Recurring concern

Insufficient emergency control-room staffing capacity

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First reported 27 Nov 2017•Latest report 20 Dec 2023

Definition

What this concern includes

Includes staffing, cover, workload and capacity deficiencies in emergency control rooms or equivalent emergency call-handling and resource-deployment functions where they impair timely call processing, judgement, prioritisation or deployment decisions.

Not included

Excludes general police, ambulance or healthcare staffing shortages where no emergency control-room capacity or call-handling function is identified.
Excludes downstream emergency response delays caused solely by vehicle, field-responder or hospital capacity after control-room work is adequately staffed and completed.
Excludes generic workload, fatigue or wellbeing concerns without a direct effect on emergency control-room call handling or resource deployment.
Excludes staffing failures in non-emergency control rooms or ordinary administrative contact centres.

Reports: 4
Individual concerns: 4
Date range: 2017–2023
Stated actions: 15

Reports over time

Reports about this concern issued each year.

* 2026 is projected from reports observed to 7 Sep 2026.

Most frequent recipients

Reports about this concern sent to each recipient.

Department of Health and Social Care1

Devon & Cornwall Police1

NHS West Yorkshire Integrated Care Board1

South East Coast Ambulance Service NHS Foundation Trust1

West Midlands Police1

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.

20 Dec2023
South Yorkshire (Western)
Concerns raised1
1. Insufficient Emergency Medical Dispatcher staffing to meet forecasted demand
This report raised 3 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.

No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
AI-generated summary

Shaun PARKS · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Shaun PARKS attended Doncaster Royal Infirmary with a heart attack and waited for an ambulance transfer to the Northern General Hospital. He deteriorated and died during a procedure on 13 December 2022. Concerns included a 3-hour 18-minute ambulance response delay, insufficient emergency dispatch staffing, and hospital delays in offloading patients that reduced ambulance availability.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Insufficient Emergency Medical Dispatcher staffing to meet forecasted demand
Wider context from the report
“(2) There were insufficient Emergency Medical Dispatcher's available to meet the forecasted demand. Staffing at YAS was below the requirement to meet the expected demand. ”
Source location
Shaun PARKS · Prevention of Future Deaths report
Page 2 · concerns
Open source report
6 Dec2022
Cornwall and Isles of Scilly
Concerns raised1
1. Insufficient CMCU staffing for experienced workloads
This report raised 3 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 7
1. Action
  Run recruitment campaigns to increase CMCU staffing and stabilise retention.
  Stated by Devon & Cornwall PoliceStated in progress
2. Action
  Regrade the RIMO role and increase its salary to support staff retention.
  Stated by Devon & Cornwall PoliceStated completed
3. Action
  Transfer some incoming-contact management from Contact to local BCUs to increase RIMO capacity for 999 calls.
  Stated by Devon & Cornwall PoliceStated completed
1. Action
  Provide dedicated Human Resources support for staff wellbeing, absence intervention, workplace adjustments and management effectiveness.
  Stated by Devon & Cornwall PoliceStated completed
2. Action
  Review shift patterns and move staffing towards peak-demand hours.
  Stated by Devon & Cornwall PoliceStated in progress
3. Action
  Implement the agreed new shift pattern for contact handlers.
  Stated by Devon & Cornwall PoliceStated planned
4. Action
  Open six additional police-station front offices and train staff to handle digital and non-urgent contact.
  Stated by Devon & Cornwall PoliceStated completed
AI-generated summary

