We knew a few weeks back the Independent Office for Police Conduct was working on the production of a ‘position statement‘ on Right Care, Right Person. It has now been published on their website, dated March 2024.
The position statement speaks for itself in many respects: it was sought, I believe, because forces and their officers and staff were nervous about the potential disciplinary implications of making RCRP decisions only for an untoward event to result.
ASSESSING DECISIONS
This speaks to something about measuring decision-making by the outcome, rather than the quality of the decision-making itself. You can’t do a job in policing, mental health or emergency response without realising you are making many of your decisions without necessarily knowing everything about the issue. Not everything is known or knowable. For example, someone ringing 999 to say they need help with their mental health may do so without making it known they are actively suicidal and their life is at risk – any call handler, whether it be in the police or the ambulance service, may then take certain decisions which would have been different if it had been known the person was actively suicidal.
So any decision by the police not to respond may have been an urgent response if the full circumstances were known or knowable; a decision by the ambulance service to offer a non-urgent response may end up being too late in the day and may have been prioritised. Where that decision is scrutinised it would be key to understand whether the call handler knew or ought to have known the person was suicidal. On some occasions, there may be other information available in addition to the content of the call itself (previous attendances at that address, the patient’s history, etc.) but often there won’t.
PROCESS AND PROCEDURE
I can’t see what is too controversial, if anything about this position – it is saying what it surely must say, that they are obliged by law to consider all cases which are, also by law, referred to them where there has been death or serious injury following police contact (which includes, for example, a call to the police which leads to no response). The IOPC cannot state it won’t examine referrals and it cannot state it won’t conduct an investigation, even if that investigation is not considering whether the conduct officers or staff amounts to any kind of conduct problem.
The emphasis in this position statement is upon effective policy, procedure and training being required and on the partnership working necessary to contextualise it. There are few things I find curious about the statement and chief amongst them is “The IOPC recognises the application of RCRP will differ across forces” – timescales for implementation aside, I find this very curious because you might ask yourself why it would differ. RCRP is predicated upon legal advice (summary available on the College of Policing website) and focusses on the legal obligation of the police. The inherent argument within is the provision of healthcare to the public is a matter for the NHS and for the public, unless certain tipping points have been met which justify a police response. This is the so-called ‘threshold’ for RCRP – crime, immediate risks to life or serious harm. Ringing the police asking for a welfare check, for example, is legally the same in Cumbria, Camden and Cambridge – it will either tip the threshold or it won’t.
Finally, the IOPC makes mention of their annual publication on deaths after custody or contact. You can find links to all of those annual reports on one of my resources pages. I hope we will see analysis within the mental health section of future reports how many incidents were thought to be RCRP related. I have observed a number of times before the words ‘street’ and ‘triage’ do not appear in any of those reports, for example, yet we know there have been several and we also know there are inquests, past and pending, which touch upon the ideas within RCRP and explicitly reference it, in some cases.
The text of the IOPC position statement is re-produced below, copyright remains theirs – this is in case it is removed from the internet in the future after any update we may see in coming years.
IOPC POSITION STATEMENT, MARCH 2024
Copyright IOPC, downloaded May 2024 from –
INTRODUCTION
Since the national launch of the Right Care Right Person (RCRP) initiative in 2023, policing stakeholders have asked for the IOPC’s opinion on it.
The IOPC recognises the application of RCRP will differ across forces and we are alive to the challenges this may present. There is no one size fits all approach to RCRP and we will continue to adapt our position as the framework is rolled out nationally. In our position statement, we aim to offer transparency about the IOPC’s stance on RCRP and provide clarity on how Professional Standards Departments (PSDs) should apply the mandatory death and serious injury (DSI) referral criteria for incidents involving RCRP.
The IOPC will continue to monitor the national roll out of RCRP and will review our position as and when required.
OUR POSITION
We agree with the principles of the Right Care, Right Person (RCRP) initiative, which are focused on ensuring that vulnerable people receive the most appropriate service from the most appropriate agency.
It is essential that forces work with local healthcare partners to ensure that vulnerable people receive a service that meets their needs, at the right time and by the most appropriate agency, wherever they live in England and Wales.
We will continue to work closely with the National Police Chiefs’ Council lead for RCRP as the framework is embedded in forces across England and Wales. We welcome the College of Policing’s review of the Mental Health Authorised Professional Practice (APP), which will look to include RCRP principles and guidance.
Our annual report on Deaths during or following police contact highlights the high number of mental health concerns, as well as drug and alcohol use in those cases, and our support for people receiving the right care when they need it.
We encourage police leaders and those in health and justice systems to work together to improve arrangements for frontline healthcare and mental health support.
Forces should continue to respond to incidents in accordance with their policing duties and responsibilities. They must also develop robust local policies, operational guidance and escalation policies, in line with the national principles of RCRP.
By law, forces are required to refer to us matters that meet the definition of a DSI, and we are required to decide whether the matter needs to be investigated and, if so, by the IOPC or the force. The definition includes circumstances where a person had contact (of whatever kind, and whether direct or indirect) with a person serving with the police who was acting in the execution of their duties; and there is an indication that the contact may have caused (whether directly or indirectly) or contributed to the death or serious injury.
Medical and healthcare agencies have the primary duty to respond to health-related calls. However, as explained in the College of Policing’s Legal overview for RCRP, the police may have a duty of care where they have assumed responsibility for a person’s care or have created (directly or indirectly) the risk of harm. Officers may also have duties under the Human Rights Act 1998 to protect individuals from a real and immediate risk to life or serious harm.
A decision not to deploy police resources in a ‘health only’ case where the police had a duty of care and/or a duty to protect the person concerned under the Human Rights Act 1998, who then suffered death or serious injury, could meet the criteria for a DSI referral.
Where there is no legal duty of care, or it is reasonably believed a health care agency has taken responsibility for a call, then a decision by the police not to deploy would not have caused or contributed to any subsequent death or serious injury. However, where a change in circumstances of the person at risk or the operational ability for the healthcare agency to attend has been communicated to the police, that may re-engage a duty of care or duty to protect, and in the event of death or serious injury, a DSI referral would be required.
If an IOPC investigation or review did take place, as with any matter, the actions or inaction of any individual would always be considered in the context of relevant legislation, local force policy, Authorised Professional Practice and any other national guidance or standards – including those on Right Care Right Person. It would be unlikely to result in a disciplinary investigation or proceedings where decisions on deployment were made in accordance with policy.
We frequently issue learning recommendations where we consider that an organisational matter such as a process, policy, or training needs to be addressed, rather than an individual’s conduct.
CONTACT US
If you would like to contact us about this statement, please email:
policyandengagementteam@policeconduct.gov.uk
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, 2024
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 