Policy paper

National Partnership Agreement: Right Care, Right Person (RCRP)

Updated 17 April 2024

When people are in mental health crisis, they need timely access to support that is compassionate and meets their needs. While there will always be cases where the police need to be involved in responding to someone in mental health crisis (for example, where there is a real and immediate risk to life or serious harm, or where a crime or potential crime is involved), police are increasingly involved when they are not the most appropriate agency to respond, and they are not able to handover care to a more appropriate professional in a timely manner. This impacts on the ability of the police to carry out their other duties effectively, and importantly, can result in people with mental health needs experiencing greater distress and having poorer experiences of the mental health care pathway.

The establishment of the Crisis Care Concordat and the expansion and improvement of mental health services, supported by investment through the NHS Long Term Plan, means that more people who require care and support are able to access this in an appropriate setting and from the right professional. However, this is not yet universally the case and there is scope for improvement through new ways of cross-agency and joined-up working.

This agreement sets out a collective national commitment from the Home Office, Department of Health & Social Care, the National Police Chiefs’ Council, Association of Police and Crime Commissioners, and NHS England to work to end the inappropriate and avoidable involvement of police in responding to incidents involving people with mental health needs. Where it is appropriate for the police to be involved in responding, this will continue to happen, but the police should only be involved for as long as is necessary, and in conjunction with health and/or social care services.

The strategic approach described in this document, ‘Right Care, Right Person’ (RCRP) ^{[footnote 1]} provides a framework for assisting police with decision-making about when they should be involved in responding to reported incidents involving people with mental health needs. RCRP has already been implemented in a number of local areas and can help to successfully reduce inappropriate police involvement in care and support better access to mental health specialists.

While each police force is operationally independent, many forces across England are beginning to adopt the RCRP approach. To successfully adopt the approach, strong partnerships need to be formed between police forces, health bodies and local authorities to identify how to implement this approach in a way that best meets the needs of the local population and the shared aims of the agencies involved. To supplement the strategic approach set out in this document, the National Police Chiefs’ Council, College of Policing, and NHS England are producing detailed guidance to support local areas with the operational delivery of RCRP.

The Right Care, Right Person approach

Right Care, Right Person is an approach designed to ensure that people of all ages, who have health and/or social care needs, are responded to by the right person, with the right skills, training, and experience to best meet their needs. Though the approach can be applied more broadly than cases relating to mental health, this document is focused on the interface between policing and mental health services, as one step towards implementing RCRP.

At the centre of the RCRP approach is a threshold to assist police in making decisions about when it is appropriate for them to respond to incidents, including those which relate to people with mental health needs. The threshold for a police response to a mental health-related incident is:

• to investigate a crime that has occurred or is occurring; or
• to protect people, when there is a real and immediate risk to the life of a person, or of a person being subject to or at risk of serious harm ^{[footnote 2]}.

The approach involves consistent use of the RCRP threshold to determine whether the police are the appropriate agency to respond at the point at which the public or other professionals report a mental health-related incident (e.g. via a call made to the police). It is important to distinguish this from the police’s powers under the Mental Health Act 1983 (MHA), e.g. section 136. While the decision to attend an incident is determined by assessing that the incident meets the RCRP threshold, the decision to use powers under the Mental Health Act, is made by an officer at the scene of an incident. Partnership arrangements governing police involvement at pre-planned interventions will continue to be managed at a local level, e.g., police attendance at section 135 MHA warrants. The police will always have the discretion to deploy to incidents and this document does not impede the operational independence of chiefs.

The RCRP threshold should be used in a way that is responsive to dynamic and changeable situations. For example, there may be occasions where a call handler initially judges that there is no clear and immediate risk of serious harm, but the situation escalates. As with all other types of incidents, the police will apply a continuous risk assessment approach, and respond as required to any change in risk, taking into account any information provided by local partners. Likewise, when the police have responded to an incident, but the threshold is no longer reached, there should be a timely transfer of support to mental health or other suitable services, with local areas working towards handovers taking place within one hour as specified in local plans (unless mutually agreed in relation to a particular incident on a case-by-case basis).

Importantly, RCRP may be used in conjunction with appropriate joint-working models that are set up between the police and health agencies locally. Examples of effective and appropriate joint working include statutory Liaison and Diversion services and locally developed health-led triage models. These services, which have a role in ensuring people access the right support, are separate from and can co-exist alongside the use of the RCRP approach.

Local partnership working to implement Right Care, Right Person

It is crucial that at the heart of planning and implementing RCRP for people with mental health needs, there is a focus on ensuring patient safety is maintained and people in mental health crisis are not left without support. This means the approach to RCRP implementation for people with mental health needs should be planned and developed jointly through cross-agency partnerships before changes to responses are introduced. While police forces will ultimately determine the timeframe for implementing the RCRP approach locally, it should be established following engagement with health, social care and other relevant partners. Once implemented, locally developed arrangements should be monitored and reviewed over time.

Implementation should be designed with due regard to the public sector equality duty and the NHS England Patient and Carer Race Equality Framework. In particular, implementation should help support the reduction of people from ethnic minorities in the urgent mental health pathway, who disproportionately experience restrictive interventions and are more likely to access mental health care via the criminal justice system. Consideration should also be given to ensuring that the way that each incident is risk assessed against the RCRP threshold is appropriate for individual needs, for example in relation to children and young people, older adults, people with a learning disability and people who are neurodiverse, including autistic people.

