His Majesty’s Coroner for Greater Manchester has issued a stinging rebuke of Greater Manchester Police following the death of Angeline Phillips — known as Ange — after a seventeen hour delay in their response to a concern for welfare which was made to them by a friend of hers. The delay in itself is important and must be acknowledged, of course, but it’s not the primary issue I want to focus on in this post. We know GMP were in so-called ‘special measures’ at the time of the incident and have since changed their Chief Constable and made significant improvements to their performance, to the point where they are held up as an example to others on many issues.
What interests me in particular, is the issue about roles and responsibilities between the police service and the ambulance service in particular, when it comes to concerns for welfare. There are a number of questions which need asking and they just all be considered together.
- Whose job is it to respond to such things if friends or relatives cannot visit people to check for themselves or perhaps have failed, having tried?
- How does this fit with ideas around people being “missing”?
- What about concerns which are more serious and may amount to a threat to life?
- Indeed, should it be the role of either of these emergency services and what does the law say about all this?
- Finally, does it matter whether a concern for welfare is raised by the public to the police or by other agencies to the police?
This can become difficult territory, so let’s try and work it through one point at a time and then see how it all fits together. The main caution I want to throw out which affects all of this:
When callers express a concern for welfare or ask for a “welfare check”, it does NOT mean they are asking just for that and that alone – without using the specific words, they may be reporting someone missing or expressing a concern that is more serious, amounting to a threat to life — never forget that and always check!
LEGAL POWERS
The police service has a core duty to protect life, obviously – so where the concern amounts to a risk of suicide or sealed injury that could be serious, they’re engaged. They have powers to enter premises to save life and limb (s17 PACE) and other powers which can be used in public places (s136 MHA), some in private places (the MCA) to manage emergencies around people who are seriouslly ill or injured. It doesn’t cover all bases, it must be said, but most life-altering or life-threatening emergency situations are covered.
The police also has certain legal duties around people who are missing – to undertake the searches which are relevant to locate people whose location is not known and this is a large part of daily police work, where local police areas can have a number of missing persons investigations on the go at the same time. They’re always graded as low, medium or high risk and command the priority and resources that the risk suggests. Where someone asks for the police to visit an address to conduct a ‘welfare check’, it may be because the person’s whereabouts is not known and in addition to the caller being concerned, they are implicitly asking the police to find the person if they are not immediately found at home.
This is why we must be careful about hearing the words ‘concern for welfare’ or ‘welfare check’ and thinking only in terms of that – the nature of a caller’s concern may amount to a threat to life, which triggers consideration of forcing entry to premises and / or be something which means they need to think of the person as missing.
DUTY OF CARE
There is also law affecting the duty of care that police force’s owe and ironically, the High Court case I’m about to refer to, is something from Greater Manchester. In an appeal from a lower court, a member of the public had reported a concern for welfare and a GMP call handler had accepted that officers would attend the person’s address and see if they were OK. There was delay and difficulty, but eventually the police did attend and tragically found the caller’s daughter deceased. In a county court claim, it was found the police did have a duty of care, despite their argument to the contrary and the claimant’s case succeeded.
In the appeal to the High Court, GMP continued their position that they did not have a duty of care and if you read the full judgment, you will see it full of other case law about the role and duties of the police.
Suffice to say here, the appeal was dismissed and the key legal point was that the police did not necessarily have a legal duty of care in all cases where a concern for welfare is reported, but where they have agreed they will undertake a ‘welfare check’, they have accepted a duty of care voluntarily and then owe it. The court pointed out, had GMP declined the request, the caller may have made other arrangements to check to find out why their calls were not being answered, but having been told the police would deal, it was reasonable of the caller to expect that officers would be asked to do what the caller taker had suggested. Hence, they had accepted a duty of care when they agree to undertake the task.