Daniel Lee Tilley · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Daniel Lee Tilley was found hanging in Newquay on 7 July 2019 and was later pronounced dead by paramedics. The report identifies concerns about insufficient police staffing and resources, including a four-hour response delay to an emergency call. The inquest concluded that it was possible the delay contributed to the outcome, although the evidence was insufficient to determine whether Daniel intended to take his own life.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Insufficient CMCU staffing for experienced workloads
Wider context from the report
“ii. a) Staffing levels in the CMCUs (both call handlers and Resource Deployment Officers) in Plymouth and Exeter are insufficient for the workloads experienced. b) There are an inadequate number of uniformed Officers available to respond in a timely fashion to the demand seen over the summer months. Let me acknowledge that I recognise these two issues are intertwined. The amount of budget the force receives will dictate what it can afford in terms of police staff and police officers. As Chief Inspector ████████ accepted during the course of this inquest, the police did the best they could with what they had; they simply did not have enough. My concern in relation to the CMCU is that this problem has existed – on the evidence I heard at inquest – for a decade or so, and it is unresolved today. I am bound to note the recent decision of HMICFRS to move the force into an enhanced level of monitoring with one of the stipulated grounds being: ‘the force does not answer, or respond to, emergency or non-emergency calls within adequate timeframes, and too many calls are abandoned…’ The jury heard from Chief Supt ████████ and ACC Leaper at inquest. They were told that staffing levels for both call handlers and RDOs were still not at the ‘design’ brief advised by BT but that recruitment processes were in hand which, it was hoped, would achieve this. They were told that three separate pieces of software were to be introduced in the New Year which, once fully operational, ought to permit greater efficiencies and speedier call management. In writing to you, I wanted to bring these matters to your attention so that you can ensure the intended improvements are realised. I understand once you start in your new role you will require a little time to bring yourself up to speed with what will inevitably be a raft of pressing issues, that budgets for 2022/3 are yet to be finalised and, finally, that the recruitment drive and IT upgrades still need to be completed. For those reasons, I have extended the time below for the formal Reply from you. ”
Source location
Daniel Lee Tilley · Prevention of Future Deaths report
Page 2 · concerns
Open source report
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Run recruitment campaigns to increase CMCU staffing and stabilise retention.

Verbatim wording from the response
“As of January 2023, we have 138 Radio Dispatch Officers (now called Resource Incident Management Officers (RIMOs)) against a design of 143 and 191 Contact Officers against a design of 194, which represents an increase in staffing levels since the inquest. These staffing levels were identified by reference to a review by BT, an independent consultant who examined our processes and staffing numbers (as previously shared in the inquest).”

Source location
Response from Devon & Cornwall Police
Page 2 · response
Published 8 December 2022
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Regrade the RIMO role and increase its salary to support staff retention.

Verbatim wording from the response
“In addition, the RIMO role has been regraded through a job evaluation process and a salary increase awarded which we anticipate will assist with retention. During exit interviews upon leaving the organisation, our outgoing staff have previously raised the issue of pay as one of the reasons for leaving the police.”

Source location
Response from Devon & Cornwall Police
Page 2 · response
Published 8 December 2022
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Transfer some incoming-contact management from Contact to local BCUs to increase RIMO capacity for 999 calls.

Verbatim wording from the response
“• Some management of incoming contact from the public has moved from Contact to local basic command units (BCUs – basically, local policing areas) to free up RIMO time to take 999 calls.”

Source location
Response from Devon & Cornwall Police
Page 3 · response
Published 8 December 2022
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Provide dedicated Human Resources support for staff wellbeing, absence intervention, workplace adjustments and management effectiveness.

Verbatim wording from the response
“• We have increased our focus on maximising the wellbeing of our staff and the support offered to them. We have dedicated Human Resources provision in place to provide enhanced support for individuals through: effective people management; increasing effectiveness of early interventions for absences to avoid unnecessary escalation; effective and timely use of workplace adjustments; empower and increase the confidence of our managers; and potentially an increase in informal performance management processes should managers not undertake their responsibilities effectively. This is with the overall aim of improving performance and retention and thus contribute to an improved service to our communities. Since the introduction of this team in October 2022 sickness levels have reduced from 15% absence rate to 11% in January 2023.”

Source location
Response from Devon & Cornwall Police
Page 3 · response
Published 8 December 2022
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Review shift patterns and move staffing towards peak-demand hours.

