NHS partners in West Lothian have recently implemented digital pass plans for patients. This will make sure all staff have up to date information about a patient’s stay in hospital, including when they can leave hospital premises and at what point they should be reported as missing, ensuring no unnecessary police involvement.
In West Lothian the Standard Operating Procedure for Reporting Missing Persons from Mental Health In-patient Services within The Royal Edinburgh Hospital and associated services, and at St. John’s Hospital is an excellent document, grounded in The National Missing Persons Framework, which provides detailed guidance for clinical staff. It demonstrates good practice through the following:
East Dunbartonshire is using the updated Glasgow and Glyde NHS Mental Health Inpatient Services Missing Person Policy. This document uses the definition of missing, and high, medium, and low risk levels as per The Framework. It clarifies the difference between ‘absent’ and ‘missing’ and when an ‘absent’ case would be reclassified as ‘missing.’ The policy also sets out all steps that should be followed in an NHS setting before contacting police, advising that high risk or ‘restricted’ patients are reported missing to police immediately.
Similarly, in Aberdeen there is updated guidance in place to inform how professionals should respond if an adult goes missing from NHS Mental Health In-patient Services.
In Dumfries and Galloway, there is strong local guidance for missing families, particularly for children who may be missing from health services, and women missing from antenatal appointments where there may be significant risk of harm to an unborn child, vulnerability, or abuse.
New Craig’s Hospital in the Highlands has bespoke care plans for each patient that outline when they can leave the hospital and at what stage they will be reported as a missing person. There are regular meetings between Police Scotland and NHS staff to provide advice on closer monitoring of patients who are repeatedly going missing. Information sharing between police and the NHS is strong at this facility and police have shared that they are able to respond quicker and more effectively due to the information sharing protocols.
Police in the Highlands work with hospital staff in the acute mental health ward with both agencies holding Return Discussions with the returned person. This is allowing services to support the adult who has returned from the missing episode and capture information that may identify any underlying causes of missing, triggers and any ongoing risks of harm.
For young people who are at risk of Child Sexual Exploitation (CSE) in Dundee, there are clear individual risk management plans in place. Staff within Education and residential homes are provided regular training on CSE. There is strong multi-agency information sharing on young people who are risk of CSE through the local Missing Person Group, and professionals work closely with the Rise Team from Barnardo’s, who support young people at risk of CSE. Dundee is building on local professional knowledge of CSE and developing their awareness of Child Criminal Exploitation (CCE). Staff in Education get regular briefings on the issue to build their understanding that young people who regularly go missing from school could also be at risk of this form of exploitation. Action for Children run the Sidestep Initiative as support for young people who are at risk of exploitation or who are currently experiencing criminal exploitation.
Forth Valley Multi-Agency Guidance: Child Trafficking and Child Criminal Exploitation is a local document that informs staff of best practice in relation to Child Trafficking and CCE. The document emphasises that CCE is often unrecognised, that young people can often be prosecuted rather than recognised as victims of exploitation, and that professionals’ understanding of the indicators of CCE, and ability to take appropriate safeguarding actions is critical.
In Perth and Kinross there is a Complex Needs Coordinator employed by the local authority who is co-located with police. If a person goes missing who is identified as having complex needs, the police can make a verbal referral and the coordinator will contact various support services and places in the community that the person may have had recent contact with.
The Autistic Missing Person Protocol (J Division Pilot) from The Lothians and Scottish Boarders is an excellent and clear to use risk reduction tool to help individuals, families, schools, and other organisations assist police in the event an autistic adult or child goes missing. It considers:
The NHS Post Diagnostic Team in West Lothian visit people with early onset dementia and discuss The Herbert Protocol with families and carers who are encouraged to use it. This ensure that families have all the relevant information required by police immediately to hand, to prevent unnecessary delays to any missing investigation.
Home Care Services in West Lothian have The Herbert Protocol in place for adults with dementia and digital care plans are updated on each visit to include details of what the adult was wearing when last seen. These procedures ensures that staff have all relevant information required by the police immediately to hand, to prevent unnecessary delays to any missing investigation.
In East Lothian there are plans to make sure that all council employees have Purple Alert downloaded on their work mobile phones. This will support efforts to find a local missing person living with Dementia as soon as possible.
In East Dunbartonshire, one page profiles are in place for adults using Care at Home services which contain information such as a person’s photo and places they frequently visit. This ensures staff have all relevant information required by the police immediately to hand, to prevent unnecessary delays to the missing investigation.