BOUNCING DEMAND
The recent comments by the Manchester Coroner after the case of Ange Phillips also focus on the fact GMP had contacted the North West Ambulance Service and ask them to deal in the first instance. The logic for this, so far as it is explained in the reported coverage, appears to be that the concern for welfare is essentially medical in nature, so paramedics might be better place to undertake whatever is needed, if the concern is found to be justified. We can all imagine why that view may be taken: if someone rang 999 asking for the police because someone was medically unwell or injured and there was no obvious reason in the report to explain what policing function was required, it might be better for paramedics to be sent. You could imagine a call saying something like “Hi Ambulance, it’s the police here – we’ve had a 999 call about a man who has injured his leg in a DIY fall from a ladder, we’ve asked various questions of the caller to see why they rang the police and there’s nothing to suggest a crime or anything similar, so we’re passing this to you and if you get there and find there is a requirement for officers, let us know and we’ll dispatch some towards you.”
Or similar! – in fairness, this does happen the other way ‘round: calls to the ambulance service about a range of things which then bounce to the police, quite rightly.
So this is the point about the Coroner’s reported comments which interest me the most: he is quote as saying it is “simply unacceptable” that a GMP call handler ‘deferred’ the call to NWAS due to it being perceived as a ‘medical incident’. I am really keen to read the Preventing Future Deaths report which the Coroner has made clear they will issue because I hope to see the rationale explained to see how case-specific this point is, very conscious that I have not hear the evidence in this case. My interest lies in seeing how general the point might be: is the Coroner saying all reports to the police of a concern for welfare must be attended without exception or is the PFD more nuanced that this? The PFD from the Coroner and the various legal findings in the Sherrat case taken together will be an interesting read and no doubt I’ll return to this once the PFD is issued because there is a wealth of learning in PFDs, as I have said before. (You can find many police / mental health PFDs on the blog.)
PUBLIC REPORTS / OTHER AGENCIES
Does it matter the source of where these things come from? – possibly, yes.
If a community mental health team report a concern for welfare because a patient failed to keep an appointment, it might be reasonable to wonder what they had attempted to do before ringing the police. This is not just pedantry or deflection: knowing that attempts at a person’s home address have been tried and failed, perhaps more than once; knowing that attempts have been made to ring their number and speak to them; knowing that their next of kin or known friends have been tried – all of this increases the information on which police decisions may well be made.
Simply failing to keep an appointment without attempts to do any of the above and it may be reasonable for the police to ask a public agency to attempt the above and call again once complete. That in turn, may mean that instead of it appearing to be a task to knock someone’s door and undertake a so-called ‘welfare check’, is more obviously a request that may lead to the person being treated as missing as soon as there’s no reply at the door or possibly, the previous work by the CMHT means that when there’s no reply, the police may feel justified to force entry because concerns have escalated in the context of there being no reply.
But imagine all this came from a relative who does not live close by? Perhaps they have a regular phone call with the person and this evening, the call didn’t happen and there was no reply when the caller rang the person? It’s one thing for someone not to answer the phone when there is no agreement about a phone calling happening; it may indicate something is awry if a planned to commitment to call doesn’t happen and the person can’t be raised. Everything turns on its own merits and that’s why it’s important to bear in mind who the words ‘welfare check’ or ‘can you just check on my brother’ may in fact need to be seen as something else, even if the words weren’t used.
POLICIES
The sad case involving Ange is not the only example of where police forces have asked ambulance services to be the first responder to a concern for welfare, predicted on either mental health concerns or more general concerns about someone’s state of mind because of life events. It’s always going to be complicated to decide who is best to respond because these matters can and do touch upon police responsibilities, but we also know there are some difficulties and limitations in the police being the first responders.
I can imagine some situations where asking other agencies to lead would seem preferable, but others where it would be problematic. That is why clear policy about all of the above is key, complicated though it may be to put that together to distinguish between the legal duties owed, the distinctions between welfare, missing or emergencies and of course, the training for staff who call receive calls and work in control rooms as well as those officers who may end up knocking doors and then having to decide what to do next. We need to ensure any ‘bouncing’ (in either direction) is appropriate and it’s done on the basis of discussion and agreement, rather than deferring demand to others without their full cooperation on the approach required.
I will do more on this one, once the PFD is published.
Winner of the President’s Medal, the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All opinions expressed are my own – they do not represent the views of any organisation. (c) Michael Brown, 2022
I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current. Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.
Government legislation website – www.legislation.gov.uk
Mental Health Cop 