Verbatim wording from the response
“• We have also reviewed (and will continue to review) the shift patterns to ensure we have more staff working in peak demand hours. In particular, the Incident Resolution Centre (IRC) moved to a new shift pattern as of January 2023. The IRC role is one of managing demand; the team undertakes crime-related tasks and crime screening, with the effect of reducing repeat calls to the organisation and the early resolution of complaints, allegations, and incidents. A new shift pattern has also been agreed for contact handlers and will be implemented in line with the Police Staff Handbook, which we anticipate being implemented in July 2023.”

Source location
Response from Devon & Cornwall Police
Page 4 · response
Published 8 December 2022
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Implement the agreed new shift pattern for contact handlers.

Verbatim wording from the response
“• We have also reviewed (and will continue to review) the shift patterns to ensure we have more staff working in peak demand hours. In particular, the Incident Resolution Centre (IRC) moved to a new shift pattern as of January 2023. The IRC role is one of managing demand; the team undertakes crime-related tasks and crime screening, with the effect of reducing repeat calls to the organisation and the early resolution of complaints, allegations, and incidents. A new shift pattern has also been agreed for contact handlers and will be implemented in line with the Police Staff Handbook, which we anticipate being implemented in July 2023.”

Source location
Response from Devon & Cornwall Police
Page 4 · response
Published 8 December 2022
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Open six additional police-station front offices and train staff to handle digital and non-urgent contact.

Verbatim wording from the response
“• Finally, we opened an additional six front offices in our police stations in January 2023 (in Tiverton, Truro, Falmouth, Penzance, Newton Abbot and Bude) increasing the provision of front office services. This enables a better service to the public by providing greater connectivity and accessibility. The front office staff will be trained to deal with digital demand and non-urgent contact demand, supported by new technology, significantly expanding the available resource base for Contact.”

Source location
Response from Devon & Cornwall Police
Page 5 · response
Published 8 December 2022
Open published response
21 Jan2020
Worcestershire
Concerns raised1
1. Insufficient control-room staff to process P2 incident logs
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 6
1. Action
  Operate the revised dispatch model with a dedicated triage terminal, supervisory incident reviews, and 24-hour reassessment and transfer of unresolved incidents.
  Stated by West Midlands PoliceStated completed
2. Action
  Improve contact handling by identifying lower-risk or non-policing incidents that do not require higher-priority control-room responses.
  Stated by West Midlands PoliceStated completed
3. Action
  Use Force Support Unit staff to manage legacy demand.
  Stated by West Midlands PoliceStated completed
1. Action
  Transfer incident logs between control rooms to share demand across available staff.
  Stated by West Midlands PoliceStated completed
2. Action
  Implement a Log Closure Doctrine to support dispatcher decision-making and focus resources on calls requiring greatest need.
  Stated by West Midlands PoliceStated completed
3. Action
  Transfer logs more than 24 hours old to a different team so dispatchers can focus on critical calls.
  Stated by West Midlands PoliceStated completed
Respondent positions 1
1. Position
  Existing systems and processes are considered sufficient to support control-room staff in managing competing demands, assessing risk and deploying resources.
  Stated by West Midlands PoliceExisting arrangements considered sufficient
AI-generated summary

