Recommendations - Sussex Police, March 2020

The IOPC recommends Sussex Police should review ‘Missing Persons Police – Appendix E – Absent Without Leave (AWOL)' policy with specific reference to the below;

The ‘Missing Persons Police – Appendix E – Absent Without Leave (AWOL)’ appears to be overdue for review. Sussex Police and Sussex NHS Trusts should review this policy document with a view to;

a) ensuring that the policy is consistent with Sussex Police’s other missing persons policies and guidance and;

b) considering whether this should be brought in line with APP for Missing Persons and the APP for AWOL patients, specifically relating to multi-agency protocols in relation to missing or AWOL patients.

At 7.06am, a nurse from the Princess Royal Hospital, Haywards Heath, contacted Sussex Police in order to report a male patient, had left the grounds of the hospital and was uncontactable. The nurse reported the man had been admitted to the Accident and Emergency Department the previous evening. The man had expressed intent to harm himself and he had been seen by the Mental Health team who considered his condition serious enough to keep him in hospital overnight. The man was due to be seen by the Mental Health Team again that morning for further assessment. The incident was classified as a ‘concern for welfare’ and graded as a Grade 2 ‘Prompt’ response. Between 7.27am and 8.08am a discussion was had between staff within the control room and the Sussex Police response team Sergeant, as to whether NHS staff were responsible for undertaking actions to locate the man, or whether this responsibility fell to Sussex Police. As a result, the incident log relating to man was mistakenly closed for a brief period, however, at 8.08am it was re-opened and the response Sergeant assigned Sussex Police units to attend the man's address.

During the course of the IOPC investigation, the following was identified in regard to the Sussex Police ‘Missing Persons Police – Appendix E – Absent Without Leave (AWOL)’ document;

i) The document was last updated in December of 2015 and was set for review in November of 2017 but remained extant in October of 2019.

ii) The document provided the following definition of ‘missing’;

“Anyone whose whereabouts cannot be established and where the circumstances are out of character, or the context suggests the person may be the subject of crime or at risk of harm to themselves or another.” (pg. 4)

This does not match the definition of missing in the main Sussex Police missing persons policy (D10), and in line with APP guidance, which is;

“Anyone whose whereabouts cannot be established will be considered as missing until located and their well-being or otherwise confirmed” (p.2)

The Sussex Police and Sussex NHS Partnerships should also review the ‘Missing Persons Police – Appendix E – Absent Without Leave (AWOL)’ with a view to establishing which agency is responsible for conducting checks to ascertain the wellbeing and whereabouts of patients absent from hospital. A specific emphasis should be placed on instances where there is either; a) disagreement as to primacy as to which agency has responsibility to conduct the necessary checks, or, b) the status of the patient is ambiguous so as to not clearly define primacy.A contingency position whereby an agency is automatically allocated responsibility to conduct the necessary checks should be established.

​The Sussex Police and Sussex NHS Partnerships should also review the ‘Missing Persons Police – Appendix E – Absent Without Leave (AWOL)’ with a view to establishing which agency is responsible for conducting checks to ascertain the wellbeing and whereabouts of patients absent from hospital. A specific emphasis should be placed on instances where there is either;

a) disagreement as to primacy as to which agency has responsibility to conduct the necessary checks, or,

b) the status of the patient is ambiguous so as to not clearly define primacy.

A contingency position whereby an agency is automatically allocated responsibility to conduct the necessary checks should be established.

At 7.06am, a nurse from the Princess Royal Hospital, Haywards Heath, contacted Sussex Police in order to report a male patient, had left the grounds of the hospital and was uncontactable. The nurse reported the man had been admitted to the Accident and Emergency Department the previous evening. The man had expressed intent to harm himself and he had been seen by the Mental Health team who considered his condition serious enough to keep him in hospital overnight. The man was due to be seen by the Mental Health Team again that morning for further assessment. The incident was classified as a ‘concern for welfare’ and graded as a Grade 2 ‘Prompt’ response. Between 7.27am and 8.08am a discussion was had between staff within the control room and the Sussex Police response team Sergeant, as to whether NHS staff were responsible for undertaking actions to locate the man, or whether this responsibility fell to Sussex Police. As a result, the incident log relating to man was mistakenly closed for a brief period, however, at 8.08am it was re-opened and the response Sergeant assigned Sussex Police units to attend the man's address.

During the course of the IOPC investigation, the following was identified in regard to the Sussex Police ‘Missing Persons Police – Appendix E – Absent Without Leave (AWOL)’ document;

The document provided the following definition of ‘absent’ when in relation to an ‘informal’ patient;

“Any informal patient who is found not to be present on the ward or in the hospital building, and grounds and who has not advised staff and is not taking agreed leave should be treated as absent for the purposes of this document.” (para 2.3, p. 6).

The category of ‘absent’ is not included in the main Sussex Police missing persons policy (D10), and the guidance for call handlers (D12) specifically states:

“There is no longer such a thing as an Absent/absentee status - persons will be deemed missing or not” (p. 1)

The document does not offer clarification on the difference between a missing person and a concern for welfare, which is how the initial call regarding the patient was originally categorised.

The document does not provide sufficient clarity as which organisation, Sussex Police or Sussex NHS Trusts, should take responsibility for locating an informal patient who has absented themselves from hospital.

​If such a situation arises, a review should take place after proactive measures to allocate responsibility have been taken, as opposed to at the material time of the patient being absent in order to avoid delay in resourcing a response.

At 7.06am, a nurse from the Princess Royal Hospital, Haywards Heath, contacted Sussex Police in order to report a male patient, had left the grounds of the hospital and was uncontactable. The nurse reported the man had been admitted to the Accident and Emergency Department the previous evening. The man had expressed intent to harm himself and he had been seen by the Mental Health team who considered his condition serious enough to keep him in hospital overnight. The man was due to be seen by the Mental Health Team again that morning for further assessment. The incident was classified as a ‘concern for welfare’ and graded as a Grade 2 ‘Prompt’ response. Between 7.27am and 8.08am a discussion was had between staff within the control room and the Sussex Police response team Sergeant, as to whether NHS staff were responsible for undertaking actions to locate the man, or whether this responsibility fell to Sussex Police. As a result, the incident log relating to man was mistakenly closed for a brief period, however, at 8.08am it was re-opened and the response Sergeant assigned Sussex Police units to attend the man's address.