In Aberdeen, protocols are in place for adults in supported accommodation. These protocols are similar to The Herbert Protocol and outline details of the persons behaviour, routine, and what steps should be taken if the person was to go missing (including who to contact, places to check, potential triggers for a missing episode and any additional needs). These protocols ensure that staff have all the relevant information required by police immediately to hand, to prevent unnecessary delays to a missing investigation.
After an episode of missing, care home staff in West Dunbartonshire hold Caring Conversations to identify any push/pull factors that may have caused the person to become Missing. Staff use creative tools such as My Home Life which incorporate visual aids to support a person to share their feelings and thoughts.
The post diagnostic team in Argyll and Bute visit recently diagnosed people with dementia to introduce the Herbert Protocol with families and carers who are encouraged to use it.
The Herbert Protocol is a form containing key information about a person living with dementia, who is at risk of going missing. This information includes, but is not limited to, medication that the person needs; places they have previously been found; historic addresses, and a recent photograph.
The post-diagnostic team ensure that people are keeping the information up to date, including a recent photograph, past addresses and other familiar content related to the person. These procedures ensure that carers and family members have all the relevant information required by the police immediately to hand, to prevent unnecessary delays to the missing investigation.
South Ayrshire have adopted a trauma-informed approach to missing, led by Trauma-Informed Practice Officers working with different local agencies. This approach ensures that local services have an awareness and understanding of trauma, that policies reflect agencies commitments to reducing trauma, and that all people receive trauma informed services. Agencies include Education; Social Work; Housing, and the NHS. Since working with Missing People as part of the National Framework Implementation Project, police and social work teams will be adopting a trauma informed approach with missing adults, children, and young people, including when supporting them on return. This is a positive step towards recognising and trauma as a push and/or pull factor of a missing episode and acknowledging that a person may have suffered trauma from harm they experienced whilst missing.
Schools in West Lothian can refer young people to an Inclusion and Wellbeing Support Service. This service takes a holistic view at meeting wellbeing needs of pupils and works in partnership with schools to support pupils and families. This service is a great source of support for pupils who are at risk of or are repeatedly going missing.
In Dundee, and Perth and Kinross, police can refer adults who are not open to services to immediate support provided by Penumbra Mental Health.
In Forth Valley, an NHS Mental Health Triage Service is run jointly by NHS Forth Valley and Police Scotland. It has been designed to help people with a mental health disorder that requires, or where an individual has symptoms that require, an urgent mental health assessment. Police can call the service and speak to a senior mental health nurse who will be able to direct people to the most appropriate service. This could include an emergency mental health assessment at the Mental Health Unit at Forth Valley Royal Hospital, or telephone counselling.
Partners in East Lothian are implementing plans that ensure staff across agencies are trained in suicide prevention and ASSIST, so that they are confident in having discussions with people at risk of suicide or self-harm and supporting them to make a safety plan.
East Ayrshire have recently employed an outreach worker whose role is to support a person with addictions. Their role is to support people with more complex issues such as people who have had frequent episodes of missing, people who have taken a near fatal overdose, and people who face additional barriers to accessing support. An example of additional barriers would be the effects of trauma generating little or no confidence in services and lack of trust in workers. The support will foster a positive working relationship with services to help the person manage their addictions and other complex issues.
In East Ayrshire, mental health, and addiction services work with a Vulnerable Person Agenda. This agenda considers an understanding of the person through a multi-agency approach and ensures agencies work together in a complementary way to support the person. Looking at missing through a Vulnerable Person Agenda lens allows partners to recognise, not only that the risk of a vulnerable person going missing will be significantly higher, but that the person is more likely to come to harm.
The West Lothian Missing Young Person’s Review Group and Missing Adult’s Review Group both meet monthly and involve representation from relevant statutory, private, and voluntary sector organisations. The groups focus on those with the highest number of missing incidents and those who are assessed as being the most vulnerable or at highest risk of harm. This enables partners to better understand and monitor performance and interventions relating to missing people within the local area.
Effective shared record systems exist between South Ayrshire Treatment and Recovery Team and local homelessness services, which allow these teams to quickly identify which agency last had contact with a potential missing person and any identified risks or concerns noted.
In South Ayrshire, The Alcohol and Drug Partnership’s Multi-Agency Vulnerable Group provides a space for relevant statutory and third sector agencies (including Police Scotland; adult services; housing; justice services; addictions services; and homelessness services) to discuss adults of concern where one or more agencies have lost contact with the adult. The group provides a space for agencies to share any relevant information regarding when an adult was last seen, and which services are working with them.
The Fife Missing Person Partnership Protocol is an excellent partnership agreement detailing a strong approach to a multi-agency response to missing, with a clear focus on ensuring that the objectives of The National Missing Persons Framework are achieved. You can find out more about this protocol below.
