Channel 4’s Dispatches programme aired an episode on Monday evening about problems within the ambulance service having placed a journalist to work undercover as a 999 call handler in the south of England. The programme is generally worth watching: I think we learned some things about how matters are managed we didn’t know before, but I would caveat by saying I thought some issues of relevance to the performance of ambulance services which are beyond their control were under-emphasised. Have a look and form your own view.
Of relevance to this post was a segment of the documentary which starts around the 29-minute mark: it is analysis of how the service struggles with mental health emergencies and immediately gets in to the Right Care, Right Person policy which is described as a “police policy”. I know a lot of my blogs over the last two years have talked about this and most of them are offering criticisms despite my having said clearly several times: there is a legitimate problem in public policy about how we manage mental health emergencies and RCRP is quite laudably trying to tackle that problem. But given it is entirely unevaluated, it’s fair to provide ongoing commentary about obvious problems (which actually, are quite easily rectified – that’s what drives me spare about this. It’s easy to solve!)
CALL HANDLING
So we see our new, inexperienced call handler (journalist) talking to a lady who rang the ambulance service about her friend. She had first contacted the police and been told it was a matter for ambulance, so she re-rang 999 – she’s already being bounced around the system and this is making her distress worse. She didn’t know her friend’s address or current whereabouts and claimed the police told her ambulance would know and she should contact them and ask. The call handler, by virtue of being a journalist working undercover had limited experience of this sort of thing (and to her credit did say she’d welcome more or better training on how to handle it), went on to explain the police know perfectly well the ambulance service will not deploy resources towards a patient whose location is not known. In all fairness, how could they?! – where do you sent the crew?
As the segment winds up, Dispatches having narrated there were “serious concerns” about implementation, safety and capacity, etc., they quoted the National Police Chiefs Council who were obviously invited to respond to what was found. NPCC stated –
“Right Care, Right Person makes sure … our communities receive an appropriate response from the professionals who are best equipped to … support them.
We will always respond where there is a real and immediate risk to the life of a person or risk of serious harm.”
And it is the claims within this quotation I wish to address – OK, I wish to attack, because they are JUST NOT TRUE on too many occasions not to worry. I’ve noticed these words rolled out almost as an automatism whenever NPCC or RCRP architects are asked about the policy and I’m becoming a little weary of hearing the same DEMONSTRABLY FALSE claims repeated.
MAKE SURE
So for those in NPCC who weren’t listening and still aren’t, we need to talk about what “makes sure” means. These are ordinary English words, they have an ordinary English meaning and it amounts to something of a guarantee, doesn’t it? “Sure” and words like “ensure” which has also been used, means a high level of certainty. To “make sure” is to remove the possibility of failing to see something through, so let’s think about it in this context.
Where are the police sending 999 calls which they have decided are not for them? –
Well, many are deflecting towards the ambulance service and several towards mental health services of various kinds, be they community or crisis teams or mental health support helplines like “111 (option 2)”, or similar. We are entitled to ask: just because they police have referred someone to an alternative, does this mean it “makes sure” they are the right service; and does it make sure this service provides a response to the person?!
We know the answers to both questions is “no” – it does not “make sure”.
EVIDENCE BASED POLICING
How do we know this? – well, in addition to the anecdotes of professionals working in those other services, we know the London Ambulance Service went formally on the record at a London Assembly meeting in February 2024 and stated 80% of all additionally deflected calls to LAS after the Metropolitan Police’s introduction of RCRP were calls which did not require an ambulance at all. Not the “right care” – nor by the “right person”. We know from the anecdotes, from research done by the King’s Fund and I know from training events I’ve run in the last year, mental health nurses are experiencing the police deflecting calls to them which are simply not appropriate to them either.
The police are not the arbitars of what is the “right care”, yet their actions assume this mantle by default – take the view it’s more appropriate than the police dealing and more appropriate the ambulance service untangle that mess if you want – but let’s not pretend it means it’s always the “right care” or “the right person”.
A mental health crisis team in an area is (usually) a team which exists to provide unscheduled care for secondary care patients already in receipt of specialist mental health services. They are often not a crisis team for anyone and everyone, yet we know people who’ve never been referred to a mental health service are sometimes being told to call a crisis team including asking those teams to go to premises they’ve never been to before, to see people they don’t know. It’s simply not what they’re for!
None of this “makes sure” of anything in particular, so I for one would be obliged to see improved accuracy by NPCC in their press releases – it risks being interpreted, at best, as a lack of understanding about this area of business, or at worst, as dishonestly and an insistence on the right to merely choreograph the appearance of a safety net when in reality, none may exist.
A BRIEF TANGENT
Before I go further with the “we will always respond” stuff, I want to make another point. Dispatches interviewed people for their documentary and one person made a point millions of hours of police effort and support for mental health demand have been removed from the system without resources for the ambulance service or wider NHS to fill that void. Now this is a difficult message, but if (and only if!) the police were declining to attend incidents where there is no legal duty to attend – that would mean they are declining to attend where people’s lives and safety are not at risk in any immediate sense and where nothing in principle prevents people accessing mental health support from the range of ways that it is – at least in theory – available, even if that does take time and why shouldn’t the police take the view people not at immediate risk should wait for the appropriate services and if they are not happy with them, because of delays, to raise that through the appropriate channels?
If they were to do that, it may mean people whose immediate safety is not compromised receive no response at all if the police don’t go – or a heavily delayed response as the ambulance service will invariably categorise a mental health welfare call as “cat 3” which means a 2hr response and every potential for it to be de-prioritised further as other “cat 1” and “cat 2” calls jump over the queue. None of that is the responsibility of the police service so why souldn’t they take a view people to whom no duty of care is owed should not receive scare resources over those to whom the police do owe a duty? – victims of crime being the obvious category. The broader documentary showed us, for example, a lady who had experienced life-altering consequences after she had a stroke and had to wait over 2hrs for an ambulance which ideally should have been on scene with her within 18mins. So we can all see how a “cat 3” welfare check would be deprioritised and how dealing with it also risks imposing delay on “cat2” calls.
My point is this: people will have a range of views about whether police attendance at something they have no legal duty to attend is better or worse then simply asking vulnerable people to wait for the NHS to respond. The harsh reality is, a police response may not be able to do much beyond ensure someone has a human with them at a difficult point, but whether the police doing this comes at a cost to other humans who have a right to expect the police to respond to other safety incidents like domestic abuse attacks in progress is another question. And if they were to do so, for how long are we asking police officers to remain with someone not at immediate risk, whilst victims may be facing equivalent risks from crime? This is what I mean when I say there is a legitimate public debate about how we want our police to spend their time.
WE WILL ALWAYS RESPOND
Back to the reassurance of NPCC the police will always respond –
First, we can already point to nineteen completed inquests so far, which generated sixteen Preventing Future Death reports which shows that is simply not true. And as I’ve written before on here, for every fatal incident before a Coroner, we can legitimately wonder how many non-fatal near miss incidents there are? – Dispatches showed us one in the programme. The lady who rang up, obviously frightened and concerned, about a friend stated to be in “serious danger” and whose location was not known, but who was bounced by the police to the ambulance service even though, as the journalist call handler made clear, no-one knew where this friend was. Quite arguably, it was a high-risk missing person and we know police officers have been formally disciplined for not grasping the risk reality of those kinds of calls.
There is a theme running through most of the PFD notices I’ve referred to, above – and it is the one which was revealed by Dispatches. The police deflecting demand to the ambulance service about cases which actually should sit with them as a police service. The thresholds for the police to respond, outlined by NPCC in the quotation, above, is about “immediate risk to life” and “immediate risk of serious harm”. Well, if a frantic friend is on 999 stating her friend is suicidal, in “serious danger” and his location is known, do we think we have an article 3 “immediate risk of serious harm”? – I’d say so. With obvious potential for that to become an article 2 risk, if it isn’t already.
It is just not true to say –
- RCRP makes sure vulnerable people in desperate circumstances “receive an appropriate response from the professionals who are best equipped to … support them”.
- RCRP ensures the police “will always respond where there is a real and immediate risk to the life of a person or risk of serious harm.”
So NPCC and others can keep saying this if they want, but unless and until actual cases in the real world stop emerging with an almost monotonous regularity, it won’t make it true. To persist in repeating this in the face of contrary evidence which has been put forward to them – repeatedly – AND COMPLETELY IGNORED turns ignorance in to a lie.
There’s no other way to say it: the PR response to Dispatches is a dishonest response because as Wilberforce said, “You may choose to look the other way, but you can never again say you did not know.”
Go back to the start: train people properly in what those A2 / A3 thresholds actually mean because I repeat, again: training I saw for RCRP whilst serving did not get this right and the way in which it was wrong – applying an overly-narrow definition – was always going to result in A2/A3 cases not being recognised for what they are: life-threatening or life-altering emergencies where the police have a legal duties to discharge.
And I said so – and I was ignored.
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.
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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