Agenda item

Note by Clerk: This item was considered earlier in the agenda than originally scheduled.

The Board received a presentation from Lisa Cope, Strategic Lead for Right Care, Right Person from Staffordshire Police.

The Board noted the four phases of the Right Care Right Person model, which set out to ensure that better protection could be given to vulnerable members of our communities and provide them with specialist help they need.

-      Phase 1 – would be launched in February 2024 and focusses on reports relating to concerns for welfare and walk-outs of health care facilities

-      Phase 2 – would be launched in May 2024 and focusses on AWOL and walk out of mental health facilities

-      Phase 3 – would launch in August 2024 and focusses on transportation

-      Phase 4 – would launch in November 2024 and focusses on S.136 / management of mental health incidents.

Underpinning the above phases, it was noted that the Police would continue to respond to all incidents where there was an immediate, real and substantial threat to life or risk of significant harm. All incidents would be reviewed on a case by case basis to assess risk, threat and harm and determine if it was right for the RCRP principles to be applied.

Staffordshire Police launched the implementation of RCRP in July 2023 through a number of multi-stakeholder events, noting the phased approach to implementation. They would continue to attend numerous partnership meetings.

A multi-agency partnership group with representatives from across local authorities, health, social care, VCSE and more was established to work through the implications of implementing RCRP and share learning. A single point of contact for stakeholders was also established.

The National Partnership Agreement, published in July 2023 set out the following actions for RCRP and Mental Health:

-      Agreement of a joint multi-agency governance structure for developing, implementing and monitoring the RCRP approach locally.

-      Reaching a shared understanding of the aims of implementing RCRP locally and the roles and responsibilities of each agency in responding to people with mental health needs.

-      Enabling universal access to 24/7 advice, assessment and treatment from mental health professionals for the public (via the NHS111 mental health option).

-      Putting in place arrangements to work towards ending police involvements in situations where the RCRP threshold was note met.

-      Embedding multi-agency ways of working that could support decision making about which service or services were most appropriate to respond to an incident reported to the emergency services.

-      Ensuring arrangements are in place to minimise delays to handovers of care between the police and mental health services.

-      Developing an approach for police and health systems to work together to quickly and efficiently identify the best place to take a person detained under Section 136.

-      Developing local escalation protocols for situations

-      Establishing effective mechanisms to support data collection and sharing across agencies.

-      Developing multi agency training to support decision making and understanding of roles and responsibilities in relation to RCRP and the Mental Health Act.

Next steps included understanding the current position of health and social care providers against the 10 recommendations and requesting a temperature check exercise is undertaken asking organisations to rate themselves using a Red, Amber, Green (RAG) assessment.

Colleagues would be asked to provide commentary where possible to support their rating. Reasoning for a responsibilities matrix was shared with the board which outlined the temperature check.

The Board were informed of lessons learned so far, including the following:

-      Getting the right representation at RCRP meetings;

-      Making use of the briefing documentation provided;

-      Having a single point of contact for RCRP;

-      Getting the messaging right;

-      Creating a feedback loop;

-      Fostering a learning and sharing culture; and

-      Investing in mental health services and lobbying for further funding.

Health colleagues noted that this was a significant change and colleagues in Staffordshire Police had been very proactive in implementing Right Care, Right Person and engaging in partnership groups. Colleagues supported the best use of scarce resource and targeting support those in need, whilst highlighting some of the operational challenges ahead in terms of timeliness and handover of cases between agencies. A topic for discussion at a future task and finish group would be around risk appetite, for those officers who are on a prolonged handover.

Similarly, it was recognised of the opportunity to use collective resources better and appreciative of the gradual approach working with partners, whilst noting the associated risks with unmanaged gaps appearing from things that the Police currently do, but wouldn’t continue doing in future. The responsibilities matrix was welcomed to this effect.

A question was raised around governance, noting that this work would need to be signed off by all agencies at the appropriate level, and where this would happen. A meeting had taken place with the ICB Chief Executive, Peter Axon where governance was discussed. Whilst it was noted this was a partnership approach, if any issues were discussed at a tactical level, this would be raised with the appropriate Executive within the Integrated Care Framework. With regards to signing this off as a whole, this is a national approach being facilitated by Staffordshire Police, but the solutions were health-led, therefore it was considered a joint iterative approach with the Assistant Chief Constable and the Integrated Care Board.

The Board continued to discuss the importance of governance around this, highlighting whether there was an opportunity at a strategic level to get partners together to look at what the tactical groups are suggesting, and whether this was accepted or whether any risks would be highlighted for review.

It was confirmed that a first strategic meeting had took place and this could take place again in the future, convened by the ACC.

Health colleagues further noted the meeting that had taken place between Peter Axon and ACC Ellison and highlighted the role of the ICB role in helping the Police to navigate health governance systems.

A question was raised on point three of the action plan, around the NHS 111 service. Further information was requested on this service and how it would be rolled out. In response, it was noted that the long term plan was parity of esteem between physical health and mental health, with national policy identifying NHS111 as an area that needed this approach. A piece of work was being implemented across Staffordshire and Stoke-on-Trent around the formal launch of NHS111 Option 2, known as the ‘mental health option’, on the 1^st April 2024. It was confirmed that local partners were resourced to provide the Option 2 service, such as MPFT and North Staffordshire Combined Healthcare. A communications campaign was ready to launch the service however was on hold until other colleagues had completed technical work ahead of the rollout.

District and Borough colleagues further highlighted the importance of exchanging information between all services that the client group access. It was noted that the Right Care, Right Person programme did not preclude any existing work on local problem solving and partnership engagement for cases around housing and complex needs and support.

Councillor Sutton highlighted point one in the key actions and questioned if this needed further work due to the comments presented by Board members. It was agreed to take these comments away from the meeting for discussion with the ACC.

Councillor Jessel suggested that the Health and Wellbeing Board may be well positioned to be the governance structure and queried the public perception of the Right Care, Right Person rollout. Concerns were also raised around patients who go missing and whether this is something that the Police would continue to support. It was noted that a change of narrative was needed for public perception of Police resourcing. By doing this, and implementing RCRP effectively, it would free up Police time to focus on the areas of public priority around burglary and anti-social behaviour. The Police would continue to support instances where colleagues need additional support that can be provided under police powers.

The Board requested that the item be brought back to a future meeting and noted that a discussion would take place offline on the points raised around governance.

Resolved – that the update be noted.