April 2024 saw the soft release of guidance on Right Care, Right Person from the Association of Police and Crime Commissioners (APCC). I say “soft release” because the document has been published on the APCC website, dated April 2024, but there was no mention on their website news section of its release, where other guidance is mentioned in a press release, or on their X account (formerly Twitter) of the release. It probably explains why I didn’t realise it was out until very recently and I’ve now had a chance to digest it. If you’re interested in APCC guidance on topics connected to this blog, you might also like to read their recent guidance on preventing deaths in and suicide following police custody.
(NB: when this post was first published, the last hyperlink was to the first edition of the APCC guidance on deaths in custody. Despite it being recent guidance, it was updated in April 2025 and it is to that edition, the hyperlink now takes you.)
The RCRP guidance “… supports Police and Crime Commissioners to fulfil their statutory duties to hold Chief Constables to account and to work in partnership in relation to the Right Care, Right Person approach.” I’m not going to go through this document line by line, but having read it, I have any questions about details claimed within like why the RCRP ‘threshold’ is paraphrased incorrectly instead of quoted accurately, why there is repeated mention of section 135 MHA when it’s nothing to do with RCRP’s four phases – at all! Even section 136: the only aspect of s136 within RCRP was phase four and that relates to the one-hour handover aspiration, not to the overall use of the power. I could go on …
MISSION CREEP
Instead, my overall impression of this guidance is to wonder how all of that might relate to mission creep?
The APCC guidance makes a distinction I’ve not heard before: between RCRP as an overall programme and the “mental health elements” of RCRP, which are reflected in the National Partnership Agreement. Now, it’s always been obvious some aspects of the RCRP programme are not about mental health per se. For example, phase one and phase two of the programme is about ‘welfare checks’ and ‘hospital walkouts’ respectively. Requests for the police to do welfare checks do not just relate to concerns about those of us living with mental health problems, they can relate to elderly relatives, children and other circumstances which just appear unusual or might amount to someone being missing. People who walkout of hospital are not just those detained under the Mental Health Act, to those who have been assessed for admission under the Act or have been in mental health settings, but also includes people who walk out of hospital emergency departments. RCRP materials often make use of the canula example – a patient walking out with a needle still in their arm.
But whilst these examples may not be about mental health per se – at least they are not about serious or enduring mental illness – they can often be about mental capacity and the cognitive ability to make decisions. If, for whatever medical reason which may not be connected to mental illness, somebody walks out of hospital with a canula in their arm whilst lacking mental capacity to make sound decisions and keep themselves safe, we start to see the police obligations kicking in to protect life or prevent serious harm or injury. This blog has often made the point that policing’s interface with mental health – a term used in its broadest conception – is not just about mental illnesses like schizophrenia, bipolar disorder or depression, but about the decisions which may be necessary under the Mental Capacity Act 2005 to keep people safe when they are unable to do so for themselves.
So the distinction in the very first paragraph of the introduction about RCRP and the mental health elements on it interested me, not least because of what it says later. Phase 4 of RCRP was always about “section 136 MHA” and specifically, the handover from police to NHS staff which takes place after it. Again, I’ve wondered on this blog why RCRP was limited to the four phases of activity it was, because you could “RCRP” a lot more if you wanted to, but they didn’t and the point I make now is that phase 4 was about a one hour handover after use of section 136 at a Place of Safety. There has been considerable discussion in police forces about whether this just means in a health-based Place of Safety which has been commissioned and set up for the purpose of receiving patients detained by the police or whether it also relates to Emergency Departments.
EMERGENCY DEPARTMENTS
The APCC guidance offers the view that a one-hour handover is something which should apply in all healthcare settings and which doesn’t just relate to the operation of section 136 MHA, as RCRP originally did. You’ll have to draw your own conclusions as to why APCC are pushing the envelope here because despite its claims of working in partnership, the extent of RCRP described in their guidance is not the RCRP to which NHS England and the Department of Health and Social Care signed up when they endorsed the NPA in June 2023. There is partnership agreement of kind to RCRP because of the NPA – if RCRP is a broader thing, then where is the partnership sign up for that vision which one might imagine is an important part of ensuring things are done in partnership.
RCRP does suffer already from a perception that it is something which has been forced upon the NHS by the police and we have already seen NHS organisations, charities and professional bodies representing healthcare staff at all levels raise concern that this is something being forced upon them.
Mission Creep is a real risk here, not least because of how narrowly RCRP was defined in the very first place – it was always going to beg questions about why just these four things in those four ways? I’ve asked that before on this blog and I still don’t understand why you wouldn’t have an RCRP phase which is, for example, about police attendance in inpatient healthcare settings in support of NHS staff. I give this example because the police are still asked to attend inpatient settings to assist with disorder, restraint and even requests to assist in administering medication – matters which have been the subject of high-profile deaths in police custody and RCRP could have a phase connected to that not least because significant work to achieve a protocol on it was undertaken in the last decade. It’s there on somebody’s shelf, pre-agreed!
So one risk from the APCC guidance we’ve now seen is that PCCs may be attempting to hold Chief Constables to account for delivering RCRP in a way which was not the basis for the original NPA or the original version of RCRP in Humberside in circumstances where there is no obvious agreement by the NHS that they will be either willing or able to support. The APCC guidance claims an evidence-based approach towards the guidance but it should be borne in mind, the topic to which the guidance relates has still not been evaluated. This is something which had to be somewhat extracted from the (now former) Chief Constable of Humberside when he gave evidence to Parliament about this in September 2023.
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 am not a police officer.
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.
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