14 Nov 2014 Kirk William Williams · Prevention of Future Deaths report Teesside
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Concerns raised 4 Lack of dialogue between police and local A&E departments about treatment misunderstandings View source Lack of memorandum of understanding or guideline for taking aggressive detainees to A&E departments View source Insufficient A&E consultant understanding of which detainees will be accepted for treatment View source Insufficient police understanding of A&E treatment for detainees View source See 1 more concern
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AI-generated summary
Kirk William Williams · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Kirk William Williams ingested several drugs and displayed highly agitated and aberrant behaviour before being restrained by police. Although one officer considered that he should be taken to hospital, he was taken to a police station and later suffered cardiac arrest and died in hospital. The concerns included differing understandings between police and A&E staff about treating aggressive detainees, and the absence of clear dialogue or guidance for managing such medical emergencies.
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× Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to NHS South Tees Clinical Commissioning Group; that does not assign responsibility.
PFD Monitor interpretation Lack of dialogue between police and local A&E departments about treatment misunderstandings
Wider context from the report “(2) Some police officers still consider that notwithstanding that they may be faced with a medical emergency, A&E departments will not treat violent or aggressive patients.
(3) The various consultants that gave evidence are clear that they will treat violent patients provided that (a) treatment is warranted and (b) they are provided with sufficient assistance from either or both the police or security staff.
(4) It therefore follows that there is a mismatch in perception and expectations between Cleveland police officers and local A&E staff.
(5) There did not appear to be a sufficiency of understanding within Cleveland Constabulary about how and whether detainees may be treated at A&E departments.
(6) Further or alternatively, the insufficiency in understanding lies with A&E consultants and their perception of what type of patients will be accepted and allowed to be treated in their departments.
(7) There does not appear to be a dialogue between Cleveland Constabulary and local A&E departments to address these particular misunderstandings or misconceptions.
(8) There does not appear to be any memorandum of understanding or guideline to cover aggressive detainees in police custody being taken to A&E departments.
(9) Without a fuller understanding of the true position, police officers will continue to be faced with the perennial dichotomy of whether to take an aggressive medical emergency detainee to an A&E department for treatment or to a police station to prevent self harm or harm to others.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to NHS South Tees Clinical Commissioning Group; that does not assign responsibility.
PFD Monitor interpretation Lack of memorandum of understanding or guideline for taking aggressive detainees to A&E departments
Wider context from the report “(2) Some police officers still consider that notwithstanding that they may be faced with a medical emergency, A&E departments will not treat violent or aggressive patients.
(3) The various consultants that gave evidence are clear that they will treat violent patients provided that (a) treatment is warranted and (b) they are provided with sufficient assistance from either or both the police or security staff.
(4) It therefore follows that there is a mismatch in perception and expectations between Cleveland police officers and local A&E staff.
(5) There did not appear to be a sufficiency of understanding within Cleveland Constabulary about how and whether detainees may be treated at A&E departments.
(6) Further or alternatively, the insufficiency in understanding lies with A&E consultants and their perception of what type of patients will be accepted and allowed to be treated in their departments.
(7) There does not appear to be a dialogue between Cleveland Constabulary and local A&E departments to address these particular misunderstandings or misconceptions.
(8) There does not appear to be any memorandum of understanding or guideline to cover aggressive detainees in police custody being taken to A&E departments.
(9) Without a fuller understanding of the true position, police officers will continue to be faced with the perennial dichotomy of whether to take an aggressive medical emergency detainee to an A&E department for treatment or to a police station to prevent self harm or harm to others.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to NHS South Tees Clinical Commissioning Group; that does not assign responsibility.
PFD Monitor interpretation Insufficient A&E consultant understanding of which detainees will be accepted for treatment
Wider context from the report “(2) Some police officers still consider that notwithstanding that they may be faced with a medical emergency, A&E departments will not treat violent or aggressive patients.
