Provision of healthcare

4. The healthcare service was and is an NHS-commissioned service on behalf of the Home Office, provided entirely separately from the contract to manage Brook House.
5. G4S Health Services (UK) Ltd (G4S Health Services) held the contract for the provision of healthcare services in Brook House from September 2014 until 31 August 2021, including during the relevant period (1 April 2017 to 31 August 2017).¹ Practice Plus Group (PPG) took over this contract in September 2021.²
6. The provision of GP services was subcontracted to Doctor PA Ltd during the relevant period and still is currently.³ Dr Husein Oozeerally, lead GP at Brook House during the relevant period and at the time of the Inquiry’s public hearings, and Dr Saeed Chaudhary were and remain the co-directors of Doctor PA Ltd, and they provided most GP services at Brook House.
7. There were a number of other key personnel during the relevant period.

7.1 Ms Maxine York, Regional Clinical Governance Manager at G4S Health Services, was responsible for the line management and clinical supervision of the Head of Healthcare at Brook House.⁴ She was not based at Brook House but had daily contact with the Head of Healthcare and face-to-face meetings when necessary.

7.2 The Head of Healthcare in Brook House from 2016 (and continuing under PPG) was Ms Sandra Calver, an experienced Registered General Nurse (RGN) who had worked in IRCs since November 2004. Her responsibilities included:

• financial budgetary control;
• the daily running of the Healthcare department;
• the line management of the Practice Managers (who were responsible for overseeing the administrative functions of the Healthcare department) and Clinical Leads (who managed and supervised the senior nurses) at both Brook House and Tinsley House; and
• the clinical supervision of the Clinical Leads.

She was also Safeguarding Lead, responsible for giving guidance on safeguarding vulnerable adults and reviewing referrals.⁵

7.3 Ms Christine Williams was the Clinical Lead at Brook House. Senior nurses under her management in turn managed nurses and healthcare assistants, some of whom were ‘bank’ and agency staff (ie temporary staff provided by third-party organisations when needed).⁶ There were a total of nine RGNs (plus four bank RGNs), five Registered Mental Health Nurses (RMNs) and seven healthcare assistants (plus five bank healthcare assistants).⁷ There were also a pharmacy technician, a learning disability nurse and two practice administrators.⁸

8. There was no in-patient healthcare unit in Brook House but there were nurses on duty, available to respond to any medical emergencies 24 hours a day, seven days a week. Otherwise, the services provided were intended to be the equivalent of primary and community care available in the community.

8.1 The nurse triage clinic was a walk-in service that was open between 09:30 and 11:30, and between 14:30 and 15:30. If someone needed to see a nurse at any other time, they could ask the officers on their wing to call Healthcare and alert the nurses. The nurses would then attend the wing to treat them, or the detained person could be brought to the Healthcare department by officers.⁹

8.2 The GP service was appointment-based. If a detained person needed to see a GP more urgently than by booking a routine appointment in advance, they would first need to see a nurse for assessment and referral. They could see the nurse in the triage clinic without needing an appointment and then the nurse would book an urgent GP appointment. GPs worked on weekdays and (for more limited hours) on weekends.¹⁰

8.3 RMNs were available at Brook House during the day. In order for a detained person to see an RMN, they first needed to be assessed by an RGN, admissions staff or a GP, who could then make a referral. Specific forms were used to refer detained people to the mental health team, which were reviewed and actioned every day. If a detained person needed to see a psychiatrist, they would first have to be assessed and referred by an RMN. A psychiatrist visited Brook House to see patients once a week for an afternoon clinic.¹¹ In 2017, there were no psychologists employed at Brook House, but the RMNs held some group psychological therapy sessions and one-to-one sessions with detained people.

8.4 The pharmacy opened for 45 minutes three times each day to dispense medication.¹²

8.5 Opticians and dentists visited Brook House periodically to hold pre- booked clinics.

8.6 There was also a substance misuse team (provided by Forward Trust, an external charity) who held one-to-one sessions with detained people to address issues with drug or alcohol misuse. ¹³

1. CJS0074040_002 paras 6-11. The contract was initially held by G4S Medical and Forensic Services (UK) Ltd, which changed its name to G4S Health Services (UK) Ltd in October 2016[↩]
2. PPG000182[↩]
3. CJS0073870; PPG000040. The Inquiry was told that PPG intends to move towards an employed GP model (PPG000169_009 paras 43-44[↩]
4. DWF000009_007 paras 33-34[↩]
5. DWF000009_006 para 27; DWF000009_007 para 33; Sandra Calver 1 March 2022 142/13-143/10[↩]
6. DWF000009_006-007 paras 27-29[↩]
7. DWF000009_006 para 27[↩]
8. DWF000009_006 para 27 [↩]
9. DWF000001_008 para 87; DWF000001_009 para 89; DWF000020_017 paras 92-94[↩]
10. DWF000020_017 para 92[↩]
11. DWF000020_017-018 paras 92-97[↩]
12. DWF000020_016 para 87[↩]
13. DWF000020_015 para 80[↩]