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Scotland - SONAR

In our last blog, we looked at the arguments for better healthcare in police custody in England and Wales. But – writing as a Scot, living in Glasgow – those countries are not the whole story. Scotland has its own challenges and its own reasons for considering ideas such as SONAR.


In January 2023, the key Scottish regulators for healthcare and police (Healthcare Improvement Scotland and His Majesty’s Inspectorate for Constabulary in Scotland) came together for the first time to review standards of healthcare in Scottish police custody.


The Scottish environment makes effective healthcare in police custody all the more important. Sadly, as the review highlighted, “drug deaths in Scotland are the highest in Europe with Scotland’s drug misuse rate currently 3.7 times that of the UK as a whole and higher than any European country”. This matters because people with psychiatric illnesses and psychotic disorders run a higher risk of police arrests compared to the general population. As a result, the inspectorate wanted healthcare teams in Scottish custody centres to “maximise opportunities to provide timely interventions to help improve health outcomes for people in their care”.


The inspectorate found a wide range of variation in the basic task of providing access to healthcare in custody. People in custody suites saw different types of healthcare professional depending on their location. They were seen at differing speeds, with targets for healthcare access varying between one and four hours.


Most relevant to SONAR, there was significant concern about the capturing and reporting of healthcare data. The Scottish report concluded:


“There was a recognition that improvement is needed in how services capture and report on healthcare data and key performance indicators in the context of police custody. There was consensus across all NHS Scotland boards that the current electronic system for recording healthcare data (Adastra) is not fit for purpose and does not support the comparison of clinical data nor enable national reporting.”


Looking more widely across the criminal justice system, inspection reports for Scottish prisons have also raised concerns over consistent provision of healthcare. The recent inspection reports for HMP Kilmarnock and HMP Edinburgh both reported concerns over accurate and timely provision of medication to prisoners.


SONAR and Police Scotland Custody


Following the report, Healthcare Improvement Scotland published a new draft framework for future inspections of police custody. It included several criteria for effective recording of healthcare information:


“Each patient seen by healthcare staff has a clinical record containing an up-to-date assessment.”


“Any contact with a healthcare practitioner is recorded on Police Scotland’s electronic custody system and a record made of any medication provided.”


These capabilities are at the heart of the SONAR case management system for police custody (SONAR Custody). SONAR has purpose-built screens for data entry, enabling the accurate and consistent recording of healthcare data, including medication. Since it can be accessed online, authorised staff can read healthcare data wherever is most convenient, from a healthcare professional’s medical room to a desktop PC in a prison.


SONAR also produces real time data to enable managers to improve the quality of service.


We look forward to joining the debate on the improvement of healthcare in criminal justice in every part of the UK.




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