Draft NHSE plans seek to ‘eradicate’ police role in care

A draft NHSE statement suggests trusts could be asked to eradicate features of the ‘serenity integrated mentoring’ care model from clinical practice, following a whirlwind of concerns in 2021 and an investigation by national clinical director Tim Kendall.

A core feature of SIM is to place a police officer within a healthcare team charged with supporting patients who frequently attend emergency services in crisis, and creating crisis plans.

The draft position statement produced by NHSE, which the regulator said is not its final version and is subject to changes, says SIM should not be used.

It also proposes the eradication of the following practices from any equivalent care model:

• Police involvement in delivery of therapeutic interventions in planned, non-emergency, community mental healthcare;
• The use of coercion, sanctions (criminal or otherwise), withholding care and otherwise punitive approaches; and
• Discriminatory practices and attitudes towards patients who express self-harm behaviours, suicidality and/or those who are deemed “high intensity users”.

The statement, which is the first indication of NHSE’s position on the SIM model but not its final stance, also suggests Professor Kendall will be seeking assurance from trust medical directors that SIM or similar models, and the above three features of concern, are no longer used. A full policy and public statement on the model is expected by the spring.

The StopSIM coalition, whose campaigning prompted the NHSE review, has been working on the final policy which it hopes will be published imminently.

They said: “Unless and until the full policy is freely available to service users and the public, service users are not equipped to protect themselves against the dangers of SIM and similar approaches.

“We hope that mental health trusts, commissioners and individual professionals will engage productively with the policy once it is available in its entirety.”

A central concern from campaigners is the approach “criminalises people for experiencing mental distress”.

Although many providers said care and therapy was not delivered by police officers, there were concerns that some roles went “beyond crisis support and urgent intervention”, into planning ongoing mental health care.

Pressure to investigate SIM, which has been used by at least 22 NHS trusts in recent years, came from patient groups and clinicians.

The draft statement suggests NHSE will be offering follow-up support on implications of its final position for local services.

Freedom of information responses suggested Devon Partnership Trust, was still piloting a SIM type model in 2022. Meanwhile, the Surrey High Intensity Partnership Programme, run by Surrey and Borders Partnership Trust, is still advertised on its website, adding the programme employs police officers in a team of healthcare co-ordinators who participate in drawing up care plans. 

Both trusts said they do not use the SIM model, or any of the three practices of concern to NHSE.

A DPT spokesman added: ”The HIP programme works closely with people who use our service to co-produce their care plan and there are a number of critical differences to the SIM model. Informal feedback from people using the service has been extremely positive and we are awaiting the outcome of a formal evaluation.”