National Preventive Mechanism Tenth Annual Report 2018–19 Police custody NPM members highlighted the considerable vulnerability and health care needs of many people in police custody, where the ongoing high use of force across England, Wales and Scotland remained a serious concern. HMICS found that across the 17 custody centres it inspected in Scotland, staff were committed to providing a good standard of care, but the quality of the custodial environment varied and was often poor, hampering the effective and efficient management of detainees. HMICS raised concerns around the inconsistencies in practice between custody centres, as well as the ability to safeguard the health care needs of highly vulnerable detainees.74 In England and Wales, there were 16 deaths in or following police custody during the year, a decrease on the 23 in the previous year. Fourteen of these were men and two were women. Ten people were identified as having mental health concerns. There were 63 apparent suicides following police custody.75 In the nine reports of inspections of police forces in England and Wales published during 2018–19, the governance and oversight of the use of force was a cause of concern in five of them, and an area for improvement in the remaining four.76 Other areas of concern included the ongoing presence of ligature points in custody suites; poor recording on custody records with the reasons for some decisions not clear enough; and some long waits for children and vulnerable adults before receiving support from an appropriate adult.77 Too few forces were recording information about the ethnicity or other protected characteristics of detainees. Greater investment and improvements in mental health support were noted in all the forces inspected, and inspectors found that people with mental illness were being held in cells as a place of safety (under section 136 of the Mental Health Act 1983) only in exceptional circumstances. This followed amendments to the Act intended to limit the use of police stations as a place of safety which came into force in December 2017. However, for those who were held, waiting times for assessment and transfer under the Mental Health Act remained high.78 Independent Custody Visitors reported that detainees were largely being treated with dignity by staff and noted improvements in the menstrual care provided to women and girls in police custody. Inspections continued to find children being detained unnecessarily in police cells, often because suitable alternative accommodation, such as local authority beds, was not available. 74 HM Inspectorate of Constabulary in Scotland, October 2018, Inspection of Custody Centres across Scotland, https://www. hmics.scot/sites/default/files/publications/HMICS20181019PUB.pdf [accessed 13/01/20] 75 Independent Police Complaints Commission, 2019, Deaths during or following police contact: Statistics for England and Wales for 2018/19, https://www.policeconduct.gov.uk/sites/default/files/Documents/statistics/deaths_during_following_ police_contact_201819.pdf [accessed 17/10/2019] 76 HM Inspectorate of Prisons, 2019, HM Chief Inspector of Prison for England and Wales Annual report 2018–19, https:// www.justiceinspectorates.gov.uk/hmiprisons/inspections/annual-report-2018-19/ [accessed 13/01/20]. 77 HM Inspectorate of Constabulary and Fire & Rescue Services, 2018, State of Policing. The Annual Assessment of Policing in England and Wales, https://www.justiceinspectorates.gov.uk/hmicfrs/wp-content/uploads/state-of-policing-2018.pdf [accessed 05/12/19] 78 Ibid. 30