Paul Alexander

Police Response  to Regulation 28: REPORT TO PREVENT FUTURE 
DEATHS 

27th June 2025 

Dear Mr Merchant, 

Thank you for your report dated 27th May 2025 in respect of the death of Mr Paul Alexander.  

I am aware that you will share my response with Mr Alexander’s family, and I firstly wish to express my sincere 
condolences to them. 

Having carefully considered your report, I have prepared a response below aligned to the four areas of concern 
raised: 

1. 

In  the  course  of  the  evidence,  it  became  apparent  the  police  had  introduced  RCRP  in  September  2023. 
RCRP is a police initiative arising out of a national agreement but to be implemented by individual police 
forces. Little or no consultation with other agencies had taken place prior to the implementation of RCRP in 
September 2023.  

2.  Whilst I heard evidence that meetings with other agencies now do take place, the specifics of Paul’s case 
and  the  broader  issues  it  raises  have  not  been  discussed  nor  is  there  any  understanding/  agreement  in 
place as to how such a situation would now be addressed.  

3.  As  much  as  the  court  was  advised  was  that  if  a  similar  situation  arose  today,  there  may  be  a  discussion 
between operational managers in the respective police and ambulance call centres, but that this would be 
reliant upon the matter being brought to the attention of those respective managers by the call taker.  

4.  The evidence from the RCRP lead at the ambulance service indicated the scenario that arose with Paul was 
not an isolated example. As such there appears to be a lacuna in how emergency services will respond to 
such a situation when it was accepted this was a call expressing concern for Paul’s welfare.  

In providing this response I have consulted with Professional Standards Directorate (PSD), Force Contact Centre, 
Right Care Right Person (RCRP) implementation leads and our force Mental Health lead. Furthermore, WYP have 
consulted with National Police Chiefs Council RCRP Project Team, Chief Inspector 

. 

1  Background 
1.1.1 

Right Care, Right Person (RCRP) 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. 

1.1.2 

RCRP is an approach developed originally by Humberside Police and partners. It sets out the principles 
around  a  partnership  approach  which  aims  to  ensure  that  individuals  in  mental  health  crisis  are 
responded to by the right professional. 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 1.1.3 

In  July  2023,  the  Department  of  Health  and  Social  Care  (DHSC)  launched  the  National  Partnership 
Agreement  (NPA):  Right  Care  Right  Person.  The  NPA  was  signed  by  Government,  the  National  Police 
Chiefs  Council,  the  Association  of  Police  and  Crime  Commissioners  the  College  of  Policing  and  NHS 
England. 

1.1.4 

The RCRP approach is being implemented in West Yorkshire in four phases.  

• 

• 

• 

• 

Phase 1 relates to ‘concern for welfare’ calls; 

Phase 2 focusses on ‘AWOL’ and ‘walk out of health care facilities’;  

Phase 3 deals with transportation of patients; and 

Phase  4  concerns  the  use  of  powers  under  sections  136  &  135  of  the  Mental  Health  Act  1983 
(MHA 1983) and voluntary mental health patients. 

1.1.5 

The  first  two  phases  of  RCRP  were  launched  in  West  Yorkshire  on  4th  September  2023.  The  latter 
phases were launched on 19th May 2025. 

2  Consultation 

In the course of the evidence, it became apparent the police had introduced RCRP in September 2023. RCRP is a 
police initiative arising out of a national agreement but to be implemented by individual police forces. Little or no 
consultation with other agencies had taken place prior to the implementation of RCRP in September 2023. 

2.1.1  Whilst RCRP was launched in West Yorkshire in September 2023, WYP had been working to, what in 
practice, are the principles of Right Care Right Person since April 2019. This was done at the time with 
the full cooperation of Integrated Care Boards (ICB) and as such the Right Care Right Person changes 
were not anticipated to impact upon the health partners as significantly in West Yorkshire.  

2.1.2 

2.1.3 

2.1.4 

2.1.5 

2.1.6 

2.1.7 

2.1.8 

An accompanying ‘Welfare Checks Deployment Procedure’ policy was implemented and was published 
on WYP website - Welfare Checks Deployment Procedure - Force Policy | West Yorkshire Police 

The  above  policy  was  discussed  with  partnership  colleagues  including  Yorkshire  Ambulance  Service 
(YAS), it was revised in September 2022 after WYP and YAS jointly approved the policy and its contents. 
Amongst those consulted at YAS was James Goulding who provided evidence at this inquest. 

Productive  and  supportive  relationships  were  already  in  place  in  West  Yorkshire,  both  at  a  strategic 
level and tactical level across our 5 Districts who deliver our frontline policing. 

In effect, RCRP represented a re-launch of existing policy and practice both internally and externally to 
adopt  a  partnership  approach  in  line  with  the  NPA.  The  implementation  has  followed  the  guidance 
included in the College of Policing Right Care, Right Person toolkit  - Right  Care Right Person toolkit | 
College of Policing and is based on independent legal advice from 
. WYP had also obtained 
legal advice from 

 ahead of launching the Welfare Checks Deployment Procedure. 

RCRP was briefed to this effect, into the inaugural meeting of the Criminal Justice Mental Health Forum 
on 26th April 2023 and has remained as a standing item since. This followed communication from the 
Home Office to all police forces advocating the RCRP approach. 

On  17th  May  2023  the  minutes  of  the  meeting  were  circulated  to  the  membership  along  with  a 
document  identifying  organisations  and  individuals  who  were  members  of  the  forum.  YAS  were 
included on this document and their representative included in the circulation. 

On 7th June 2023 the second Criminal Justice Mental Health Forum (CJMHF) was held. Representatives 
from across the  partnership  were present including West  Yorkshire Police and YAS. A further update 
was provided on RCRP. 

2 

 
 
 
 2.1.9 

Prior  to  the  launch  of  RCRP,  WYP  had  been  engaged  in  discussions  with  YAS  on  establishing  a  joint 
operating model for mental health response vehicles, an initiative which directly referenced and was 
delivered  to  support  the  RCRP  approach.  (August  2023).  Representatives  from  YAS  attended  some 
initial training sessions WYP delivered to Contact Centre staff. 

2.1.10  The WYP Senior  Responsible Officer (SRO) 

 wrote to Executive leads  of each Trust 

(September 2023) to brief them on the above. 

2.1.11  A  RCRP  Communication  subgroup  was  established  (October  2023)  and  SROs  were  appointed  in  each 
partner  agency,  coordinated  by  WYCA  (October  2023).  A  joint  communications  strategy  was  agreed 
between partner agencies aligned to RCRP (November 2023). 

2.1.12  Updates  on  the  implementation  of  RCRP  have  been  reported  into  Community  Outcomes  Meetings, 

chaired by the Deputy Mayor for Policing and Crime since September 2023. 

2.1.13  WYP have collaborated with partner agencies to deliver joint-agency RCRP training days and workshops 
to hundreds of people across the partnership at different levels. Several of these have been delivered 
in collaboration with colleagues from YAS and Social Care including two large events hosted by WYP on 
12th and 26th April 2024. 

2.1.14  Further events have included urgent and emergency care partners through to third sector colleagues. 

2.1.15  The launch of Phases 3 and 4 of RCRP again continues partnership-led work around the transportation 
of  mental  health  patients,  use  of  Section  135  and  Section  136  of  the  Mental  Health  Act  1983  and 
in  the  context  of  RCRP  and 
voluntary  patients.  Existing  governance  has  been  strengthened 
opportunities  to  improve  have  been  identified  and  developed.  Two  pilot  initiatives  are  under  way  in 
collaboration  with  partner  agencies  –  a  community-based  mental  health  assessment  initiative  and  a 
Webley  Handover  initiative.  Both  have  been  communicated  with  partner  agencies  and  will  be 
comprehensively evaluated before being adopted into ‘business as usual’. 