(3) The various consultants that gave evidence are clear that they will treat violent patients provided that (a) treatment is warranted and (b) they are provided with sufficient assistance from either or both the police or security staff.
(4) It therefore follows that there is a mismatch in perception and expectations between Cleveland police officers and local A&E staff.
(5) There did not appear to be a sufficiency of understanding within Cleveland Constabulary about how and whether detainees may be treated at A&E departments.
(6) Further or alternatively, the insufficiency in understanding lies with A&E consultants and their perception of what type of patients will be accepted and allowed to be treated in their departments.
(7) There does not appear to be a dialogue between Cleveland Constabulary and local A&E departments to address these particular misunderstandings or misconceptions.
(8) There does not appear to be any memorandum of understanding or guideline to cover aggressive detainees in police custody being taken to A&E departments.
(9) Without a fuller understanding of the true position, police officers will continue to be faced with the perennial dichotomy of whether to take an aggressive medical emergency detainee to an A&E department for treatment or to a police station to prevent self harm or harm to others.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to NHS South Tees Clinical Commissioning Group; that does not assign responsibility.
PFD Monitor interpretation Insufficient police understanding of A&E treatment for detainees
Wider context from the report “(2) Some police officers still consider that notwithstanding that they may be faced with a medical emergency, A&E departments will not treat violent or aggressive patients.
(3) The various consultants that gave evidence are clear that they will treat violent patients provided that (a) treatment is warranted and (b) they are provided with sufficient assistance from either or both the police or security staff.
(4) It therefore follows that there is a mismatch in perception and expectations between Cleveland police officers and local A&E staff.
(5) There did not appear to be a sufficiency of understanding within Cleveland Constabulary about how and whether detainees may be treated at A&E departments.
(6) Further or alternatively, the insufficiency in understanding lies with A&E consultants and their perception of what type of patients will be accepted and allowed to be treated in their departments.
(7) There does not appear to be a dialogue between Cleveland Constabulary and local A&E departments to address these particular misunderstandings or misconceptions.
(8) There does not appear to be any memorandum of understanding or guideline to cover aggressive detainees in police custody being taken to A&E departments.
(9) Without a fuller understanding of the true position, police officers will continue to be faced with the perennial dichotomy of whether to take an aggressive medical emergency detainee to an A&E department for treatment or to a police station to prevent self harm or harm to others.
” Open source report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Keep the Durham emergency-department process under review and discuss arising concerns monthly in relevant meetings.
Verbatim wording from the response “The process is kept under review by the Trust and any arising issues are discussed on a monthly basis in relevant meetings depending on the nature of the concerns raised, i.e. frequent attenders; mental health, drugs or alcohol related issues or violence and aggression incidents. The Trust has confirmed that some of those meetings do include representatives from Durham Constabulary.” Source location 2014-0499-Response-by-South-Tees-Clinical-Commissioning-Group
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Inform relevant NHS and police staff about the agreed detainee-management guidance.
Verbatim wording from the response “• All relevant staff, both NHS and Police, to be informed of the guidelines agreed for future reference.” Source location 2014-0499-Response-by-South-Tees-Clinical-Commissioning-Group
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Establish joint guidance for assessing, treating, discharging and communicating information about aggressive or medically unwell detainees attending emergency departments.
Verbatim wording from the response “A meeting was held between the Medical Directors and senior A&E medical staff of both Foundation Trusts and Detective Chief Superintendent ████████ from Cleveland Police.” Source location 2014-0499-Response-by-South-Tees-Clinical-Commissioning-Group
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Hold discussions with Durham Constabulary to ensure officers know that patients should be taken to the emergency department.
Verbatim wording from the response “County Durham and Darlington NHS Foundation Trust have confirmed that the lead Security Officer for the Trust has held discussions with Durham Constabulary lead officers to ensure that all police officers know that patients should be taken to the Emergency Department.” Source location 2014-0499-Response-by-South-Tees-Clinical-Commissioning-Group
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Information checked against published PFD reports and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations