NHSE warns new policy creates risk for service ‘already under enormous pressure’

National mental health director Claire Murdoch has written to integrated care board leaders and mental health trust CEOs about the possible impact of the “right care, right person” policing model which is being rolled out across England.

In July, policing minister Chris Philp gave all forces the green light to implement the RCRP model. The approach was first trialled in Humberside and involves officers only attending mental health calls where there is a risk to life or serious harm.

Now, in a letter seen by HSJ, Ms Murdoch has admitted the new model is a “major change for services already under enormous pressure” and warns that implementing all of the actions set out in the national partnership agreement may take time between the police and the NHS. This took three years in Humberside, she notes.

Ms Murdoch wrote: “I know you will all be doing your best to make this work, but I am so mindful of the risks to services and people with mental health problems, as I am sure you are too.”

ICB chiefs and mental health CEOs are therefore being asked to report any challenges to the safe and effective implementation of the model, including the need for additional resources or risks to patient safety, to the Department of Health and Social Care.

Systems are being asked to provide information on timescales including when they plan to implement certain phases of the model, These include, for instance, removal of police involvement in responding to people going missing from health facilities in cases where there is no risk of serious harm or criminality.

The survey also asks how systems plan to mitigate risks to individuals experiencing a mental health crisis in their areas.

Ms Murdoch wrote that it is “essential” systems jointly agree phased plans clearly setting out timescales and capital, workforce and revenue requirements, carefully assess the impact of changes on the safety of individuals, and include clear escalation routes.  

Mental health professionals have been raising concerns about the model in recent weeks, and have reported instances where officers have been instructed not to respond to any mental health calls. This is known as “unilateral withdrawal”.

Ms Murdoch told HSJ: ”We agreed to implement the right care right person approach for people at points of crisis, in partnership with the police, to ensure those needing mental health support can get the right help at the right time. We’re really clear that no unilateral withdrawal can possibly be safe or desirable, and what we can’t have is vulnerable people left to fall through the cracks. There’s good evidence of working in partnership [from Humberside] and so it should be possible for others to do so too.

“If there are problems of any kind that ICBs can’t work through constructively or if they think there’s a risk to people, we would expect them to escalate — regionally, in the first instance, but we do want to know nationally as well.”

NHSE is keen for such experiences to be reported to them and the government.

The Royal College of Psychiatrists, while supporting reduced police involvement in mental health incidents, has questioned the evidence base of RCRP and repeated concerns about the risk of unilateral withdrawal.

The National Police Chiefs’ Council said police forces in England increasingly receive complex calls about “significant mental health crises and vulnerabilities”, which has a “significant impact” on available resources.