Adam’s Story – What is it like working as an Enhanced Care Practitioner in a police custody environment?

Adam’s Story – What is it like working as an Enhanced Care Practitioner in a police custody environment?

Are you someone that thrives on independence? Perhaps you have prior experience in fields such as A&E or ITU? Perhaps you’ve previously worked as a paramedic but are ready for a new challenge? These are just some of the backgrounds that lend themselves well to a career in custody healthcare.

We sat down with Adam Pooley, one of our Essex based Enhanced Care Practitioners to talk about his career working in custody healthcare with CRG Medical Services.

Tell us a little about what your role as an Enhanced Care Practitioner is all about.

“My job role now as a Enhanced Care Practitioner is about staff management – supporting the staff and offering assistance when required. Outside of my management duties I have a clinical role to respond to things like sudden deaths, hospital bloods and intimate searches.”

What’s your career background? What did you do before working as an Enhanced Care Practitioner?

“My background is nursing – I previously worked in A&E and ITU, I’ve worked in Anaesthetics and post-op recovery as well. I came over to forensic medicine in 2013, and throughout that time have worked in lots of police forces – the Met, down south in Wiltshire and up north in Nottingham as well.”

What drew you to working in forensic medicine?

“I worked with a guy in A&E who did it. I was a junior nurse at the time and he was my shift lead, and he was doing custody work part time. Through talking to him I got interested, and one day he took me out with him so I could see what it was like, and the rest is history! I fell in love with it, so here I am all these years later!”

Were there any misconceptions you had about working in custody? What surprised you the most about it?

“From the point of view of working alongside the police and in custody settings, safety was always something that was a concern, certainly in the beginning when I first started. What I quickly realised is you are so much safer working in a police station than you are in any other healthcare job! When I was in A&E we had a lot of violent and aggressive people, and if anything ever happened you’d have to wait for the police to arrive. Here you’ve got lots of police around you – everyone wants to protect the medic! I think people would be surprised how well we are looked after by the police.”

Is there a typical day in the life when you’re a HCP?

“We do 12 hour shifts, from 7 til 7. We’ll do two days, two nights followed by four off. I normally start by logging on with the Call Centre before my shift starts and find out what’s going on across the county – making sure we’re fully staffed and none’s off sick or any last minute absences. Then I’ll go to my nearest custody suite and log on, then it’s time to start checking in with staff. Prior to starting shift I’ll try to plan my day – who I need to go and see, if I need to go and do supervisions etc. It doesn’t always go to plan – I have clinical duties, so there may be other things I need to see to first.”

“This role is most like A&E triage – anything could come through the door! We see a lot with diabetes and epilepsy, a huge part of the role is dealing with substance misuse, alcohol dependency, mental health – it’s about knowing a little bit about a lot! We always have an FME who works remotely who we’ve got as backup, but anything could come through those doors so we have to be ready!”

It sounds like it is a really mixed day! What are the most important skills or personality traits for someone wanting to work in custody healthcare?

“First of all it’s about having a core knowledge base – A&E and ITU background helps with that, and paramedic tends to thrive in this kind of role because of their background being out working on their own. It’s about being empathetic, having communication skills and being able to talk people down.”

“We do get grumpy people in – now I’m no threat, this isn’t a threatening face! We’re not in police uniforms, actually away from the custody environment outside, in here it could just be their GP they’ve come to see – we’ve got a couch, it’s a clinical environment for them, so people tend to open up. It’s about using your communication skills, being an advocate – it’s about being impartial as well. Just because someone’s being arrested, it doesn’t mean they’re guilty, but they could be a victim. It’s about knowing what questions to ask and how to obtain the information you need so we can best help the DP with onward referrals and outside organisation that we work with.”

What have been the biggest challenges and learning curves?

“From a healthcare professional point of view, even coming from an A&E background, it was very apparent I was on my own. I was the only medically trained person on site, my team effectively went from lots of experienced doctors and nurses to the police who aren’t medically qualified. That was a massive challenge in the beginning. Whatever role you’ve done before, working in custody is a very different environment but it’s a fantastic one, I would encourage anyone to do it.”

“Moving onto the ECP managerial side, my personality is actually quite soft, so when I first became a manager and had to do disciplinaries and investigations, I did find it difficult to put on that managers hat, so I’ve had to work on that and become more assertive – I think I’ve got over that not so it’s all good!”

What have been the most rewarding aspects of your role?

“When we receive feedback, these organisations we refer people onto literally turn people’s lives around. It’s wonderful when you see somebody that’s turned their life around because of your referral…everybody has a story – I like to learn about people and get those stories out of people. Whatever the outcome from a clinical justice point of view, everybody has a story and we can help people, and I find that very very rewarding.”

2020 has been a challenge for the whole healthcare sector – what were the biggest challenges affecting your work?

“People would come in at the beginning of the first lockdown all “I have coronavirus, you need to stay away from me” – I think they believed that would be a way to get themselves out of custody! There’d be a lot of spitting (albeit not towards medical staff) and violence towards the police and that was really challenging, because at the beginning we didn’t have a real way of telling if someone was positive or how we were going to manage that. Just like for the NHS and other organisations, it’s been a steep learning curve for all involved.”

Why should someone consider a career in custody healthcare?

“It’s just so rewarding. No-one’s born a drug user, it’s about digging in deep because some people want that help and we can do those referrals. Others don’t want your help, they’re not willing to accept they have a problem, and that’s ok too because I have no doubt there will come a point where they want that help. Remain open minded and let’s go out and help these people!”

Is there any final advice you’d like to give about working as a custody nurse or custody healthcare practitioner for CRG Medical Services?  

“It’s so different from any other healthcare role. Come and try it out and I’m sure like myself you’ll fall in love with it!”

Are you interested in exploring a career in custody healthcare? We’re currently looking to speak to experienced nurses and paramedics across the country for a variety of roles – check out our latest jobs online or email your CV to to discuss working for CRG Medical Services.

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