The Protocol is inclusive of a wide range of agencies: Police Scotland (P Division); Fife Council; NHS Fife; Fife Health & Social Care Partnership; Criminal Justice; Education & Children’s Services; Scottish Care; Multi-Agency Public Protection Arrangements (MAPPA); Housing and Public Protection; the Scottish Prison Service; and third sector organisations. The Protocol outlines an information sharing network between these agencies, to ensure appropriate and timely information is shared, in reference to information sharing protocols already in place.
Agencies across Fife have a clear understanding of their roles and responsibilities around missing from reporting to return procedure, made clear within the protocol. Access their Protocol below.
Fife Missing Person Partnership Protocol
In Aberdeen, there is a focus on multi-agency planning and prevention. In cases where a child or young person is repeatedly missing, multi-agency meetings and trigger plans allow for additional responses beyond an initial response to a missing incident to be considered. These meetings facilitate discussion around care plans and safeguarding, any risks to the child or young person and any additional support needs. Meetings also allow local agencies to discuss a more flexible response to a child or young person who may have specific needs (for example, a young person for whom police contact may be a trigger).
In West Dunbartonshire Police Scotland have good working relationships with the Coastguard and Fire service. In cases where someone has gone missing on the water, the Partnership Approach to Water Safety hold regular meetings to address water safety concerns in regard to any incident and discuss measures that can be put into place to mitigate risk and improve water safety.
On Shetland; adult services, Police Scotland and the NHS, including mental health services and occupational health, work closely together to put in safety measures for adults with cognitive impairments or those lacking capacity who are at risk of going missing. Through the Adult Services Initial Inquiry Procedure, social work will support a family to make plans and safeguarding arrangements to prevent missing episodes for adults at risk. Occupational Health play a key role in prevention planning by implementing safety measures such as Telecare, exit sensors, and the Buddy System which is a GPS tracker. Telecare refers to monitoring systems that can use a range of electronic devices, such as personal alarm buttons worn on the body, or motion detection. It is an unobtrusive way of monitoring individuals to help service users live with greater safety and independence in their own home. These types of prevention measures are crucial in the Shetland Islands where the weather and exposure to the elements can put someone at high risk during a missing episode.
On Shetland the Coastguard is included in care and prevention planning for adults at risk living on the outer isles. Due to extreme weather conditions and distances from the mainland to the outer isles, multi-agency partners in Shetland recognise the importance of utilising resources from outside traditional care services to ensure that the response is timely, and the person is found.
On Shetland in the outer islands as well as in the North and the West, areas such as Walls, Unst and Yell, there is no police presence and a population of approximately 200 people therefore this locality faces additional challenges in regard to resource. The distance to travel to some of these locations will require the use of a ferry and can take up to 3 hours. Furthermore, these remote areas can present additional challenges and dangers in terms of being so close to cliffs, poor weather conditions and proximity to the sea. The community and police in Shetland have demonstrated excellent resilience to these challenges. Professionals such as doctors, nurses and fire staff will assist in the search for a person with Dementia along with family and the wider community to support the police in searching for the person. Police have also built strong partnerships with the Coast Guard, Fire Service and Mountain Rescue to boost resources and locate a missing person as quickly, safely and efficiently as possible.
In Argyll and Bute partners in education demonstrated excellent practice when responding to children and young people going missing. Education provide support to the family of the missing person during the investigation, coordinating with multi-agency partners to ensure the young person is located as soon as possible and ensuring information is handed over to police and social work when the school day is over. Good practice from education is consistent when the missing young person is located and has returned from the missing episode. This is demonstrated by school staff offering the young person a Return Discussion with a professional they know and trust and exploring any required supports/modifications to school life as well as potential referrals for support.
In Argyll and Bute Children’s Houses have a Missing Person Prevention Plan in place, along with the Not At Home protocol. The Prevention Plan is a comprehensive document to ensure staff and agencies involved have an accurate and up to date profile of the young person at risk of going missing. The form includes prompt questions for the professional completing the form to ensure as much information is collected as possible. The form includes information on the young person’s mental health and support involved; past behaviour (including details of previous missing episodes), and the inclusion of information relating to Child Sexual Exploitation (CSE) and Child Criminal Exploitation (CCE). This is crucial for prevention work and delivering the most effective support for a child following a missing episode.
