This year, the University of Sunderland is kindly providing its London base as a venue.
Please note that agenda is currently being developed and is subject to change. However, in order to allow you to confidently book your travel in advance, the start and finish times will not change.
10.00 – Registration and refreshments
10.30 – AGM
Members will be asked to accept the annual report and elect people to (or stand for election to) NAAN‘s board of trustees.
11.15 – Open Space
Your most important appropriate adult issues are guaranteed to be on the agenda – because you define the agenda! Bring your challenges and bright ideas and share them with colleagues. Move freely between discussions when you’ve contributed or gained what you could.
12.45 – Networking Lunch
A sandwich buffet lunch and a chance to informally network with AA professionals
13.30 – Panel session: Working together to identify and support vulnerable suspects of all ages.
Recent changes to PACE Code C have placed greater emphasis on identifying vulnerabilities, both in adult and child suspects. What will this look like in practice? How can practitioners from different disciplines work together to ensure suspects get the support they need? We’re putting together a practice-focused panel to stimulate discussions about effective practice.
Panel members include:
- Sgt Chris Bentley (Custody Sergeant, West Yorkshire Police)
- Dr Isabel Clare (Consultant Clinical & Forensic Psychologist, University of Cambridge and former AA)
- David Tremlett (Senior Health Care Professional, UK Association of Forensic Nurses and Paramedics Steering Group Member, Member of The International Association of Forensic Nurses)
- Ivan Trethewey (NHS England Liaison and Diversion)
- Police station legal representative (invited)
- Grev Wallington (NAAN Effective Practice Manager and former AA scheme co-ordinator)
15:15 – Updates and wrap up
15.30 – Close
Dave Tremlett qualified as a Registered General Nurse in October 2001. After spending 2 years working in Elderly Medicine and the community setting he became a Custody Nurse in November 2003. Dave is now approaching his 16th year working in Police Custody and volunteers his time on the steering group for the United Kingdom Association of Forensic Nurses. He is also a member of the International Association of Forensic Nurses and likes to share his daily work on his twitter account @NurseCustody.
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This cross-government Victims Strategy sets out a criminal justice system-wide response to improving the support offered to victims of crime and incorporates actions from all criminal justice agencies, including the police, Criminal Prosecution Service and courts.
This strategy builds on the good progress the Government has made over the past few years to ensure victims have the right help in the aftermath of a crime and are properly supported in the process of seeing justice delivered.
The Government’s vision is for a justice system that supports even more victims to speak up by giving them the certainty that they will be understood, that they will be protected, and that they will be supported throughout their journey, regardless of their circumstances or background.
FFLM | Faculty of Forensic & Legal Medicine Consent from children and young people in police custody in England and Wales for medical examinations
The Faculty of Forensic and Legal Medicine have published guidance for clinicians working in forensic healthcare, specifically police custody, on the therapeutic and forensic considerations for children and young adults.
The legal position of children and young people under the age of 18 years (the legal upper limit of childhood) is different to that of those over 18 years. This legal difference applies to consent to, and refusal of, treatment and examination by child detainees, i.e. those under the age of 18 years. In this document, the terms ‘child’ and ‘young person’ are used interchangeably.
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This year the UK Association of Forensic Nurses and Paramedics (UKAFN) conference will focus upon Adverse Childhood Experiences. Adverse Childhood Experiences are not only very important for Nurses and Paramedics working in Police Custody and Sexual Assault Referral Centres, but their understanding is essential for all those working with individuals within the Criminal Justice System. This will include, but is not limited to:
- Custody nurses / paramedics
- Sexual assault nurse examiners
- Nurses and paramedics working in HM Prison or Youth Offending Institutes
- Forensic healthcare contract managers
- Police custody services
- Police officers, sergeants and inspectors
- Sexual assault examination teams
- Liaison and diversion practitioners
- Appropriate Adults (AA)
- Independent Custody Visitors (ICV)
- Rape crisis workers
- Independent Sexual Violence Adviser (ISVA)
Professionals working in these settings will encounter children who have been or still are being exposed to Adverse Childhood Experiences as well as meeting adults who are suffering the effects of their Adverse Childhood Experiences. This conference will highlight the impact of Adverse Childhood Experiences and the negative effect these have across the individual’s lifespan and focus on how those of us working in police custody of Sexual Assault Referral Centres may be able to help.
The Rt. hon. the Lord Bradley
Rt Hon Lord Bradley PC was first elected as Member of Parliament (MP) for the constituency at the 1987 general election, having served as a councillor in Old Moat Ward (Manchester) since 1983. After the 1997 general election he became a junior minister at the Department of Social Security, and then became Deputy Chief Whip and Treasurer of the Queen’s Household in 1998. He was a junior minister in the Home Office for Criminal Justice, Sentencing, and Law Reform from 2001-2, and then a backbench MP and member of the Health Select Committee. He is a member of the Privy Council.