Jason Paul DEVOTI · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Jason Devoti had a history of mental health issues and alcohol dependency and was found deceased in accommodation on 9 October 2018 after West Midlands Police failed to attend a P2 welfare-check request for more than 22 hours. The inquest heard that he died from acute ethyl alcohol poisoning, although the time of death could not be established. The principal concerns were police control-room backlogs, inadequate escalation and training, and the risk that vulnerable people subject to P2 incidents would not receive a timely response during periods of increased demand.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Insufficient control-room staff to process P2 incident logs
Wider context from the report
“(2) The four police Dispatchers working in the Bournville control room gave evidence to the inquest that: (a) At the time of these events a very large number ( 150-200 ) of P2 incident logs would regularly be outstanding at the beginning of a shift; (b) That many of those logs would be "overdue" – which meant not only that they had passed the one hour deadline, but in fact that more than 6 hours had passed since the log was last looked at; (c) That those operating the terminals which would have to try to deal with these logs were overwhelmed by the number of logs they had to deal with; (d) That if there was an escalation process in force at the time, then: (i) Either dispatchers were not sufficiently aware of the process so as to be able to act in accordance with it; or (ii) They were being given the impression by supervisors that there was little point in escalating overdue logs to them, as there was little that could be done; (e) That the reason for the large number of logs being overdue was mainly because there were insufficient officers to deploy to incidents, but also because there were not enough staff in the control room to work through the logs; (f) That measures taken to reduce the number of overdue logs ( known as ████████ ) would provide only temporary respite before the number of overdue logs built up again; (g) That at various times since these events, there had been little improvement in the situation: in January 2019 the situation was "still overwhelming" ( ████████ ); in June 2019 there would always be a lot of overdue logs ( ████████ ); in October 2019 there were still too many P2 logs that were not being dealt with in time ( ████████ ); the current situation is "a little better" in that "more robust decisions are being taken by call takers", but there are still problems now, and "the crux is that we don't have enough police officers on the streets to deal with incidents" ( ████████ ). ”
Source location
Jason Paul DEVOTI · Prevention of Future Deaths report
Page 2 · concerns
Open source report
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Operate the revised dispatch model with a dedicated triage terminal, supervisory incident reviews, and 24-hour reassessment and transfer of unresolved incidents.

Verbatim wording from the response
“b. Changes to control room model - The model that is used within dispatch is continually reviewed to ensure that it delivers the most effective approach. Changes were implemented in the summer of 2019 in order to manage incoming demand and the risk contained within existing logs. This includes the introduction of a dedicated triage terminal. This terminal does not hold legacy demand, therefore is able to review every new incident log sent to”

Source location
2020-0017-Response-from-West-Midlands-Police_Redacted
Page 3 · response
Published 8 February 2020
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Improve contact handling by identifying lower-risk or non-policing incidents that do not require higher-priority control-room responses.

Verbatim wording from the response
“e. This has been combined with a focus within Contact handling, around the policing purpose for incidents. Historically there were incidents being created as a P2 that were lower risk and should have been graded as a P3, or where there was no policing response required. This has further reduced unnecessary demand on control rooms.”

Source location
2020-0017-Response-from-West-Midlands-Police_Redacted
Page 4 · response
Published 8 February 2020
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Use Force Support Unit staff to manage legacy demand.

Verbatim wording from the response
“8. It was presented during the inquest that the reason for the number of outstanding incident logs was due to resourcing challenges because of austerity and the availability of officers to deploy. This has been addressed in a number of ways since the incident involving Mr DEVOTI:”

Source location
2020-0017-Response-from-West-Midlands-Police_Redacted
Page 4 · response
Published 8 February 2020
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Transfer incident logs between control rooms to share demand across available staff.

Verbatim wording from the response
“d. Load sharing across control rooms to match demand with resource. Logs are now transferred to another control room to ensure that demand is equally managed across all staff.”

Source location
2020-0017-Response-from-West-Midlands-Police_Redacted
Page 5 · response
Published 8 February 2020
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Implement a Log Closure Doctrine to support dispatcher decision-making and focus resources on calls requiring greatest need.

Verbatim wording from the response
“b. Instituting a “Log Closure Doctrine” to encourage bolder decision-making from dispatchers dealing with emergency calls to ensure resources are focussed on those calls requiring greatest need.”

Source location
2020-0017-Response-from-West-Midlands-Police_Redacted
Page 6 · response
Published 8 February 2020
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Transfer logs more than 24 hours old to a different team so dispatchers can focus on critical calls.

