de Viggiani Nick
University of The West of England, Department of Health and Applied Social Sciences, Faculty of Health and Life Sciences, Glenside Campus, Blackberry Hill, Stapleton, Bristol BS16 1DD, United Kingdom.
J Forensic Leg Med. 2013 Aug;20(6):610-7. doi: 10.1016/j.jflm.2013.03.014. Epub 2013 Mar 28.
Police custody healthcare services for detainees in the UK are most commonly outsourced to independent healthcare providers who employ custody nurses and forensic physicians to deliver forensic healthcare services. A pilot was introduced in 2008 by the Department of Health to explore the efficacy of commissioning custody healthcare via the NHS, in the wake of the 2005-2006 shift of prison healthcare to the NHS. The objective was to improve quality and accountability through NHS commissioning and the introduction of NHS governance to the management and delivery of custody healthcare. This article discusses key themes that arose from the project evaluation, which focused on the commissioning relationship between the police, the NHS commissioner and the private healthcare provider. The evaluation observed an evolving relationship between the police, the local NHS and the front-line nurses, which was complicated by the quite distinctive professional values and ideologies operating, with their contrasting organisational imperatives and discordant values and principles. A key challenge for commissioners is to develop synergy between operational and strategically located stakeholders so that they can work effectively towards common goals. Government policy appears to remain focused on creating safe, supportive and humane custody environments that balance criminal justice and health imperatives and support the rights and needs of detainees, victims, professionals and the public. This remains an ambitious agenda and presents a major challenge for new criminal justice health partnerships.
在英国，为被拘留者提供的警察羁押医疗服务大多外包给独立医疗服务提供商，这些提供商雇佣羁押护士和法医来提供法医医疗服务。2005 - 2006年监狱医疗服务转由国民保健服务体系（NHS）负责后，2008年卫生部推出了一个试点项目，以探索通过NHS委托提供羁押医疗服务的成效。其目标是通过NHS委托以及将NHS管理模式引入羁押医疗服务的管理和提供过程来提高质量和加强问责制。本文讨论了项目评估中出现的关键主题，该评估聚焦于警方、NHS委托方和私立医疗服务提供商之间的委托关系。评估发现警方、当地NHS和一线护士之间的关系在不断演变，由于存在截然不同的专业价值观和意识形态，以及相互矛盾的组织要求和不一致的价值观及原则，这种关系变得复杂起来。委托方面临的一个关键挑战是在一线和战略层面的利益相关者之间形成协同效应，以便他们能够朝着共同目标有效合作。政府政策似乎仍侧重于营造安全、支持性和人道的羁押环境，平衡刑事司法和健康需求，并支持被拘留者、受害者、专业人员和公众的权利及需求。这仍是一项雄心勃勃的议程，对新的刑事司法与健康伙伴关系构成重大挑战。