In South Lanarkshire The local Missing Young Person’s Group meets weekly and involves representation from relevant statutory organisations. The group focuses on those with the highest number of missing incidents and those who are assessed as being the most vulnerable or at highest risk of harm, along with a lens of contextual safeguarding. Within this group there is a focus on multi-agency prevention planning. It was agreed that in cases were a young person is repeatedly missing, multi-agency meetings and plans can allow for additional responses beyond general missing processes to be considered – for example, the discussion of care plans, risks to the young person, additional support needs, etc. These meetings also allow the local agencies to discuss a more flexible response to a young person who may have specific needs.
In Renfrewshire Police Scotland and Kibble, a private care provider, are working closely together to prevent missing episodes from the children’s houses. Kibble and Police Scotland are developing an information sharing agreement to ensure information can be shared effectively to locate a missing young person as quickly as possible. Regular meetings are taking place between partners to look at prevention and planning for young people residing in Kibble’s children’s houses.
In Inverclyde partners in education work closely with the children’s houses to ensure a young person is provided with support upon return from a missing episode. Young people will be offered the choice of who conducts their return discussion. Guidance teachers will offer emotional support and discussing any required supports/modifications to school life as well as potential referrals for support.
Staff from a residential unit in Dundee have built good working relationships with police. Community police visit the residential unit in plain clothes to get to know young people, which staff have reported as a positive development.
A residential home in Dundee reported that the Not at Home policy has led to a reduction in missing incident reports to police. Residential care staff are trained in how to use the Not at Home category appropriately. Staff continue to have discussions with the young person if they have been categorised as ‘not at home,’ so that they can continue to accurately assess risk.
In West Lothian the Families Together Team works with the whole family of a looked after young person where appropriate, assisting with ongoing communication between a young person and their family, helping to make returning home a secure option.
Police in East Lothian have been proactive in building relationships between partners by attending meetings at the residential homes and identifying Single Points of Contact (SPOCs). There is now a SPOC for each of the local units in East Lothian.
Glasgow has implemented the Respect Programme in children’s residential care settings. This programme is designed to improve partnership working between residential care settings and Police Scotland allowing a clear understanding of each agency’s role in response to a missing episode. If care home staff contact police, and following a conversation between both parties it is decided that a child or young person should be deemed as ‘not at home’ rather than missing, then there is no requirement for any further police involvement and the child’s absence will be managed by care home staff. A key concept is that care home staff are appropriately guided and empowered to act as any parent would to safeguard and manage children in their care. If the risk to the child or young person becomes ‘intolerable’ to the staff member reporting the incident, consideration should then be given to reporting the child missing to Police Scotland, generating a multi-agency response.
Police in East Dunbartonshire have a Single Point of Contact for children’s residential care homes. This officer attends the care homes on a weekly basis, which encourages staff and children and young people to build positive relationships with local police, supports information sharing and improves working relationships.
In the Highlands, Aberlour’s Guardianship Project is undertaking significant work to improve the multi-agency response and support for Unaccompanied Asylum-Seeking Children (UASC) who are at risk of going missing. This is largely due to Children’s Services now having a dedicated social worker for unaccompanied asylum-seeking children along with regular meetings taking place between multi-agency partners about the best way to support these children in the Highlands. Aberlour’s Guardianship Project are having conversations with young people at the beginning of a support relationship around the risks of going missing and the project clearly outlines the steps they would take if they suspected a young person was missing. Police Scotland liaise directly with the UASC social worker in Childrens Services to ensure that the Philomena protocol is completed upon the young person’s arrival into the Highland area.
In Argyll and Bute partners demonstrate a trauma informed practice when supporting Unaccompanied asylum seeking children. Partners recognised the factors which may impact on an unaccompanied child’s unwillingness to have a Return Discussion but are proactive in exploring how best they can support a young person when they return from a missing episode. Staff in the children’s houses recognise that traumatic life events and stressors can lead to people going missing and exposure to harm while missing can lead to further trauma on an individual.
The Child Protection Team in East Lothian are developing in-house training to compliment the Missing People Return Discussion e-learning. The training will include where to record the Return Discussion, where it is stored, who with and how the person facilitating the discussion should share the information and local area referral options.
In Edinburgh, a pilot is underway with Alzheimer’s Scotland. Alzheimer’s Scotland is delivering Return Discussions for adults with dementia following referral from Police Scotland.
In North Ayrshire, Adult Services plan to take the role of coordinating Return Discussions locally. This will involves Adult Services offering to complete Return Discussions or identifying an alternative appropriate agency to complete them, depending on the returned person’s preference. It is a priority locally for people to be able to choose who completes their Return Discussion. For adults with additional needs, NHS Learning Difficulty Nurses will be considered as appropriate professionals to complete a Return Discussion should the returned person be involved with this service.