2.1.16 

It  is  therefore  our  position  that  WYP  engaged  comprehensively  with  partner  agencies  ahead  of  the 
launch  of  RCRP  and  that  our  procedures  remained  consistent  with  existing  practice  which  had  been 
discussed  and  approved  by  partner  agency  colleagues.  RCRP  enabled  a  re-launch  of  our  partnership 
approach to responding to mental health crisis in communities. It has enabled service improvements 
including  early  decision  making, 
improved  partnership  communication  and  collaboration  and 
continuous improvement from shared learning. 

3  Shared learning to address gaps in service 

Whilst I heard evidence that meetings with other agencies now do take place, the specifics of Paul’s case and the 
broader issues it raises have not been discussed nor is there any understanding/ agreement in place as to how 
such a situation would now be addressed. 

3.1.1 

3.1.2 

As  detailed  above,  the  Criminal  Justice  Mental  Health  (CJMH)  meeting  has  been  developed  with  the 
support of WYCA to act as the central governance meeting for RCRP 

Several RCRP sub-groups have been developed from learning identified from incidents and partnership 
discussions which include: 

• 

• 

RCRP Data subgroup – to share partnership data to understand service delivery across the system 

RCRP Communications subgroup – to promote shared understanding of RCRP, impact on service 
delivery and to quickly initiate joint communication across partners delivering RCRP 

3.1.3 

Previous coronial inquests have been discussed in the meeting to communicate key issues arising and 
develop a partnership strategy to address concerns. 

3 

 
 
 
 3.1.4  WYP  and  YAS  met  following  these  inquests  and  followed  with  joint  workshops  involving  our  contact 
centre to understand how each service assesses concern for welfare incidents. Location of the patient 
and our escalation process were discussed, both of which have continued to be developed to address 
learning  from  these  inquests.  We  are  meeting  with  YAS  for  a  joint  agency  workshop  based  on  the 
circumstances of this case and wider learning on 25th July 2025. 

3.1.5  WYP  and  YAS  have  also  collaborated  following  an  inquest  to  review  our  joint  procedures  around 
hospital and healthcare walkouts. This has led to the development of joint policies and procedures with 
partners in the West Yorkshire Association of Acute Trusts (WYAAT) 

3.1.6 

3.1.7 

As  detailed  further  in  the  ‘escalation’  section  below,  the  health  system  is  navigating  significant 
challenges including increased demand, complexity, lack of resources and system-wide changes. RCRP 
has  improved  our  understanding  and  identification  of  these  gaps,  many  of  which  were  not  apparent 
prior  to  implementation.  A  number  of  these  gaps  are  system  wide  and  are  further  complicated  by 
multiple trusts and organisations working within the West Yorkshire region within different ICBs. 

Implementing RCRP has facilitated  more holistic discussions around these gaps and has enabled WYP 
to  refine policies and  procedures in line with these wider  system challenges. The improved data and 
information  sharing  has  enabled  gaps  to  be  identified  and  where  possible  closed.  However,  in  many 
cases these gaps in service can only be mitigated, for example the availability of out of hours support 
for mental health crisis. 

3.1.8 

Under  RCRP,  several  internal  review  processes  have  been  improved  and  streamlined  to  enable  rapid 
learning to take place. 

3.1.9  WYP  Professional  Standards  Department  review  every  death  or  serious  injury  (DSI)  following  police 

contact. 

• 

• 

Identifies any operational or safety-critical issues in respect of procedures, training or 
equipment used; and  

Ensures individual, team and organisational learning takes place and is addressed locally and 
nationally, as appropriate. 

3.1.10  A  specific  procedure  has  been  designed  with  the  support  of  WYP  Professional  Standards  to  facilitate 

the early triage of RCRP DSI cases to consider this: 

RCRP DSI process: 

• 

The PSD Reviewing Officer forwards a summary of the incident to the WYP RCRP mailbox 
which is monitored by the implementation team. 

