Police missing person searches
Failures in police search procedures for missing persons, including inadequate thoroughness and lack of follow-up.
58 items
3 sources
Source spread
Where this theme appears
Police missing person searches has been flagged across 3 independent accountability sources:
34 PFD reports
23 IOPC recs
1 PHSO decision
When the same issue appears across inquiries, coroner reports, and regulators independently, it indicates a recurring issue across the public record.
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Source-grouped records are useful for tracing where a concern came from. Large sections show the 50 strongest matches for that source; counts still show the full theme total.
PFD Reports (34)
Natalie Ainsworth
Concerns: Critical information about a vulnerable missing person's suicide threat was not passed to officers, resulting in an inaccurate police risk assessment and inappropriate response to her mental health history.
Response (Durham Constabulary): • The Force has reviewed processes around the recording of additional information received into the Force Control Room as part of a missing person investigation. • Changes have been made …
Responded
Michael Sweeney
Concerns: Police training on 'excited delirium' is not widely understood by other health professionals, risking miscommunication and missed diagnoses of underlying medical conditions. Standardising the term to 'extreme agitation' is needed.
Response (Metropolitan Police Service): The Metropolitan Police Service has addressed potential information gaps for civil staff with practice notes and in-house training, and developed a detailed joint agency call-handling protocol with the London Ambulance …
Response (London Ambulance Service): The London Ambulance Service does not agree with the recommendation to use the term 'extreme agitation', preferring 'acute behavioural disturbance' (ABD). They have engaged with police and reviewed guidance, and …
Responded
Shaun Elliott
Concerns: The coroner noted that a missing person coordinator was not in post at weekends, that Shaun's family expressed a number of concerns and frustrations in regard to family liaison, and that the definition of 'High Risk' was not clearly applied.
Overdue
William Hafele
Concerns: Inadequate training and communication between police and hospital staff on missing persons procedures led to critical information omissions, misclassification, and a complete failure to investigate Mr. Hafele's whereabouts.
Response (Surrey Police): Surrey Police are reviewing and updating their Missing Person Policy to align with new ACPO guidelines, including clarifying risk assessment processes and responsibilities, and making information available on officers' MDTs. …
Response (Surrey Borders Partnership NHS): The Trust has emphasized the importance of the Missing Persons (MISPER) process and instructed staff to complete Appendix A. A member of the Clinical Assurance team is assigned to ensure …
Responded
James Barrett
Concerns: Ineffective missing persons searches were hampered by reliance on volunteer mapping systems rather than a police stand-alone system, and the lack of tracking devices for searchers.
Response (James BARRETT): Hampshire Constabulary has submitted a business case for the purchase of a MAPYEX system. Procurement Services has been requested to provide information to identify a timeline for purchase, training requirements …
Overdue
Stewart Akins
Concerns: Critical information about the deceased's repeated suicide intentions recorded in police custody was not relayed to the Magistrates' Court, leading to bail being granted without full awareness of the high self-harm risk.
Response (S Akins): West Mercia Police revised its practice so all Prisoner Escort Forms are signed as accurate by the custody sergeant, who has overall responsibility for ensuring risks are correctly documented and …
Responded
Tyrone Lock
Concerns: Police failed to classify a vulnerable person exhibiting clear distress as such, treating him as an absconding suspect. This led to a missed opportunity for a crucial helicopter deployment, potentially preventing death.
Response (National Police Air Service): NPAS will support West Mercia Police in a critical incident debrief and offer opinions on improvements in awareness or training. They will also discuss the matter with the NPAS Independent …
Response (West Mercia Police): West Mercia Police has undertaken an extensive programme to raise awareness of vulnerability, piloting a programme in Telford and rolling it out across West Mercia in 2017. They have also …
Responded
Mark Banks
Concerns: Police failures in call handling included not contacting ambulance services as requested, incorrectly grading a high-risk call, and insufficient efforts to search for and check on the deceased's wellbeing.
Response (Devon Cornwall Police): Devon and Cornwall Police have reviewed their grading and deployment policy and operational practices regarding call grading and incident creation. They have also put in place training packages for staff, …
Responded
Ozeivo Akerele
Concerns: Police failed to locate the deceased during an intensive search due to a critical oversight in searching a nearby disused graveyard, and subsequent efforts were inadequate.
Response (West Midland Police): The case will be referred to the National Missing Persons Operational Group to consider amending guidance around how a search is co-ordinated in similar cases. This will provide clarity around …
Responded
Rastislav Petrisko
Concerns: Inconsistent risk assessment and classification of a patient, combined with a delayed police notification policy for absconding low-risk patients, led to an unacceptable delay in emergency response.
