Policy for NHS to contact MPS when a patient from a mental health ward goes missing concerns for their welfare

Freedom of information request reference no: 01.FOI.22.022942

I note you seek access to the following information:

Can you confirm if the Police should be contacted in the first instance rather than LAS if a patient on a mental health ward goes missing?

Is this the usual process for [NHS] staff to call LAS rather than the police? Also, at what point would the Police be expected to attend an address if there were concerns raised for their welfare?

Decision

I have today decided to disclose the located information to you in full.

Please find below information pursuant to your request above.

The Metropolitan Police have recently launched the Affinity Protocol, a professional partnership between the Metropolitan Police Service (MPS) and NHS Mental Health Services. This partnership is essential to deliver an effective and proportionate response to missing persons, arising from mental health service provisions. The Affinity Protocol ensures that existing policy is adhered to and that the National Missing Adults Framework is referenced appropriately. The protocol strengthens the professional partnership by identifying the key areas of joint responsibility and by raising mutual awareness.

Missing Persons Authorised Professional Practice (APP) exits to ensure that cases of missing persons are investigated effectively. The Missing APP states that NHS Trusts must have Absent Without Leave (AWOL) policies, setting out guidance and expected actions. Staff must ensure that all AWOL Policy responsibilities are met in order to comprehensively determine whether a report to police is required. Not all patients that are AWOL will necessitate a police missing person’s investigation.

The MHA 1983 Code of Practice (para 28.15) indicates that there are three situations that should always and immediately be reported to the police by healthcare services:
patients subject to Part III MHA 1983 – this means patients connected to criminal proceedings, either before or after trial or conviction
patients who are dangerous
patients who are particularly vulnerable.

‘‘There is no obligation in law for hospital staff to report any other relevant matters immediately or at all. As the police have a role in searching for missing people, however, expectations around AWOL patients outside of the above three situations should be set out in a clear protocol.’’

If the decision is made to report a patient missing to the Police the expectation is this will be completed via the online portal. It is pertinent that NHS staff provide as much detail as possible to enable the Police to grade the risk appropriately and formulate an investigation plan. If it is a high risk emergency scenario, the hospital should call 999.

In cases where the patient is found, the police should only be asked to assist in returning a patient to hospital if necessary. If the patient’s location is known, the role of the police should, wherever possible, only be to assist a suitably qualified and experienced mental health professional in returning the patient to hospital.

In terms of attendance at a patient’s address if concerns were raised as to their welfare, is important to note that in the context of welfare checks Police have no general responsibility for safety or welfare of members of the public. The central principle is that police will respond to requests to carry out a welfare check ONLY when they engage one of the core duties of police:

protecting life and property
preserving order
preventing the commission of offences
bringing offenders to justice

Article 2 of the European Convention on Human Rights, incorporated into UK law by the Human Rights Act 1998, places a positive duty on all agencies, to protect life. This positive duty to protect life will depend on the severity and the circumstances, it is not an absolute, as prescribed by the Court ruling in Osman v UK 1988 - the police have no ‘duty of care’ except in the circumstances below:
“In the opinion of the Court where there is an allegation that the authorities have violated their positive obligation to protect the right to life in the context of their above-mentioned duty to prevent and suppress offences against the person, it must be established to its satisfaction that the authorities knew or ought to have known at the time of the existence of a real and immediate risk to the life of an identified individual or individuals from the criminal acts of a third party and that they failed to take measures within the scope of their powers which, judged reasonably, might have been expected to avoid that risk.”

The MPS will respond to a request for a welfare check, if it is established that there is a real and immediate risk to life, or when the information available suggests there is a real and immediate risk to the life of the person. Unless this threshold is reached, police have no duty, and therefore no power, to take any action once outside those premises.