SONAR CMS Data Portal

I have already written about SONAR’s ability to join up healthcare information across criminal justice settings. The quality of healthcare information is also crucial.

The SONAR Data Portal – Which went live in a custodial setting for the first time last week – is designed to help managers identify problems in their data, as well as support their decision-making.

Coroners’ reports regularly highlight the harm that can arise from poor collection and entry of data. In one example, healthcare professionals in a police custody suite did not enter the correct level of risk on the electronic custody record, and were not sure of the meaning of the grade of risk:

““During the course of the evidence, it became apparent that the HCPs were not using objective and/or consistent criteria to assess the risk of [redacted], meaning that (a) the grade of risk assigned to AF was inconsistent and/ or inaccurate and (b) no one else knew what was meant by the grade of risk recorded in the electronic custody record. (2) Further, none of the HCPs who gave evidence used the criteria described in the online training materials.”

In another example, an offender did not receive a mental health screening within 48 hours, which was the procedure. The offender was also logged under different names, so that his information was incomplete:

“For example, according to the mental health team, multiple prison stays, under different names meant that Mr Kunarathnam's records were not easy to find. Records were kept but often not shared with others at the correct time.”

Last week, a new NHS England review of health and social care in women’s prisons recommended that prisons collect a wider range of data so that managers and researchers can better understand whether different groups of women experience services differently.

The SONAR Data Portal responds to all of these concerns. In terms of data quality, it will flag up data errors in existing criminal justice healthcare records systems. It will identify gaps in offender health records – for example, records which do not have NHS numbers.

For managers, it will generate reports on performance against KPIs, allowing managers to identify necessary improvements in services. And it will support joined-up thinking around resettlement and rehabilitation. For example, it could flag prisons which have a high number of offenders without a registered abode, and therefore a need for housing support.

Excellent healthcare information in criminal justice is not only joined-up but also accurate and actionable. I hope the SONAR Data Portal is a good way to achieve this.

Restorative Justice - Thriving Survivors

Last week SONAR was proud to be a headline sponsor of the annual conference of Thriving Survivors, a Glasgow-based charity delivering restorative justice services.

Like SONAR, Thriving Survivors uses a healthcare-based approach to improving outcomes in justice and wider service provisions. We were thrilled to be part of the conference and to engage with so many other people passionate about improving health, justice and survivor led approaches.

Restorative justice means the bringing-together of people responsible for harm and victims/survivors, either face-to-face or indirectly. It aims to give victims/survivors their voice and to help people responsible for harm understand the consequences of their actions.

The Restorative Justice Council outlines the practice of Restorative Justice using the following six key principles:

1. Restoration – the primary aim of restorative practice is to address participants needs and not cause further harm. The focus of any process must be on promoting restorative practice that is helpful, explores relationships and builds resilience.

2. Voluntarism – participation in restorative practice is voluntary and based on open, informed, and ongoing choice and consent. Everyone has the right to withdraw at any point.

3. Impartiality – restorative practitioners must remain impartial and ensure their restorative practice is respectful, non-discriminatory, and unbiased towards all participants. Practitioners must be able to recognise potential conflicts of interest which could affect their impartiality.

4. Safety – processes and practice aim to ensure the safety of all participants and create a safe space for the expression of feelings and views which must result in no further harm being caused.

5. Accessibility – restorative practice must be respectful and inclusive of any diversity needs such as mental health conditions, disability, cultural, religious, race, gender, or sexual identity.

6. Empowerment – restorative practice must support individuals to feel more confident in making their own informed choices to find solutions and ways forward which best meet their needs.

According to the Ministry of Justice, Sir Charles Pollard, the former chief constable of Thames Valley Police, was the key pioneer of restorative justice for adults in the UK when he introduced it to his force in the 1990s. The MoJ then commissioned research which found that it led to reductions in offending of up to 14 per cent.

It has been part of mainstream government policy since the 2010 green paper “Breaking the cycle”. The College of Policing has collected the up-to-date evidence of its positive impact, including reductions in post-traumatic stress symptoms in victims, reduced reoffending and (as a result) reduced costs to the criminal justice system.

Influenced by the work of Dr Judith Herman of Harvard Medical School, who spoke at the conference, Thriving Survivors seeks to help people understand and recover from the trauma that they have undergone. They believe that this process of “restoration” – of reflection and understanding – can benefit all of society. As they argue: approaching life “through a restorative lens … will allow individuals to experience full, healthy and fulfilled lives, which in turn will create a prosperous and a restorative Scotland.” That is a fantastic goal which has my full support.

Thank you, Thriving Survivors, for letting us be part of this important event.

Scotland - SONAR CMS

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.