•  An initial triage is made on the incident and police response, assessed against force policy. A 
response is provided to PSD on whether the response met the requirements of force policy. 

• 

• 

• 

• 

Based on this the force may instigate misconduct proceedings. PSD also forward any 28A 
Learning Recommendations from the IOPC following their review of cases referred to them. 

Immediate safety or policy implications are identified and addressed at this stage, but in line 
with protecting the integrity of any misconduct investigation. 

Learning from such cases is (and has been previously) shared with internal staff through force 
messages, operational briefings, via senior leadership teams, via Contact Centre Focus Group 
contacts and in the meetings discussed above. 

This learning is and has been shared with partner agencies in the above meetings, but also in 
specific meetings and workshops organised at the appropriate time following the incident.  

3.1.11  RCRP is discussed in a number of internal and external meetings and forums: 

4 

 
 
 
 •  Mental Health Improvement Meeting – develops a place-based/local approach to partnership 

• 

• 

working. 
RCRP Focus Group Meeting – regular meeting with WYP Contact Centre teams to review incidents 
and developments, share learning and enable feedback. 
Tri-Service Collaboration (Police/Fire/Ambulance) – a strategic meeting for blue light services to 
discuss wider system pressures. RCRP has been discussed consistently since November 2023 and 
discussions have taken place between WYP and YAS Head of Partnerships to build joint working 
and collaboration between services. As part of this collaboration a Memorandum of 
Understanding was developed for concern for welfare incidents where West Yorkshire Fire Service 
can provide support with gaining entry to properties. This is a key piece of partnership working 
between agencies which has developed from a pilot to “business as usual” since RCRP has been 
launched. 

3.1.12  Learning  from  incidents,  inquests  and  communication  with  partner  agencies  has  enabled  several 

improvements to be made to WYP internal processes and procedures: 

• 
• 
• 

Introduction of an RCRP toolkit to support effective decision making (June 2024) 
RCRP question set to apply a structured approach to each Concern for Safety incident (June 2024) 
Contact Focus Group established (November 2023) trained to deliver peer to peer training on RCRP - 
delivered updated training across Contact teams (July 2024) 
• 
Internal escalation process updated and escalation training delivered to supervisors (February 2025) 
•  Discussions with YAS on their updated AQM and process for welfare checks where ‘location not known’ 

leading to a workshop discussion (September 2024) with YAS RCRP lead 
•  Discussions with YAS on updated (real-time) escalation process (April 2025) 
• 

Toolkit updated to reflect learning on repeat callers, front page now assesses if the report is a ‘further 
report’ or a ‘new report’ (June 2025) 

•  Audit and review cycle implemented with Contact Team Leaders reviewing RCRP decisions on their 

• 
• 

own teams (October 2024) 
Bespoke performance and compliance data product created (July 2024) 
Internal Audit of RCRP completed for WYP Contact Centres (November 2024) with learning identified 
and actions completed to improve practice 

4  Escalation process – WYP/YAS 

As much as the court was advised was that if a similar situation arose today, there may be a discussion between 
operational managers in the respective police and ambulance call centres, but that this would be reliant upon 
the matter being brought to the attention of those respective managers by the call taker. 

4.1.1 

4.1.2 

4.1.3 

There has been an existing ‘Escalation Policy’ in force prior to the launch of RCRP, contained within the 
‘Welfare check deployment criteria’ Policy, which was updated in consultation with YAS in August 2022.  

This  policy  applied  the  same  threshold  for  deployment  as  the  subsequent  ‘Right  Care  Right  Person’ 
deployment  threshold  as  West  Yorkshire  Police  had  looked  at  non-Policing  demand  prior  to 
Humberside Police. In effect, WYP staff were being reminded of the existing escalation process as part 
of RCRP training from launch in September 2023. 