In 2009, Lord Bradley authored a review of people with mental health problems or learning disabilities in the criminal justice system (the Bradley Report) to examine the extent to which offenders could, in appropriate cases, be diverted from prison to other services and the barriers to such diversion.
Zoe Lodrick | Psychotherapist
‘Psychological trauma associated with ACEs and its long-term legacy’
Zoe will utilise neurobiology to highlight the human response to threat and its purpose in survival. She will then postulate that ‘immediate survival reaction’ (as seen in so many who experience ACEs), has a cost in terms of post-trauma symptomatology. Particularly, as is often the case, the symptomatology is not understood within the context of the traumas experienced and are instead perceived as ‘bad’ behaviour.
Duncan Craig | Survivors Manchester
‘#HeToo Male victims/survivors of VAWG crimes’
This presentation looks at male victims/survivors of sexual abuse and asks why are we still so silent about male sexual violence.
Elicia Curtis and Zoe Cox | REIGN (RECLAIM Project)
‘An ACE childhood on all accounts’
The presentation by REIGN will cover what Child Sexual Exploitation/Abuse (CSE/A) is from a survivors perspective, calling the statutory definition into question; the challenges faced by victims of CSE/A and engagement with services, and the effects of CSE/A as an adverse childhood experience on a young person into adulthood.
What are Adverse Childhood Experiences?
The term Adverse Childhood Experiences (ACEs) is used to describe a wide range of stressful or traumatic experiences that children can be exposed to whilst growing up. ACEs range from experiences that directly harm a child (such as suffering physical, verbal or sexual abuse, and physical or emotional neglect) to those that affect the environment in which a child grows up (including parental separation, domestic violence, mental illness, alcohol abuse, drug use or incarceration). Studies have shown that the more ACEs individuals experience in childhood, the greater their risk of a wide range of health-harming behaviours and diseases as an adult.
Frequencies of Adverse Childhood Experiences
The results of an ACE study in England which found the following:
- 53% have experienced 0 ACE
- 23% have experienced 1 ACE
- 15% have experienced between 2-3 ACEs
- 9% have experienced 4 or more ACEs
The impact of Adverse Childhood Experiences
When exposed to stressful situations, the “fight, flight or freeze” response floods our brain with Corticotrophin-Releasing Hormones (CRH), which usually forms part of a normal and protective response that subsides once the stressful situation passes. However, when repeatedly exposed to ACEs, CRH is continually produced by the brain, which results in the child remaining permanently in this heightened state of alert and unable to return to their natural relaxed and recovered state. Children and young people who are exposed to ACEs, therefore, have increased – and sustained – levels of stress. In this heightened neurological state a young person is unable to think rationally and it is physiologically impossible for them to learn.
ACEs can, therefore, have a negative impact on development in childhood and this can, in turn, give rise to harmful behaviours, social issues and health problems in adulthood. There is now a great deal of research demonstrating that ACEs can negatively affect lifelong mental and physical health by disrupting brain and organ development and by damaging the body’s system for defending against diseases. The more ACEs a child experiences, the greater the chance of health and/or social problems in later life.
ACEs research shows that there is a strong dose-response relationship between ACEs and poor physical and mental health, chronic disease (such as type II diabetes, chronic obstructive pulmonary disease; heart disease; cancer), increased levels of violence, and lower academic success both in childhood and adulthood.
Epidemiological evidence showed that there was an increased risk (adjusted odds ratio) of having health and social problems in adulthood for those individuals who had experienced 4+ ACEs, compared to those with no ACEs. Individuals with 4 or more ACEs were:
- 4 x more likely to have become pregnant or got somebody pregnant under 18 years of age
- 31 x more likely to have had a sexually transmitted infection (STI)
- 2 x more likely to be morbidly obese
- 2 x more likely to have a liver or digestive disease
- 4 x more likely to a regular heavy drinker
- 4 x more likely to be a current smoker
- 10 x more likely to be a heroin or crack user
- 5 x more likely to have been assaulted in the last 12 months
- 8 x more likely to have assaulted someone in the last 12 months
- 9 x more likely to have been arrested or imprisoned
- Free parking
- Free refreshments
- Hot meal
- Prize draw to win a tablet or an accredited forensic photography course
- Free conference bag with goodies
By Train: Stoke-On-Trent train station is ideally located for those travelling from afar. It is situated 0.2 miles, which is only a 5-minute walk from the station to the conference. Stok-On-Trent is serviced by trains from across England, Wales and Scotland.
By Car: From the A500, follow the signs for ‘Staffs University. Pass under the railway bridge. At the roundabout take the first exit. Pass through the first set of lights and at the junction (with the City of Stoke-On-Trent Sixth Form College on the right) stay to the right side of the left-hand lane (marked ‘A52 Leeek’). Continue straight on through the traffic lights along Leek Road. After two pedestrian crossings, continue on a short distance until you reach the next set of traffic lights. You will notice the Staffordshire University main entrance on the right. Turn right onto the campus. See map for printable instructions and map.
