First reported 16 Apr 2015•Latest report 8 Apr 2026
Definition
What this concern includes
Includes failures in arrangements between police, healthcare and probation or closely connected custody functions to identify, record, transfer, access, clarify and acknowledge safety-critical risk information about people subject to care, supervision or public-protection arrangements.
Not included
Excludes generic communication, documentation or information-system deficiencies where no safety-critical risk-information-sharing condition is identified.
Excludes failures in clinical assessment, treatment, probation supervision or police response after relevant risk information has been reliably shared.
Excludes information sharing with families, courts or other recipients unless it directly forms part of the same police-healthcare-probation risk-information interface.
Excludes single-service risk records and named systems where cross-service sharing is not the deficient condition.
Reports
14
Distinct published reports
Individual concerns
14
A report can raise multiple concerns
Date range
2015–2026
First to latest report issue date
Stated actions
34
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Ministry of Justice5
HM Prison and Probation Service4
Department of Health and Social Care3
Home Office3
Metropolitan Police Service3
National Police Chiefs’ Council3
NHS England2
Probation Service2
Association of Police and Crime Commissioners1
Birmingham and Solihull Mental Health NHS Foundation Trust1
Central and North West London NHS Foundation Trust1
College of Policing1
Crown Prosecution Service1
Cumbria Constabulary1
Greater Manchester Combined Authority1
Ministerial department8
Police force8
NHS trust7
Executive agency4
National policing body3
Executive non-departmental public body2
Prison or young offender institution2
Sub-organisation2
English county council1
English metropolitan district council1
Justice inspectorate1
London borough council1
Mayoral policing body1
Non-ministerial department1
Ombudsman1
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
Nottinghamshire
Concerns raised1
Lack of formal information sharing and reliable handover between the CFT and Prison Healthcare
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.10
Action
Establish practical information-sharing arrangements and named contacts between community forensic and prison healthcare teams.
Stated by Northamptonshire Healthcare NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 13 April 2026.
Action
Implement a formal information-sharing procedure requiring prompt, secure, documented handover of clinical and risk information, standard documents, and escalation when contact fails.
Stated by Nottinghamshire Healthcare NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 13 April 2026.
Action
Share and agree the information-sharing guidance with CFT staff, Prison Healthcare providers, and HMP Lincoln to establish consistent cross-organisational expectations.
Stated by Nottinghamshire Healthcare NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 13 April 2026.
Action
Embed the information-sharing guidance through team briefings, clinical supervision, and induction for new staff.
Stated by Nottinghamshire Healthcare NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 13 April 2026.
Action
Maintain a dedicated CFT Link Worker as a consistent Prison Healthcare contact with oversight of information sharing, timely responses, continuity, and service liaison.
Stated by Nottinghamshire Healthcare NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 13 April 2026.
Action
Establish bimonthly interface meetings with HMP Nottingham Prison Healthcare teams to review cases, address communication issues, monitor guidance adherence, and escalate risks.
Stated by Nottinghamshire Healthcare NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 13 April 2026.
Action
Work jointly with Northamptonshire Healthcare NHS Foundation Trust to clarify responsibilities, availability expectations, responsiveness, and escalation pathways.
Stated by Nottinghamshire Healthcare NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 13 April 2026.
Action
Conduct quarterly audits of information-sharing timeliness, documentation completeness, and escalation, and report findings to relevant quality and accountability groups.
Stated by Nottinghamshire Healthcare NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 13 April 2026.
Action
Issue and disseminate information-sharing guidance to prisons through booklet, wallet-sized and intranet formats.
Stated by HM Prison and Probation Service and Ministry of Justice and Nottingham PrisonStated completedThe respondent said that this action was complete when they made their response on 13 April 2026.
Action
Ask the Information Sharing Advisory Group to examine the circumstances of Mr Thornton’s death, identify learning and assess whether updated guidance is needed.
Stated by HM Prison and Probation Service and Ministry of Justice and Nottingham PrisonStated plannedThe respondent said that this action was planned when they made their response on 13 April 2026.
Milton Keynes
Concerns raised1
Failure to reliably consolidate and share relevant prisoner risk information
This report raised 15 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
Action
Revise handover documentation, including a prompt to identify information requiring sharing with prison colleagues.
Stated by Central and North West London NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 26 March 2026.
Action
Ensure healthcare participation in multidisciplinary forums, weekly Safety Intervention Meetings and daily wing briefings.
Stated by Central and North West London NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 26 March 2026.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Healthcare services alone cannot mitigate all risks within custody.
Stated by Central and North West London NHS Foundation TrustUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
East London
Concerns raised1
Failure to inform the hospital of release from police custody
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
Action
Complete mapping of existing information-sharing pathways for releases from custody.
Stated by Metropolitan Police ServiceStated completedThe respondent said that this action was complete when they made their response on 3 October 2025.
Action
Develop a protocol for lawful, prompt notification of appropriate mental health services when people in crisis are released from custody.
Stated by Metropolitan Police ServiceStated in progressThe respondent said that this action was in progress when they made their response on 3 October 2025.
Action
Work with mental health partners to develop consistent London-wide arrangements, accountability lines and welfare escalation routes after release.
Stated by Metropolitan Police ServiceStated in progressThe respondent said that this action was in progress when they made their response on 3 October 2025.
Action
Develop guidance for custody and investigating officers on identifying risk, recording indicators and initiating referrals or notifications before release.
Stated by Metropolitan Police ServiceStated in progressThe respondent said that this action was in progress when they made their response on 3 October 2025.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
The DPS review was appropriate and went as far as expected because it identified no conduct, performance or organisational learning.