The policy is referenced above and is publicly available via the WYP website. This Policy held until 30th 
October  2024,  when  it  was  updated  to  reference  RCRP  and  the  increased  scope  of  this  approach 
beyond  welfare  checks  alone.  The  updated  section  now  outlines  three  scenarios  requiring  the 
escalation procedure to be utilised: 

5 

 
 
 
 • 

• 

• 

The escalation procedure must be utilised if a Right Care Right Person (RCRP) decision not to 
attend is appealed by a partner agency.  

The matter can also be escalated to a supervisor when a member of the public insists on 
police attendance, following a no deployment RCRP decision. 

In the event of a disagreement between the requesting agency and police in terms of the 
immediacy of any risk to life or the identified policing objective that has necessitated the 
request being made, the matter must be subject of the escalation procedure to clarify 
whether police resources are deployed. 

4.1.4 

4.1.5 

4.1.6 

4.1.7 

4.1.8 

The  circumstances  of  this  case  would  give  rise  to  the  second  and  third  points  above,  reflecting  the 
further call to WYP requesting a welfare check and the signposting of the caller by YAS to WYP on the 
grounds that a missing person investigation should be considered. 

This  updated  policy  reflects  discussions  with  partnership  agencies,  including  a  revised  escalation 
process which was discussed with YAS in September 2024. Since this date, WYP have been in regular 
contact with YAS to develop and introduce an improved escalation process to streamline and widen the 
scope of escalation to support in cases where the RCRP threshold to deploy is not met. 

Processes, procedures and terms of reference have been designed and have been approved by the Call 
Handling lead for YAS following consultation. 

Every  escalation  must  be  documented  by  WYP  using  a  digital  form,  this  applies  a  National  Decision 
Making  rationale  to  the  situation  which  can  therefore  be  communicated  with  blue  light  partners 
including YAS. On submission of this form, a copy is automatically forwarded to the WYP RCRP mailbox 
to act as an audit trail and enables a review of quality. 

As  detailed  above,  the  WYP  RCRP  Toolkit  has  been  updated  to  provide  specific  direction  for  contact 
officers and supervisors to consider formal escalation from the outset, based on repeat calls or callers 
re-directed from another service. The toolkit outlines the process to the call taker/supervisor to guide 
them through the process. 

4.1.9 

A training package was developed and has been delivered to contact centre supervisors and managers. 
Completion of this training is being monitored to ensure that all staff at this level are trained. 

4.1.10  A  daily  escalation  review  now  takes  place,  including  any  incidents  highlighted  to  the  RCRP  team  by 
Contact which have no form completed. Feedback is provided to staff based on the quality and extent 
of the escalation and shared with contact centre leadership team. 

4.1.11  Every  “concern  for  safety”  incident  recorded  by  WYP  is  subject  to  an  automated  question  set  which 

asks the call taker – 

• 

• 

• 

• 

Is this call reporting a concern for a person’s welfare? 

Is there a real and immediate risk to life? 

I confirm I have applied the RCRP toolkit to this call 

Copy/paste the toolkit recommendation below *and* complete a THRIVE, based on your NDM 
(National Decision Model) assessment of this call 

4.1.12  The  responses  to  these  questions  are  documented  on  each  incident  log,  meaning  that  any  incidents 

flagged as requiring a supervisor review are queried for escalation daily. 

4.1.13  A  monthly  partnership  meeting  has  commenced  with  YAS  where  escalated  cases  are  discussed  to 
identify shared learning and ensure a feedback loop is in place. YAS also raise any incidents submitted 
on Datix referrals concerning police attendance/non-attendance. 

4.1.14  These improvements to the escalation process are intended to bring improvements to communication 
between WYP and YAS and to reduce incidents where a caller is signposted between agencies for the 
same call. 