Overdue
Rosario Cordero-Sanz
Concerns: Special police officers lacked essential equipment and training in mental health and missing person processes. Communication failures and inability to access critical information meant a high-risk patient's status was missed, delaying appropriate action.
Response (Metropolitan Police Service): The MPS purchased and distributed 100 tablet devices for MSC officers in September 2018 and completed the rollout in November 2018. Local learning was implemented for MSC officers and a …
Responded
Catherine Horton
Concerns: Multiple failures in a missing persons investigation, including incorrect closure due to severe understaffing and high workload in the police missing persons unit.
Response (Metropolitan Police Service): The MPS has updated investigator toolkits on mobile devices, provides safeguarding officers in BCU Operations Rooms, delivers mandatory week-long training to officers posted to MPUs, and increased staffing levels in …
Responded
Alfred Sykes
Concerns: The report identified unspecified matters of concern indicating a risk of future deaths.
Response (Greater Manchester Police): GMP will review all high-risk missing person searches daily with another officer and appraise the Force Search Coordinator. Annual PoISA/Search Manager CPD will include refresher training using incidents that have …
Responded
Nimo Younis
Concerns: There was a critical communication breakdown between mental health ward staff and police regarding a missing patient, with staff lacking understanding of police protocols and information requirements, leading to delayed high-risk classification.
Overdue
Imane Bouasbia
Concerns: Police failures included inadequate communication of suicidal ideation during handover, absence of a risk assessment for self-harm, and a limited, non-expedited response to a direct suicidal text message.
Response (Metropolitan Police Service): The MPS emailed all SOIT officers and Public Protection Department managers with the instruction that SOIT and investigating officers must inform a supervising officer if they receive any contact from …
Overdue
Ewan Brown
Concerns: A lack of joint police-health policies for vulnerable missing persons, absence of multi-agency meetings, inadequate police mental health training, and poor information sharing protocols hindered effective risk assessment and search efforts.
Overdue
Zeyna Partington
Concerns: GMP officers lack understanding of ACT markers and policies cause delays in missing person investigations. A national ANPR system for vehicle tracking is not fully implemented, leading to missed alerts.
Response (Greater Manchester Police): Greater Manchester Police acknowledges concerns about the use of PNC markers and ANPR data. They are reviewing the use of high priority markers for vulnerable missing persons and are working …
Responded
Steve Cooke
Concerns: Critical communication failures by emergency operations control, including dispatching an ambulance to the wrong address and inadequate follow-up with contacts, led to a severely unwell patient not being located.
Response (South East Coast Ambulance Service): South East Coast Ambulance Service is updating its processes for 999 and 111 calls to ensure call handlers ask for the address instead of suggesting it, and improving the process …
Responded
Anthony Preston
Concerns: The police Missing Person Policy requires review to ensure it is fit for purpose and adequately addresses risks.
Overdue
Joseph Martin
Concerns: Systemic and individual failures in police information sharing meant critical concerns from a psychiatrist about a vulnerable missing person's psychotic relapse were not recorded or relayed to other officers or agencies.
Overdue
Neil Parkes
Concerns: Police failures to identify an unconscious patient despite hospital requests and a missing person report meant critical medical history was inaccessible, hindering treatment.
Response (Warwickshire Police): Warwickshire Police reviewed their response to the incident and provided words of advice to control room staff, organizational learning was circulated, and changes were implemented to improve responses in similar …
Responded
William Savory
Concerns: There was a significant two-hour delay in initiating the missing persons protocol for an informal patient, as staff were unaware of the requirement to act immediately. This lack of awareness poses a risk of future delays and deaths.
Overdue
Hannah Warren
Concerns: There is a national lack of formal guidance and training for correlating missing person risk assessments with vehicle stop priorities, leading to dangerous mismatches and inappropriate response levels.
Response (National Police Chiefs Council and College of Policing): The NPCC and College of Policing state that missing persons APP sets out clear processes and procedures and that current ACT instructions should be followed with an instruction to STOP …
Response (Metropolitan Police Service): The Metropolitan Police Service is developing a training package on ANPR and ACT reports, to be rolled out within 12 months. A new Service Level Agreement will require higher authorisation …
Response (Home Office): The Home Office acknowledges the concerns and states that the College of Policing sets standards for police investigations, including ACT reports. They have consulted with the College, Metropolitan Police and …
Responded
Anthony Ingram
Concerns: Crucial information about a suicidal missing person, including means of suicide and transport, was not shared between police forces due to a lack of standardized cross-border protocols.
Response (National Police Chiefs Council): The NPCC has initiated a Task and Finishing Group and developed draft advice on cross-border missing person enquiries, which has been circulated for consultation. The National Transfer form is being …
Responded
Rebecca Fisher
Concerns: GMP officers failed to recognize high-risk missing person status due to poor understanding of mental health risks, misapplication of "golden hour" guidance, and inadequate information sharing. The effectiveness of new training and tools remains unconfirmed.