Parking: There are five car parks on the Leek Road site at the Stoke-On-Trent campus. Car park 1 is immediately on your left at the mini roundabout. All other car parks can be found by turning right. Please refer to the detailed campus map for the exact locations. POSTCODE FOR CAR PARK: ST4 2DF.
Matthew Peel Latest News criminal justice act, Crisis, custody nurse, custody paramedic, detention, Forensic healthcare, mental health, PACE, police, Police custody, Self-Harm, sexual offences, Suicide
This report published by the Independent Office for Police Conduct presents figures on deaths during or following police contact that happened between 1 April 2017 and 31March 2018. It provides a definitive set of figures for England and Wales, and an overview of the nature and circumstances in which these deaths occurred.
This publication is the fourteenth in a series of statistical reports on this subject, published annually by the Independent Office for Police Conduct, formerly the Independent Police Complaints Commission (IPCC). On January 8 2018, IPCC became the Independent Office for Police Conduct. This change was set out in the Policing and Crime Act 2017. The change was made because the IPCC had double in size since 2013, taking on six times as many investigations – and we asked the Government for structural changes to better suit our much-expanded organisation. To produce these statistics, the IOPC examines the circumstances of all deaths that are referred to us. We decide whether the deaths meet the criteria for inclusion in the report under one of the following categories:
- road traffic fatalities
- fatal shootings
- deaths in or following police custody> apparent suicides following police custody
- other deaths following police contact that were subject to an independent investigation
Come and listen to some dynamic speakers with a snappy, action-packed agenda:
- Dr James Taylor BSc MBChB MRCS FRCA FFPMRCA FFICM Consultant in Pain Management, Intensive Care Medicine and Anaesthesia. Associate Medical Director at Bradford Teaching Hospitals Foundation NHS Trust. Seminar: A series of case-based discussions to improve prescribing of strong opioids and gabapentinoids for chronic non-cancer pain and to guide strong opioid reduction in primary care. Please bring a case you are finding challenging. James is a Member of Professional Standards Committee for Faculty of Pain Medicine RCoA. Co-editor of Core Standards in Pain Management service in UK RCoA. Co-author Guidelines for the Provision of Anaesthesia Services (GPAS) Guidance on the Provision of Anaesthesia Services for Acute Pain Services. Pain in a secure environment RCoA/PHE faculty member.
- Dr Soraya Mayet BSc, MBBS, PGCert, FRCPsych, MD Consultant Psychiatrist Addictions. Humber NHS FT/Honorary Senior Lecturer – HYMS. Lecture.
- Dr Joanne Thomas, Associate Medical Director, Spectrum. Experienced Researcher, Lead and Practitioner in General Practice, CDTS and Secure Environments. Lecture: Focussing on Medicolegal aspects of prescribing at this conference.
- Dr Sarah Alderson, GP and NIHR Academic Clinical Lecturer in Primary Care. Researcher, Lecturer and GP, Seminar: Reducing harmful opioid prescribing in Primary Care. The majority of opioid prescribing occurs in primary care for chronic pain. The number of patients taking long-term opioids has doubled in the past five years and those taking strong opioids has increased 10-fold. With one-quarter of patients taking opioids above levels recommended by national guidelines, there is a pressing need to address prescribing in primary care. Dr Alderson will explain how the Campaign to Reduce Opioid Prescribing in West Yorkshire successfully reduced opioid prescriptions for chronic pain in primary care using case studies and example practices.
- Mr Graeme Dixon – Service manager for Agencia. He leads the team in delivering the Opioid and Analgesic Dependence project which has attracted regional and national interest and won an award at the RCGP Substance Misuse Conference. Seminar: Getting ahead of the Game. In this seminar, Graeme will share the experience of creating and running a service specifically designed to identify patients at risk of developing an addiction to prescribed and over-the-counter painkillers. It includes case studies, outcomes, results and some myth-busting. The seminar is highly interactive with a focus on how behaviours can be changed for the benefit of patients and health professionals.
- Dr. Dan Roper – Chair Hull Clinical Commissioning Group (C.C.G). Dan was born in Hull. After graduating at Edinburgh University he completed his GP training in Hull and then worked in the city as a GP for 30 years. He was involved in the training of new GPs for 25 years and medical students for over 10 years. The interpretation of art and culture in the context of understanding human behaviour and change has always been an interest and has been integrated into his educational methods. Hull CCG was a committed sponsor of the Hull City of Culture and Dan spoke about Arts and the NHS at the Hull Substance Festival Dan cares deeply about improving the city’s health and has a long history of working with local organisations to promote health issues and equality of opportunity.