6 

 
 
 5  Clarify position on responding to concern for welfare incidents 

The evidence from the RCRP lead at the ambulance service indicated the scenario that arose with Paul was not 
an isolated example. As such there appears to be a lacuna in how emergency services will respond to such a 
situation when it was accepted this was a call expressing concern for Paul’s welfare. 

5.1.1 

The National Partnership Agreement for RCRP states: 

“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” 

5.1.2 

This follows independent legal advice obtained for RCRP which outlines: 

“The police do not generally owe a duty of care under common law to protect individuals from harm – 
either harm caused by themselves or others. Where the police do not act, it is unlikely that they will be 
held to have breached a duty of care.” 

5.1.3 

The police may owe a duty of care to protect persons from harm where they have either: 

• 
• 

assumed responsibility to care for them 
created (directly or indirectly) the risk of harm” 

5.1.4 

5.1.5 

5.1.6 

5.1.7 

5.1.8 

Our response to a concern for welfare incident follows the principles set out in College of Policing APP - 
Safe and well checks | College of Policing 

As reflected in College of Policing guidance – “Police officers are neither trained nor equipped to carry 
out clinical assessments on the mental health or wellbeing of an individual (no matter how urgent the 
issue is) and it is not appropriate for them to fulfil the role of a healthcare professional.” 

The above is reflected in WYP “Concern for Welfare” policy and pre-dated RCRP as discussed above. 

An  assessment  is  made  on  every  such  concern  for  welfare  incident,  reinforced  with  an  automated 
question set on the incident log which directs the contact officer to complete the required actions. This 
includes  the  use  of  the  RCRP  toolkit  which  supports  the  officer  to  make  structured  and  consistent 
decisions on deployment of police resources. 

The RCRP toolkit was developed based on practice in Humberside Police and reflects our own Concern 
for  Welfare  policy,  to  help  operational  staff  navigate  the  policy  requirements.  It  has  now  been  used 
over  40,000  times  to  support  operational  decisions  and  in  over  95%  of  RCRP  incidents  since  being 
launched on 16th July 2024. 

5.1.9 

Each incident is not only assessed to understand when a legal duty of care is owed to an individual, but 
also against the core role and purpose of policing. 

5.1.10  As above, every “concern for safety” incident recorded by WYP is subject to an automated question set 

which asks the call taker – 

• 

• 

• 

• 

Is this call reporting a concern for a person’s welfare? 

Is there a real and immediate risk to life? 

I confirm I have applied the RCRP toolkit to this call 

Copy/paste the toolkit recommendation below *and* complete a THRIVE, based on your NDM 
(National Decision Model) assessment of this call 

7 

 
 
 
 5.1.11  The  toolkit  recommendation  referred  to  above  contains  practical  advice  to  the  member  of  staff  on 
what  action  to  take  based  on  their  navigation  through  the  toolkit.  This  includes  advice  on  when  and 
whom to signpost callers to where appropriate. 

5.1.12  Where there is no legal duty of care and the incident does not meet the core purpose of policing, the 
caller must be informed of this decision. At this point the call taker may signpost the caller to a more 
appropriate agency based on their assessment of the call, following guidance from College of Policing. 

5.1.13  There  is  specific  guidance  in  the  toolkit  and  Concern  for  Welfare  policy  on  when  to  signpost  to 

Yorkshire Ambulance Service – 

“The call taker must note that Yorkshire Ambulance Service (YAS) are not the appropriate service for all 
mental health incidents. YAS do not conduct general concern for welfare checks. Their deployment 
criteria is set ‘for persons in immediate need of emergency medical care.’” 

5.1.14  There  is  further  guidance  on  our  intranet  to  call  takers,  highlighting  that  the  Ambulance  Service  will 
only  deploy  an  ambulance  if  the  location  of  the  patient  is  known.  The  location  of  the  patient  has 
caused challenges in some incidents, where a different definition of location has been applied by WYP 
and YAS.  

