I am trying to establish at what point after arrival at a HBPOS the police responsibility effectively ends and when the officers can lawfully withdraw leaving the patient in the care of health professionals.
what protocols and agreements should be in place around this?
There have been various opinions on this, over the years!
On one hand, the Webley v St George’s case (2014?) established something to suggest that police could withdraw only where another agency had agreed to take over and been provided with the background information that meant they knew what they were taking on … but important to remember, that was not a s136 case and the A&E department concerned was not acting as a ‘place of safety’.
Then, police forces have asked for legal advice on this point and I’ve seen two barristers’ opinions on it: one said there was no obligation at all on the police to remain, but that walking away had to be balanced against the police’s legal responsibility to prevent crime: so if the patient was an obvious risk to the safety of NHS staff, beyond their ability to manage someone’s clinical presentation, there could be a secondary duty to remain. The other barrister suggested the police should remain unless the NHS agreed to take over.
The Royal College of Psychiatrists published multi-agency national guidance on standards in 2011 which suggested the NHS should establish PoS arrangements (and staffing for them) which allow the police to handover those detained to PoS staff and leave again within an hour, even where the person is exhibiting disturbed behaviours. In 2013, they published an update document for CCG commissioners which reduced that period to half an hour - I know of nowhere at all that delivers this consistently in reality.
It also has to be understood that police officers and their supervisors are allowed to determine what they prioritise: I have experience of being in a situation where NHS staff were insistent that police remain with a man detained under s136 MHA, but the man being entirely calm and with no obvious risk background, this conflicted with outstanding emergencies that were extremely serious and must take priority because safety was at immediate risk. I doubt there would be a finding that the police were legally obliged to remain there, if doing so compromised their operational capacity to safeguard others in greater need.
Take your pick from that lot, if it helps!
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I can add very little to Michael’s comprehensive reply. But you seem to have hit the nail on the head with your original question. Protocols and agreements need to be in place (and adhered to!).
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In Wales, all agencies have signed up to the Mental Health Crisis Care Concordat, see here https://gov.wales/sites/default/files/publications/2019-03/mental-health-crisis-care-concordat.pdf
The concordat will hopefully encourage all partner agencies to develop a local plan with clear agreements in place. Where issues arose, such as Police not remaining in a POS, and health staff feeling vulnerable with a potential violent person, or Police having to remain at the POS for an unreasonable amount of time, this would then go to a specific group for resolution.
In England, information available here About - Mental Health Crisis Care ConcordatMental Health Crisis Care Concordat
I found the concordat mostly helpful when responding to 136 notifications. Crisis or MHA Administrators would alert me of a 136 arrest, and ask when I could attend. If I had a concern that the person posed a risk of violence, I would insist the Police remain, within earshot of the interview room. On rare occasions I would want them present when undertaking the assessment.
Whilst our POS was reasonably secure, there might be occasions where an admission may be resisted, I would check with the receiving ward if they were able to safely escort the person from the POS to the ward. If they could not, I would again ask the Police to assist us. I would say that the Police were receptive on the whole, and on a number of occasions was grateful for their support.
But there is still disagreement about the question posed: when, if ever, does the law reach a point where the police are no longer obliged to remain. And at least one LHB A&E dept declines to agree with the agreement - meaning it’s ultimately not an agreement at all.
And both Codes are now out of date and their content ambiguous (not just on this point).
There is no legal requirement for officers to stay with the patient.
Health Based Place of Safety should have agreed Standard Operating Procedure in place.
Our Standard Operating Procedure requires that a joint risk assessment should be carried out between the police officers and the nurse managing HBPOS to determine whether police officers are required to stay at the HBPOS.
The agreement to stay at the HBPOS is jointly reviewed on a regular basis. However, Officers can leave for operational reasons.