This month sees the Faculty of Forensic and Legal Medicine‘s (FFLM) publication ‘Recommendations for the collection of forensic specimens from complainants and suspects‘ for the collection of forensic specimens updated. The Forensic Science Sub-Committee, which UKAFN is represented, meets every six months to review and revise the recommendations as appropriate.
The Forensic Science Sub-Committee also considers questions sent in by members of FFLM and other interested parties, including UKAFN members. Here are the questions with answers from the last six months.
Check your email inbox for this Summers UKAFN newsletter . The newsletter has been emailed to all members. UKAFN have moved to using MailChimp to send out the newsletters, if you have not received your newsletter email, firstly please check your ‘Junk’ email folder, if still not received an email please contact UKAFN.
This edition includes;
Alcohol withdrawal Pathophysiology
Taken with consent – Medical photography
Farewell to Steve McKean
Sexual offensive focus
Police custody focus
Competitions to be won
Members can access the newsletter in the ‘Members only area’
The European Drug Report 2018: Trends and Developments provides a timely insight into Europe’s drug problems and responses. The European Monitoring Centre for Drug and Drug Addiction (EMCDDA) flagship report is built on a thorough review of European and national data that highlights emerging patterns and issues. This year it is accompanied online by 30 Country Drug Reports and resources containing full data arrays and graphics, allowing an overview for each country.
Michael Linnell of Linnell Communications (www.michaelllinnell.org.uk) has provided a brief summary.
Overall internet sales have ensured Europe is now in a global market.
Cocaine. Indications are that cocaine supply has increased along with purity, with signs of rising use and an increase in cocaine users seeking treatment.
Fentanyl and new opioids: Five fentanyl derivatives were investigated in 2017. These substances were available in a number of novel forms including nasal sprays. They were also sometimes found mixed with other drugs, such as heroin, cocaine or fake medicines, with the consequence of users often being unaware that they were consuming the substance. Overall, 38 new opioids have been detected on Europe’s drug market since 2009 — including 13 reported for the first time in 2017. This includes 28 fentanyl derivatives, 10 of which were reported for the first time in 2017.
Synthetic cannabinoids: are increasingly linked to health problems and the largest group of new substances monitored by the EMCDDA and are becoming increasingly chemically diverse, with 179 detected since 2008 — including 10 reported in 2017. In the United Kingdom, use of synthetic cannabinoids among prisoners is of particular concern. A survey conducted in 2016 in UK prisons found 33 % of the 625 inmates reported the use of ‘Spice’ in the last month; in comparison, 14 % reported last month cannabis use.
Naloxone: Responding to opioid overdose: the role of naloxone Prisons: an important setting for implementing responses.
Heroin: seizures in terms of quantity declines. The discovery of several laboratories for converting morphine to heroin in the Netherlands, Spain and the Czech Republic in recent years suggests that some heroin is manufactured in Europe. According to available trend data, the number of first-time heroin clients more than halved from a peak in 2007 to a low point in 2013 before stabilising in recent years.
Overdose: It is estimated that at least 7,929 overdose deaths, involving one or more illicit drug, occurred in the European Union in 2016. This rises to an estimated 9,138 deaths if Norway and Turkey are included, representing a 4 % increase from the revised 2015 figure of 8,749; the EU situation is overall stable compared with 2015. As in previous years, the United Kingdom (34 %) and Germany (15 %) together account for around half of the European total. The most recent data show an increase in the number of heroin-related deaths in Europe, notably in the United Kingdom, where the majority of overdose deaths (87 %) involved some form of opioid.
MDMA: increased production and seizures. Until recently, in many countries, MDMA prevalence had been on the decline from peak levels attained in the early to mid-2000s. In recent years, however, monitoring sources suggest stabilisation or increased use of MDMA in some countries.
Other drugs: ketamine and GHB remain low: Seizures of other illicit drugs are reported in the European Union, including around 1,800 seizures of LSD (lysergic acid diethylamide) in 2016, amounting to 97, 000 units. The overall number of LSD seizures has almost doubled since 2010, although the quantity seized has fluctuated.
New benzodiazepines: The EMCDDA is currently monitoring 23 new benzodiazepines — 3 of which were detected for the first time in Europe in 2017. Some new benzodiazepines are sold as tablets, capsules or powders under their own names. In other cases, counterfeiters use these substances to produce fake versions of commonly prescribed anti-anxiety medicines, such as diazepam and alprazolam, which are sold directly on the illicit drug market. While the number of seizures of benzodiazepines decreased in 2016 compared with 2015, the quantity seized increased significantly. During 2016, more than half a million tablets containing new benzodiazepines such as diclazepam, etizolam, flubromazolam, flunitrazolam and fonazepam were seized — an increase of about two-thirds on the number reported in 2015.