The signatories of this agreement intend that the cross-agency partnerships set up in each area to implement the RCRP approach for people with mental health needs work together on achieving the following:

• Agreeing a joint multi-agency governance structure for developing, implementing, and monitoring the RCRP approach locally. People with lived experience of the urgent mental health pathway, including those from ethnic minorities, should form part of the governance structure and be actively engaged in considering how RCRP is implemented. In addition, from a health system perspective, Integrated Care Boards will play a key role in coordinating the approach to supporting the implementation of RCRP.
• 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. Given that ‘mental health needs’ covers people with a broad spectrum of needs, this should include agreeing what is the remit of health services (primary care and secondary mental health services), local authority services (including social care and substance misuse services), and voluntary, community and social enterprise organisations.
• Enabling universal access to 24/7 advice, assessment, and treatment from mental health professionals for the public (via the NHS111 mental health option), as well as access to advice for multi-agency professionals, including the police, which can help to determine the appropriate response for people with mental health needs. Plans should be put in place to communicate the availability of this advice to the public and other organisations/professionals locally, who may otherwise call the police as their first point of contact.
• Putting in place arrangements to work towards ending police involvement in the following situations, where the RCRP threshold is not met:
  • initial response to people experiencing mental health crisis.
  • responding to concerns for welfare of people with mental health needs (i.e., undertaking welfare checks), where the person is already in contact with a mental health service or other service commissioned to provide mental health support.
  • instances of missing persons from mental health facilities, and walkouts of people with mental health needs from other health facilities (e.g., the Emergency Department).
  • conveyance in police vehicles.
• Embedding multi-agency ways of working that can support decision-making about which service or services are most appropriate to respond to an incident reported to the emergency services (e.g., whether it is police, ambulance, or mental health services, or a joint agency response). For example, health-led, integrated multi-agency triage of 999 calls that enables shared decision-making has been shown to be effective in reducing avoidable police deployment, use of section 136 MHA and police conveyance.
• Ensuring arrangements are in place to minimise delays to handovers of care between the police and mental health services. Currently, there can be significant delays in accessing appropriate mental health expertise and facilities, particularly at evenings and weekends, and when someone is detained under section 135 or 136 of the MHA. These delays are detrimental to the person with urgent mental health needs and the family or friends supporting them and impacts on police capacity to fulfil wider duties. Systems should look to reduce these delays as far as is safe to do so, working towards a timeframe of one hour as specified in local plans (unless mutually agreed in relation to a particular incident on a case-by-case basis).
• 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 of the MHA, to reduce time spent on conveyance.
• Developing local escalation protocols for situations including: significant system delays that result in people being inappropriately under the care of the police when they should be accessing mental health support; detentions in custody (all areas should be ending the practice of detaining people with mental health needs in police cells); and reoccurring situations where health partners feel the RCRP threshold is met but a police response is not provided. Protocols should include information on how to escalate urgent issues that cannot be resolved locally and processes for identifying reoccurring issues that indicate a system change is required.
• Establishing effective mechanisms to support data collection and sharing across agencies, to inform the development and implementation of RCRP, including any changes required to ways of working and wider-system resourcing. The data should enable an understanding of local urgent and emergency mental health need, current levels of police involvement in mental health related pathways, and the impact of the changes introduced under RCRP, both operationally and in terms of the experiences and outcomes of people requiring urgent mental health support. This includes monitoring the impact for people from ethnic minorities, and other groups with specific needs, such as children and young people, and autistic people, and taking action where inequitable impact is identified.
• Developing multi-agency training to support decision making and understanding of roles and responsibilities in relation to RCRP, as well as the Mental Health Act.

National support for implementation of Right Care, Right Person

To support local implementation of Right Care, Right Person for people with mental health needs, The National Police Chiefs’ Council and College of Policing are currently developing a national toolkit, covering topics including decision-making in relation to the RCRP threshold for police response, partnership working, training requirements, and data standards and evaluation. In tandem, NHS England are co-producing guidance with multi-agency professionals and people with lived experience of mental health problems, on how to strengthen the interface between multi-agency partners within the urgent mental health pathway.

There will also be an evaluation of the rollout of the RCRP approach for people with mental health needs. Findings from this evaluation, as well as wider learning about good practice from local partnerships across the country, will be shared to support successful implementation.

• Rt Hon Chris Philp MP, Minister of State for Crime, Policing and Fire
• Maria Caulfield MP, Parliamentary Under Secretary of State for Mental Health and Women’s Health Strategy
• Deputy Chief Constable Rachel Bacon, NPCC Mental Health Lead
• Claire Murdoch, National Mental Health Director, NHS England
• Lisa Townsend, Police and Crime Commissioner, APCC Mental Health lead
• Andy Marsh QPM, Chief Executive Officer, College of Policing

1. Please note, the National Partnership Agreement, the RCRP approach and the guidance/toolkits that will be published to support the implementation of RCRP are not statutory and do not seek to override legislation, regulations, or statutory guidance that the police or health and social care partners are subject to. ↩

2. Detailed legal guidance is being produced as part of the National Police Chiefs’ Council and College of Policing toolkit on the operational considerations of Right Care Right Person. ↩