Verbatim wording from the response
“c. Reducing the number of logs held by each dispatcher. Logs more than 24 hours old are now dealt with by a different team so that dispatchers can concentrate on the most critical calls without the distraction of managing older logs.”

Source location
2020-0017-Response-from-West-Midlands-Police_Redacted
Page 6 · response
Published 8 February 2020
Open published response
Source evidence

How this respondent position was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Existing systems and processes are considered sufficient to support control-room staff in managing competing demands, assessing risk and deploying resources.

Verbatim wording from the response
“13. In relation to the lack of resources to deal with incidents, the introduction of the escalation process allows for the use of any resource to respond to an incident where the risk dictates. It has taken time to embed this process and we are now seeing this supporting delivery. This has become more focused during Force TRM, held three times a day, where decisions are made to move additional resources according to demand.”

Source location
2020-0017-Response-from-West-Midlands-Police_Redacted
Page 6 · response
Published 8 February 2020
Open published response
27 Nov2017
West Sussex
Concerns raised1
1. Shortage of clinicians in the Emergency Operation Centre
This report raised 3 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 2
1. Action
  Obtain approval for and implement a project plan introducing recruitment and retention changes for Emergency Operations Centre clinicians.
  Stated by South East Coast Ambulance Service NHS Foundation TrustStated in progress
2. Action
  Change call-volume forecasting and review rotas to align clinician capacity with demand.
  Stated by South East Coast Ambulance Service NHS Foundation TrustStated planned
AI-generated summary

Barbara Joan Howard · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Barbara Joan Howard fell at home on 19 July 2017, experienced delays in ambulance response and backup, and was taken to hospital, where she died from injuries sustained in the fall on 20 July 2017. The concerns included ambulance and clinician staffing shortages, failure to make a priority-assessment call when the response exceeded the target time, and ambulance-call auditing below the stated target.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Shortage of clinicians in the Emergency Operation Centre
Wider context from the report
“(2) In evidence, I heard that when a call is not responded to within the national target time, in this case, 30 minutes, then a Clinician should ring the patient to ascertain the priority of the call within the category. On 19 July 2017 this was not done and they were around 15 clinicians short within the Emergency Operation Centre. I was informed that there are now 9 clinicians in training the Emergency Operation Centre but this still means that there are 6 staff members short. ”
Source location
Barbara Joan Howard · Prevention of Future Deaths report
Page 2 · concerns
Open source report
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Obtain approval for and implement a project plan introducing recruitment and retention changes for Emergency Operations Centre clinicians.

Verbatim wording from the response
“To address this issue, Secamb have created a project plan to address our EOC issues, including the implementation of radical changes to the recruitment and retention of the EOC clinicians. This plan is currently with the Director of Operations for sign-off and will then be presented to the Trust’s Executive for approval, after which it will be implemented. I attach a summary of the plan. Our initiatives also include:”

Source location
2017-0420-Response-by-South-East-Coast-Ambulance-Service-NHS-Trust
Page 2 · response
Published 27 February 2018
Open published response
Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation
Change call-volume forecasting and review rotas to align clinician capacity with demand.

Verbatim wording from the response
“b. A change to the way we forecast volumes of calls, together with a rota review, to try better to align clinician capacity with demand.”

Source location
2017-0420-Response-by-South-East-Coast-Ambulance-Service-NHS-Trust
Page 2 · response
Published 27 February 2018
Open published response

Data last updated 7 September 2026

What this concern includes

Not included

Reports over time

Concerns raised1

Insufficient Emergency Medical Dispatcher staffing to meet forecasted demand

Concerns raised1

Insufficient CMCU staffing for experienced workloads

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.7

Concerns raised1

Insufficient control-room staff to process P2 incident logs

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

Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1

Concerns raised1

Shortage of clinicians in the Emergency Operation Centre

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

Actions described in response 7

Actions described in response 6

Respondent positions 1

Actions described in response 2