No Evaluation

We need more honesty about where we are with Right Care, Right Person. Not least because this is yet another major programme in policing and mental health which is proceeding to be rolled out, entirely unevaluated. We had street triage, we had Liaison and Diversion and then the High Intensity stuff – none of it was thoroughly and properly evaluated before someone said, “That seems like a good idea – why don’t we all do that, too?!”

On the 19th September 2023, the former Chief Constable of Humberside Police, Mr Paul Anderson, appeared alongside his Police and Crime Commissioner and Chief Constable Craig Guildford QPM of West Midlands Police at the Health and Social Affairs Select Committee. The committee was accompanied on that occasion by two members of the Home Affairs Select Committee to discuss RCRP given the obvious health-police overlap. Towards the end of the evidence session, Mr Anderson was asked about evaluation of the scheme and it had to be somewhat extracted from him that evaluation thus far was entirely about policing outcomes, primarily in terms of estimates about officer-hours saved. You can read the transcript of that session – see questions 9-12 on pages 5-7.

There was nothing in it about healthcare outcomes (for the other agencies) or, as you might imagine, about public outcomes for those who were either ringing the police or having the police called upon them and then being bounced elsewhere, however appropriate that may have been. And you’ll notice in the press releases for RCRP after finalisation of the National Partnership Agreement in June 2023, all the headline talk was about “one million hours saved” – you had to read deep in to the press releases to see much about public safety, health or wellbeing and you won’t find any health service press releases or social media about the new NPA on the NHS England website.

That, in itself, is interesting,

EVALUATION

The tweet at the top of this post is from a custody sergeant in Devon and Cornwall Police after having undergone training in RCRP, presumably ahead of his force moving towards introduction of the scheme. The claim he makes is really specific on a number of levels and it absolutely fascinates me, both for what it claims and for what the claim itself suggests about attitudes towards this area of police work —

“Making sure the right agency deals with calls, instead of the police being the default first responder. It has been shown to improve outcomes, reduce demand on all services, and make sure the right care is being delivered by the right person.”

I submit: every single claim in this tweet, bar one, is simply not provable. Worse still, it’s both known and knowable that it’s not provable and unlikely to be true. Now, perhaps the sergeant is tweeting this as his interpretation of the training or perhaps this is what he’s been told in the training – as he and his head of custody declined to reply to questions about the tweet, you’ll have to guess about that, I’m afraid.

You’ll also have to decide for yourself what it says about attitudes, in either circumstance.

Right, let’s go! —

• “Making sure the the right agency deals with calls” —
• What we know from the ambulance service, for example is many calls now being declined by the police are being bounced to the ambulance service.
• We know this from two sources: it is in the letter from the Chair of the Association of Ambulance Chief Executives to the chair of the Health and Social Care Affairs Committee in January 2024 and we know this from evidence given at the London Assembly by the Chief Executive of the London Ambulance Service (LAS).
• Now, you can take the view by all means, that mental health calls are more appropriate for the ambulance service than the police if you want to – perhaps you prefer officers free or “dealing with crime” and paramedics tied up with mental health demand they cannot manage either rather than them answering 999 acute medical calls – but none of that is the same thing as the ambulance service being the “right” agency.
• It might be nothing more than doing wrong thing righter.
• The LAS Chief Executive pointed out how most people being ‘bounced’ had a health need, but not one that usually requires an ambulance so we are still far from ensuring “the right agency deals”, even if some are a little relieved the wrong agency definitely isn’t.
• It may be it’s just “doing the wrong thing righter”.

• “Police being the default first responder” —
• Of course, the police are called plenty of times as first responders to mental health calls, but most mental health calls to the police do hit the published threshold for a police response.
• It’s also not necessarily a default approach – sometimes, the police are called because GPs, 111 or others tell people to ring them.
• It is also true to say the ambulance service and Emergency Departments are also often suggested as a first responder option – they too have their frustrations around mental health demands where they are often little better placed to assist people but police officers may not realise this, because they are not informed about situations where advice has been “ring 999 for an ambulance” or “go to ED”.

• “It has been shown to improve outcomes”.
• Has it?! – where has it been shown? And I really do mean to ask very precisely: where has this been shown?
• The scheme simply has not been evaluated – at all.
• I’m really open to learning on this point and I always want more to read on these topics but I’m yet to know of any study, anywhere by anyone that talks about anything other than police time saved.
• The former Chief Constable of Humberside Police, Paul Anderson, who was the architect of this approach, admitted when questioned in Parliament in September 2023 there has been no evaluation of RCRP in his force or elsewhere, prior to it being scaled up nationally.

• “Reduce demand on all services” —
• Again – where is this shown?!
• And do you really mean on ALL services?
• I’m aware Humberside claim it saves just over 1,400 or 1,500 officer-hours a month but I’m not aware of any study, report or other claim this is saving any other organisation time or reducing demand overall across the public sector.
• Maybe it is – but my point remains, if you’re going to tweet about this, where’s your evidence?
• Indeed, from the ambulance sources mentioned in the top bullet point, we can see demand on the ambulance service has gone up considerably, even if it is in respect of what everyone might agree are “health” calls – they’re just mostly not ambulance calls, as best we can tell without a proper evaluation.

• “Make sure the right care is being delivered” —
• Yet again – does it? … does it really ensure this?!
• Doesn’t it sometimes mean the wrong care is being delivered by a different wrong person or that no care is being delivered at all?!
• I’m taking these words at their everyday meaning but “making sure” or “ensuring” (a word used elsewhere to make the same point about RCRP) means essentially guaranteeing it will happen, doesn’t it?
• One of the reasons many people think the police experienced rising mental health demands over the last twenty-to-thirty years is the absence of the right care – it all too often just doesn’t exist and there’s a gap the police (and ambulance and ED) are filling.
• “We don’t know whether community care works because we’ve never tried it properly”, wrote an award-winning journalist covering this topic over twenty years ago and we know services have been cut even more since then.
• We have community mental health teams which are severely under-staffed and over-worked with some CPNs carrying more than twice the workload – there is a national vacancy rate in mental health nursing of 20% and in some teams in London it is as high as 50%.
• If you’ve ever watched mental health services debating how best to support patients with substance (ab)use conditions or personality disorders and witnessing calls for prosecution in lieu of care, you’ll see how little of the “right care” is often available from over-worked, under-resourced professionals.
• You don’t fix that and ensure anything different by bouncing 999 calls to the ambulance service, crisis team or GP however strongly you feel the police shouldn’t be dealing.

We need to see proper research on this scheme – and I mean by proper researchers, not internal evaluation reports which examine things very partially and with obvious bias and partiality. It needs to include police and health service outcomes, it needs a proper research methodology and impact but most importantly of all, we need to see the outcomes for the public – and that has to include consideration of how many people died, suffered serious injury or near-misses after RCRP decision-making. I’m already satisfied these numbers are not zero and we’ll have to wait for inquests, proper research and other investigations to see if that was avoidably so.

We have seen the national mental health charity Rethink writing to the Home and Health Secretaries about RCRP to ask them to direct a pause because of what they claim are inquests and “a series of tragic deaths”. Sadly, the Guardian article making this claim after comments by Rethink’s Chief Executive is absent on the detail of what that means, but we do know of one inquest which has already caused concern in London.

So there it is – evaluation, evaluation, evaluation!  We need some because we don’t have any and it needs to be decent quality lest it be rendered meaningless. I hope what I heard last year is not true – that free evaluation of RCRP in Humberside by a very reputable university research group was once declined.

I really do hope that’s not true.

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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, 2025.
I am not a police officer.

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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