police and the ED

see also:

• when are doctors required to compulsorily report patients in Australia
• searching patients, suspicious behaviour, unknown substance, weapons or crime within the ED

• In Australia, police are to be contacted on “000” (not the local police station) and will require:
  • Name, telephone number and location of incident;
  • The immediate safety threat;
  • What the person is saying or doing;
  • Whether the person is affected by alcohol or drugs;
  • Whether weapons are present;
  • Who else is present;
  • Any other information which may assist with the police response.

• If medical staff are unable to manage a person's behaviour through internal clinical guidelines and procedures, a Code Grey must be activated to request support of the Emergency Response Team (ERT). If the ERT are unable to deescalate the behaviour, the Incident Commander will determine if an urgent police response is required.
• Consideration should be given to the following:
  • Genuine and immediate risk of self-harm to the individual or harm to any other person;
  • The person is causing significant damage to property and if not contained may cause further damage;
  • The person is believed to have committed a criminal offence within the hospital;
  • The person is believed to have committed a serious crime or public is at risk (but this requires consideration of the duty to patient confidentiality versus public safety)
  • The person has a weapon which cannot be safely removed from the person (Code Black)
  • The presence of any other parties who pose a threat or are abusive or violent; and
  • Knowledge of the patient’s recent history of violence where police response was required
• The AHA or DON must contact the Police immediately if an unauthorised person is observed in a secured high risk area (i.e. Pharmacy, Mortuary, Cashiers Office, Pathology) - see searching patients, suspicious behaviour, unknown substance, weapons or crime within the ED
• Police may also need to be contacted if a patient absconds and there is either a belief the patient may be at risk to themselves or others (may just require a safety check), or the patient is on a mental health assessment order
• see also when are doctors required to compulsorily report patients in Australia

• WH policy - managing requests for patient information from police - WH intranet only
• In Victorian public hospitals:
  • Police wanting patient information from staff should first seek permission to speak to the staff member from General Counsel (during business hours) or the After Hours Coordinator
  • It is a criminal offence for any person to request or obtain access to health information by threat, intimidation or false representation
  • Staff may only disclose patient information where the law specifically allows it.
  • Public hospital staff are not permitted to disclose information regarding patients on the basis that there is ‘unlawful activity’ or that it is ‘for a law enforcement function’.
  • Staff may disclose patient information:
    • if the patient consents
    • if it is about the condition of a patient in general terms (eg stable, critical, life threatening or deceased)
    • if legislation expressly requires disclosure
    • if in response to a valid court order (eg search warrant, subpoena or request from the Coroners Court
    • by providing a statement directly to the court (not the police), but only if police first make a written request setting out the issues to be addressed in the statement and the patient has provided written authority for the preparation of a statement
    • if permitted by the Minister for Health or an authorised delegate
    • to the extent necessary to identify a patient or to enable police to contact a relative for compassionate reasons if the patient has died, is missing or has been in an accident or misadventure and cannot consent to disclosure and never objected to the disclosure
    • if staff reasonably believe that disclosure is necessary to prevent a serious and imminent threat to anyone’s life, health, safety or welfare or a serious threat to public health, safety or welfare. Staff should consider relevant circumstances described by police as well as the clinical implications of disclosure.

• if a patient is deceased, consent to the disclosure of information about the patient may only be given by the patient’s ‘senior available next of kin’. Consent is not required when reporting a death to a coroner.
• If the deceased patient is an adult (i.e. 18 or older), the patient’s ‘senior available next of kin’ is:
  • The patient's spouse or domestic partner (includes a same-sex partner);
  • If no spouse or partner is available – a child of the patient who is 18 or older;
  • If no spouse, partner or child is available – a parent of the patient; or
  • If no spouse, partner, child or parent is available, a sibling of the patient who is 18 or older.
• If the deceased patient is a child (i.e. under 18), the patient’s ‘senior available next of kin’ is:
  • A parent of the child;
  • If no parent is available – a sibling of the child who is 18 or older; or
  • If no parent or sibling is available – a guardian of the child.

• Police wanting to interview a patient should first seek permission to access the ward/department from General Counsel (during business hours) or the After Hours Coordinator.
• Police may only interview a patient if the patient’s treating doctor approves and considers that it would be clinically appropriate to do so. This means that the treating doctor considers that the interview would not worsen the patient’s condition or adversely affect the patient’s treatment or recovery.
• Whether or not the patient is competent to be interviewed is a matter for police, not hospital staff.
• It is a criminal offence for a person to intentionally obstruct police in executing their duties. Where police are present at a patient’s bedside and they wish to interview that patient staff must not hinder the police in the execution of their duties unless the patient’s health is at risk.
• If the patient’s treating doctor decides that it is clinically appropriate for police to interview a patient:
  • staff do not need to seek patient consent and should allow police appropriate access to the patient; and
  • It is up to the patient to respond to police; hospital staff should not intervene or give legal advice; and
  • Police and the doctor must liaise to determine the interview time and location; and
  • If the patient has a cognitive disability (intellectual disability, acquired brain injury or dementia) or a mental illness, police are responsible for contacting the Office of the Public Advocate and arranging for an independent third person to be present; and
  • hospital staff must still comply with privacy laws regarding disclosure of patient information as outlined above and police must respect the hospital's legal obligations.

• Police wanting to collect property/evidence from a patient (e.g. clothing, weapons, personal effects, DNA, fingerprints or photographing or filming a patient) must first seek permission to access the ward/department from General Counsel, (during business hours) or the After Hours Coordinator.
• If permission is given, police must ensure that collection of patient property/evidence is lawful.
• Police are not entitled to collect any hospital property (e.g. a patient’s medical record) without a search warrant.
• In considering police requests to collect patient property/evidence or remaining in restricted areas, the patient’s treating doctor will base the decision on the doctor’s primary duty to the patient.
• Hospital staff should not seize or collect patient property/evidence on behalf of police
• Police wanting to collect property/evidence from a patient must:
  • Comply with any reasonable decision of the patient’s treating doctor relating to patient care; and
  • Not ask hospital staff to collect patient property/evidence on behalf of police; and
  • Recognise that if they are attending to ensure the taking of blood from a suspected driver in relation to a motor vehicle collision, it is not essential that they witness the taking of the blood. The patient’s treating doctor will respond to the police request to take blood as soon as clinically possible. Police should remain in the waiting room until the doctor indicates that the blood has been taken.

• Victoria:
  • see Road Safety Act 1986 Section 55a
    • A person is not obliged to undergo an assessment of drug impairment if more than 3 hours have passed since the person last drove, was an occupant of or was in charge of a motor vehicle.
  • see Road Safety Act 1986 Section 55b
    • This section applies if a police officer reasonably believes that an accident involving one or more motor vehicles has resulted in death or serious injury.
    • Subject to subsections (4) and (5), the police officer may require any person who the police officer reasonably believes was, or may have been, driving or in charge of a motor vehicle involved in the accident at the time of the accident to allow a registered medical practitioner or an approved health professional nominated by the police officer to take from the person a sample of that person's blood for analysis.
    • the police officer may require the person to accompany a police officer to a place where the sample is to be taken and to remain there until the sample required to be taken has been taken or until 3 hours after the accident, whichever is sooner.
    • subsection (4): A person is not obliged to allow a sample of the person's blood to be taken for analysis if more than 3 hours have passed since the accident.
    • subsection (5): A police officer must not require a person to allow a sample of the person's blood to be taken for analysis under this section if the person is taken to a place for examination or treatment in consequence of the accident.