Stated by Metropolitan Police ServiceNo action considered necessaryThe respondent said that no further action was needed.
Manchester South
Concerns raised1
Failure of the prison-to-probation process to share and locate key risk information
This report raised 8 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Use the new digital referral process to combine prison and probation information, including custodial behaviour and suicide and self-harm risk, for Approved Premises assessments.
Stated by Ministry of JusticeStated completedThe respondent said that this action was complete when they made their response on 22 January 2025.
West Sussex, Brighton and Hove
Concerns raised1
Failure of LDS and police information sharing about custody mental health presentation
This report raised 11 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.6
Action
Develop a standard template and guidance with NPCC and CPS for transferring relevant Liaison and Diversion assessment information to police.
Stated by NHS EnglandStated plannedThe respondent said that this action was planned when they made their response on 29 July 2024.
Action
Maintain documented, verbally delivered and CCTV-recorded custody handovers, with live risk updates, shared access, audit trails, staff training and peer review.
Stated by Sussex PoliceStated completedThe respondent said that this action was complete when they made their response on 29 July 2024.
Action
Record custody risks and concerns discussed with Liaison and Diversion staff on the detainee’s risk assessment and care plan.
Stated by Sussex PoliceStated completedThe respondent said that this action was complete when they made their response on 29 July 2024.
Action
Consider best practice through the Betterment Workstream, including a nationally recognised pre-arrival risk assessment for communicating custody risks.
Stated by National Police Chiefs’ CouncilStated in progressThe respondent said that this action was in progress when they made their response on 29 July 2024.
Action
Raise NHS Trust information-sharing failures between criminal justice pathways as a detainee welfare concern.
Stated by National Police Chiefs’ CouncilStated completedThe respondent said that this action was complete when they made their response on 29 July 2024.
Action
Add a standard template for written information shared with police colleagues to the Custody Pathway SOP.
Stated by Midlands Partnership University NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 29 July 2024.
East London
Concerns raised1
Unclear and incomplete sharing of risk information between probation and the MPS
This report raised 24 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
Action
Use CONNECT and Proactive Management Plans as the primary searchable police record for integrated offender management.
Stated by Metropolitan Police ServiceStated completedThe respondent said that this action was complete when they made their response on 2 August 2024.
Action
Develop and use a process map guiding Police Offender Managers and supervisors to obtain, record and manage risk information before and after prison releases.
Stated by Metropolitan Police ServiceStated completedThe respondent said that this action was complete when they made their response on 2 August 2024.
Action
Maintain mandatory professional registration for Probation Officers to strengthen continuing development, performance and accountability.
Stated by HM Prison and Probation ServiceStated completedThe respondent said that this action was complete when they made their response on 2 August 2024.
Birmingham and Solihull
Concerns raised1
Lack of formal notification of police disagreement about risk category
This report raised 11 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
Action
Share information with health systems on establishing multi-agency governance, delivery structures, risk management, escalation and communication.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 6 June 2024.
Action
Issue guidance to health systems covering multi-agency governance, delivery structures and real-time and retrospective escalation processes.
Stated by NHS EnglandStated plannedThe respondent said that this action was planned when they made their response on 6 June 2024.
Action
Review and update the WMP Missing Person Policy to address daily appraisal attendance, clinician risk assessments, recording, and investigation-closure notifications.
Stated by West Midlands PoliceStated in progressThe respondent said that this action was in progress when they made their response on 6 June 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.7
Position
Operational and clinical partners are best placed to respond to relevant concerns and reassess local risk, communication and escalation processes.
Stated by Department of Health and Social CareRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
The mental health trust cannot formally record differing risk opinions because it lacks access to police systems.
Stated by West Midlands PoliceUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Position
Specific issues concerning police ways of working are for the National Police Chiefs’ Council, College of Policing and West Midlands Police to address.
Stated by Home OfficeRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
Each Chief Constable decides whether and when to implement Right Care Right Person and which elements of the national framework to adopt.
Stated by Home OfficeRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
The APCC cannot mandate its members to undertake actions in response to the identified safety concerns.
Stated by Association of Police and Crime CommissionersOutside remitThe respondent said that this matter was outside its role or authority.
Position
Operational implementation of Right Care, Right Person is assigned to Chief Constables rather than Police and Crime Commissioners.
Stated by Association of Police and Crime CommissionersRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
RCRP did not apply because the case was treated as a missing person involving immediate risk requiring police response.
Stated by National Police Chiefs’ CouncilDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Hampshire, Portsmouth and Southampton
Concerns raised1
Incomplete information sharing between healthcare and prison security staff
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
Operational staff cannot access healthcare records because medical confidentiality prevents direct access to SystmOne.
Stated by HM Prison and Probation ServiceUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Position
Existing multidisciplinary meetings, briefing sheets and observation books are considered sufficient to share necessary prisoner safety information.
Stated by HM Prison and Probation ServiceExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Inner North London
Concerns raised1
Failure to pass relevant incident and vulnerability information to ambulance and hospital staff
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Improve officers’ sharing of vital incident information with colleagues, ambulance crews and medical staff.
Stated by Metropolitan Police ServiceStated in progressThe respondent said that this action was in progress when they made their response on 30 December 2020.
Wiltshire and Swindon
Concerns raised1
Failure to provide healthcare professionals with complete relevant mental-health information for frontline assessments
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
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Includes failures in arrangements between police, healthcare and probation or closely connected custody functions to identify, record, transfer, access, clarify and acknowledge safety-critical risk information about people subject to care, supervision or public-protection arrangements.
