse who stood up to make the point that to understand what deprivation means you have to ‘live’ it. I agreed with her suggesting that within agencies the people best placed to understand deprivation are those that cross people’s thresholds and even then they will probably only understand 10% of it unless they internalise the lived experience of residents or have experienced that way of life. You could have heard a pin drop. It was like I had denied the holocaust.

Later, the meeting was divided into work groups with the customary flipcharts and marker pens. The facilitator suggested topics for discussion in groups and said,“Anyone that wants to learn more about deprivation, go with Hazel.” Nobody did except me and I found a source of learning for my neighbourhood police team within the health service.

Following a series of training days that were delivered by The Health Complexity Group at Exeter University to my police neighbourhood team we set about a new way of working that relied on the team positioning itself legitimately at the periphery of the local communities we served.

The introduction of Police Community Support Officers (PCSOs) gave the team unprecedented access to the neighbourhoods. Funding by the Neighbourhood Renewal Fund (NRF) and subject to monthly reports on their social impacts, including health, directed the PCSOs and subsequently police officers to look for health outcomes in their police interventions. Learning from the Health Complexity Group glued this all together.

A neighbourhood police sergeant in a nearby town had the same provision of NRF funding as me and used it to execute more drugs warrants claiming health outcomes. Seen from a police perspective his approach was more successful than mine in the short term. In the medium term the social impacts and health outcomes of my approach were extraordinary and I will describe them in future blogs. The following are appetisers for you:

The local health visitors’ team leader and I agreed that I would pass police information to her when I thought it pertained to a child’s health under the auspices of the Crime and Disorder Act. I visited the health centre and passed information that we had found a 15 year old girl in the arms of a homeless man in a local graveyard. A community midwife at the other end of the room interrupted, “I thought she might be pregnant, I’ll see her again.”

The team worked with the Health Promotion Service on their street games project. All of the team were trained by the Health Promotion Service and achieve Level 1 Sports Coaching Awards. They then set about organising street games in the town. An immediate effect was that children started talking to the police, looking forward to their regular visits to their estates and anti-social behaviour went down. The school noticed this and invited us into their truancy meetings and attendance and achievement went up. This led us to start free regular dance workshops for children (more on that in a later blog) and the local school reported that children stopped arriving at school with hangovers and started to learn and become healthier.

If you are wondering, what evidence do you have to support this? We gathered a great deal of anecdotal evidence and community stories, and most importantly we used NICE Public Health Guidance PH17Promoting Physical Activity for Children and Young People, to shape our police neighbourhood practice, so of course we had good social and health impacts. This is what led Adam Brimelow, the BBC health correspondent to describe my police neighbourhood team as a ‘special health service’ on the BBC Radio 4 Today Programme in 2009.