Quick Guide – Should I Stay or Should I Go?

This quick guide is an attempt to “operationalise” some complex issues but you should refer to your area’s policy and supervisors for specific local requirements.

  • Unless A&E is set up and designated as the main NHS Place of Safety, only remove to A&E if the person presents with a RED FLAG.
  • Remain with the patient in A&E – they are not set up to manage the legal detention of the person.
  • They provide physical, urgent healthcare connected to RED FLAGS.
  • INITIAL ACTION – Place of Safety
  • Arrive at an NHS PoS – do PNC / Intelligence checks to understand risk.
  • Share that risk information where it is relevant to the NHS keeping themselves safe.
  • Require risk information known to the NHS be shared with you.
  • Jointly rate each detainee as LOW, MEDIUM or HIGH risk.
  • Patients who are LOW RISK – should be left with NHS staff for assessment.
  • Patients who are HIGH RISK – should be supported to protect NHS staff and the individual.
  • Patients who are MEDIUM RISK – should be subject to agreement between staff over whether the police are needed.
  • Some medium risk patients will require police security; others may be known to staff and be safe without police security.
  • If in dispute about MEDIUM RISK patients – remain in situ and refer the matter to your supervisors and subsequently to your inspector.
  • If the NHS demand that the police remain with LOW RISK patients because they are short-staffed, email your inspector.
  • This should be taken up with the MH trust and MH commissioners – it is not right for a range of reasons.
  • There is no legal obligation per se, for the police to remain in an NHS place of safety.
  • There is a legal obligation on the police to prevent crime / protect life.
  • Police leaving an NHS Place of Safety once the patient has arrived:
  • It arises from the Royal College of Psychiatrists Standards on s136 (p8).
  • Remaining in an NHS PoS may be necessary to prevent crime against NHS staff.
  • 68-70% of all assaults on NHS staff are against mental health professionals.

Winner of the President’s Medal,
the Royal College of Psychiatrists.

Winner of the Mind Digital Media Award


All opinions expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2012

I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current.  Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.

Government legislation website – http://www.legislation.gov.uk

3 thoughts on “Quick Guide – Should I Stay or Should I Go?

  1. Sorry if showing my ignorance, but fairly sure I may be red flagged. What exactly is red flagged and how does it work?

  2. Yet again you imply the mentally ill are dangerous to others.
    If 68% of all assaults on NHS staff are against MH (un)professionals, well, that is probably because they are incompetent and abusive. I wonder how many of those ‘assaults’ were in fact reactions by an ill and terrified
    E.g. I was verbally abused for days deliberately provoking me to get a reaction (they do this) and threatened with restraint, was not and never have been violent, just tried to leave the situation and was restrained. I discovered that there is a vicious lie in my notes about my having hit a member of staff to justify the restraint – THIS DID NOT HAPPEN.

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