5.1.15 

In this case the location of the patient was known and recorded as such on the WYP incident log. The 
call to Police detailed a concern for the welfare of Mr Alexander who was at that time outside in the 
street  as  witnessed  by  the  caller.  Furthermore,  the  location  he  was  observed  was  outside  his  home 
address. Mr Alexander was named by the caller, and a history of mental illness was disclosed. The caller 
requested a welfare check on Mr Alexander. 

5.1.16  On this basis the caller was signposted to Yorkshire Ambulance Service, in line with 5.1.5 above. 

5.1.17  Based on the further call to WYP an opportunity was missed to re-assess and escalate our assessment 
with  YAS  using  the  escalation  process  in  place  at  the  time.  This  escalation  process  has  since  been 
reviewed to  capture  all incidents where  there  is a disagreement on which service should attend, the 
process is outlined from 4.1.1 above. 

5.1.18  As  discussed  above,  the  RCRP  deployment  threshold  did  not  change  existing  processes  in  West 
Yorkshire. These processes were communicated with partner agencies ahead of the implementation of 
RCRP, including Yorkshire Ambulance Service who were directly involved in the updated Welfare Check 
Procedures signed off in 2022. 

5.1.19  A joint evaluation of RCRP was carried out by  the  Home  Office and Department  of Health and Social 
Care  in  December  20241  which  outlines  some  of  the  unintended  consequences,  risks  and  learning 
identified by stakeholders. This includes the following: 

“Decision making can be difficult for control room staff, incidents are often not clear cut, and decisions 
are based on information staff are provided with, which can be incomplete… Police said implementation 
was an iterative process where any concerns raised were considered through checkpoint reviews before 
each phase, and policies amended as appropriate” 

5.1.20  The  evaluation  made  the  following  recommendations  to  support  the  continuing  implementation  of 

RCRP across police force areas: 

•  multi-agency working groups meeting regularly to discuss implementation plans openly 

• 

• 

internal communication within organisations so everyone understands the RCRP approach and 
external communication with partners 

sharing of learning between partner organisations and across areas 

1 https://www.gov.uk/government/publications/evaluating-the-implementation-of-right-care-right-
person/right-care-right-person 

8 

 
 
 
 • 

• 

• 

• 

adequate training for staff, ensuring legal responsibilities and guidelines are followed 

effective safety protocols and single points of contact to facilitate communication 

a phased implementation approach 

establishing robust and trusted escalation processes for reviewing incidents 

5.1.21  WYP  reviewed  the  evaluation  and  the  recommendations  at  the  time  of  publication,  all  these  areas 
formed  part  of  the  ongoing  implementation  plan.  As  highlighted  above,  the  escalation  process  has 
been developed following partnership discussions and incidents arising. 

6  Conclusion 
6.1.1 

The  implementation  of  RCRP  in  West  Yorkshire  has  been  delivered  with  partners  who  were  briefed 
ahead of the formal start of RCRP in September 2023. I must reiterate the position that RCRP did not 
reflect  any  change  in  existing  processes  but  allowed  us  to  integrate  and  improve  our  approach  from 
working more closely in partnership to improve existing. 

6.1.2  We are continuing to work closely with Yorkshire Ambulance Service and wider partnership colleagues 
to  identify  and  share  learning,  gaps  in  service  and  any  issues  and  concerns  arising  to  continuously 
improve our service delivery. 

6.1.3 

I am hopeful that the detail in this response demonstrates how much RCRP has developed since the 
tragic  circumstances  of  this  case.  As  was  discussed  in  the  inquest,  our  approach  has  been  to  better 
identify,  understand and mitigate the risks  presented from gaps in  care for mental  ill health. We are 
continuously  reviewing  incidents  to  improve  our  policing  and  partnership  response  aligned  with  the 
RCRP approach. 

6.1.4 

In conclusion I hope this response addresses the concerns that you have raised and demonstrates our 
commitment to delivering RCRP as a partnership approach. 

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