For The Want of a Nail

Guest BLOG from Chief Constable Simon COLE, former lead on mental health for the National Police Chiefs’ Council.

For the want of a nail the shoe was lost
For the want of a shoe the horse was lost
For the want of a horse the rider was lost
For the want of of a rider the battle was lost
For the want of a battle the kingdom was lost
And all for the want of a horseshoe nail

I must confess that I had always thought (and still do think) that this was about Richard III’s defeat at Bosworth Field, Leicestershire, but then, as the chief constable of the city in which he is laid to rest, for me Richard is the most alive and omnipresent of medieval monarchs in day to day life! However, my researcher (well Wikipedia) tells me that this quote is attributed to Benjamin Franklin, Founding Father of the United States of America.

I am always interested in how such basics impact on policing. For every positive impact of grand strategies or complex delivery plans it does seem that commonsense, compassion and attention to detail have a place too. They are the nails that hold things in place.

There are often stories in the national press about bed shortages in the world of health, and about logjams of patients waiting to move out into social care. What does that have to do with policing? Because policing is part of a huge, complicated, system that supports people we are absolutely at the heart of these issues. The lack of beds for mental health patients, accompanied often by problems accessing appropriate transport, sees police officers and staff spending time hunting for those crucial nails. A cursory look across social media quickly reveals officers and staff having to transport people who are ill in police vehicles, often after lengthy waits. This is not what is described in the Mental Health Crisis Care Concordat.

The concordat focuses on four areas;

  • Access to support before crisis point
  • Urgent and emergency access to crisis care
  • Quality of treatment and care when in crisis
  • Recovery and staying well

That should be supported by local agreements, and overseen by a partnership group that includes a combination of police, PCCs, partnership trusts, ambulance trusts, health commissioners, and local authorities amongst others. They are the people who decide how many ‘nails’ there are: how many bed spaces, how many vehicles for transportation, how many actual places in the Place of Safety. If there aren’t enough of those nails, or there are too many, then they need to know that is the case. It is also the place where some dynamic, innovative partnership based systems thinking can take place to drive progress.

Escalation of what is going well, and what isn’t going well, is really important. That is both as things are happening through control rooms and duty teams, and then slower time through the provision of data and information. That will enable those who are doing the commissioning of health services to see that they have got enough nails, enough horses and enough riders. Because of course the kingdom that we are fighting for is one where people who are ill receive timely, compassionate and appropriate support. For want of a nail that Kingdom can be lost….if you doubt that then please just pop to Leicester and ask Richard III.

Simon Cole QPM is Chief Constable of Leicestershire Police.

IMG_0053IMG_0052Winner of the President’sMedal from the Royal College of Psychiatrists.

Winner of the Mind Digital Media Award


4 thoughts on “For The Want of a Nail

  1. “through the provision of data and information. That will enable those who are doing the commissioning of health services to see that they have got enough nails”
    It surprises me that, for example, a number of CCGs in the south west are unable to answer a simple FOI question about the numbers of people presenting at A&E with self harm / non accidental injuries.

    How can Wiltshire and North Somerset commission the required services when they dont understand the the size and nature of the problem?

  2. Hello Mr Cole, How nice to see you here.

    Do hope your location in a Cornish field is not indicative of a downturn in your circumstances. But, there again, we live in interesting times.

    I appreciate your points regarding the dearth of nails, but I get the impression that there are plentiful supplies of hammers, and those directing hammering operations.

    All that I hear, whether regarding the prison service, prison and court escorts, policing, nursing, caring, the armed services, teaching, social workers, is that there are severe shortages of skilled frontline staff but a surfeit of what are classed as managers but are often bureaucrats.

    However fine, impeccable and well considered our plans for preventing, addressing, managing and following up on our problems, if there are insufficient funds and personnel to implement such plans, then we are just presenting window dressing to the public. However attractive and comforting that might be, such plans might well be a distraction at best and a deceit at worst.

    I have every confidence that when you return to civilization, you will use your best efforts to highlight the problem and your solution and pursue the matter until we have a far more satisfactory situation than the present one.

  3. “That will enable those who are doing the commissioning of health services to see that they have got enough nails, enough horses and enough riders.,…”

    It’s a shame this contributor doesn’t meet your usual standard of clarity…. It would be easy to interpret this blog, hopefully wrongly, as the police are alright it’s just health mismanaging their plentiful resources.

    The police have been struggling with massive cuts, it’s a relatively new experience as previous govts have relied on keeping the police sweet, the NHS has been chronically underfunded. Perhaps come back and criticise health management when the police have been notified that any reorganisation or structural change they make will need to be put out to tender to the private sector and some PCCs have been told their police services are in irredeemable debt and need to be sold off.

    The election of PCCs is in many sense a joke but it places police firmly in the public sector as a service; they may be under pressure but they will not and can’t be sold off to business.

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