Response (Greater Manchester Police): GMP has rolled out an Aide Memoire system, enhanced training, developed a supervisor's checklist, and conducts audits every six months to improve responses to missing persons. District performance is reviewed …
Responded
Heather Findlay
Concerns: Staff are unprepared for patients absconding, with policies lacking clear guidance on following or police engagement, leading to confusion and potential non-attendance by police for distressed patients.
Response (NHS England): NHS England acknowledges the concerns, states that it is not the appropriate organisation to respond to many of them, but will consider the Trust's response and has been sighted on …
Response (Metropolitan Police Service): The MPS has the Affinity Protocol in place since 2021 and will undertake work as part of the implementation of the Right Care, Right Person to ensure policies of all …
Response (Home Office): The Home Office describes the Right Care Right Person (RCRP) approach to assist police decision making. It states that the investigation of a missing person report is an operational decision …
Response (East London NHS Foundation Trust): The Trust has updated its Missing and AWOL policy, reviewed procedures for patients leaving acute wards, and changed observation guidance. They will review their Risk Assessment policy and the Grab …
Responded
Lee Bowman
Concerns: Police made significant assumptions about a missing person, focusing on past addiction rather than prioritizing crucial family information regarding his current mental state and usual daily contact.
Response (College of Policing): The College of Policing will update its Missing Persons APP to alert police officers and staff to the need to avoid imprecise terms such as 'chaotic lifestyle' and instead set …
Responded
REDACTED
Concerns: Police guidance for missing person risk assessments lacks clarity, potentially leading to inconsistent decision-making by officers in complex cases.
Overdue
Helen Kerr
Concerns: Mental health teams failed to act on repeated information about declining patient mental health, delaying appropriate treatment. Crucially, information sharing between police and mental health services out-of-hours is inadequate, and risks to staff from patients' delusions were not addressed.
Response (Surrey and Borders Partnership NHS Foundation Trust): The Trust updated its website with referral routes, enhanced collaboration with families, and revised the SBAR tool to include carer/family views. They have also implemented mandatory training for staff on …
Response (Surrey Council): Surrey Council explains that the SCARF process is not designed for emergency referrals and that a clear process exists for officers to contact the Emergency Duty Team out of hours.
Response (Surrey Police): Surrey Police is reminding all officers to undertake research as soon as practicable when dealing with members of the public, including asking the Force Control Room to do so on …
Responded
Amy Levy
Concerns: Police failed to leave voicemail messages when attempting to contact family members during a critical emergency, potentially delaying location and aid for a critically ill individual.
Response (College of Policing): The College of Policing will support national sharing of best practice on voicemail protocols, update the national Contact Management Curriculum to address voicemail guidance in emergencies, and ensure forces align …
Response (Avon and Somerset Police): Avon and Somerset Constabulary will introduce a dedicated force policy and procedure for 'suicidal' cases, update the Concern for Welfare policy to mandate leaving voicemails or text messages, and provide …
Response (Surrey Police): Surrey Police has updated its procedure to include guidance on leaving voicemails, is incorporating this guidance into training for new recruits and detectives, and will evaluate the effectiveness of the …
Responded
Charlotte Tetley
Concerns: A narrow police policy interpretation requires explicit intent to end life for high-risk missing person response, while ambulance services decline calls if whereabouts are unknown, increasing risk of death.
Response (Cheshire Constabulary): Cheshire Constabulary provides background information on the Right Care, Right Person policy and explains their actions in this specific case, noting that hospital staff made further enquiries and determined they …
Responded
Lewis Bates
Concerns: Lack of guidance for 999 call handlers on 'reasonable enquiries' for missing persons and confusion with the 'Right Care Right Person' initiative led to an inappropriate police response.
Response (Greater Manchester Police): GMP is undertaking a review of policies, delivering updated training to call handlers, reinforcing escalation protocols, and implementing quality assurance measures through supervisory reviews. The FCCO's in-house guidance system, Sherlock, …
Responded
Katherine Wright
Concerns: Police lack structured training and clear guidance for conducting adequate searches in missing person cases, and there are no protocols for officers to escalate safety concerns during searches.
Response (Thames Valley Police): Thames Valley Police has reviewed their Missing Persons Operational Guidance and included a new section dedicated to the searching of premises for missing persons which includes sections on the extent …
Responded
Mansoor Zaman
Concerns: Nursing staff failed to instigate MHA authorisations, adequately document care, reappraise risk after violent behaviour and absconding, and promptly report a missing patient to the police via emergency channels.
Responded
IOPC Learning Recommendations (23)
Recommendation - Staffordshire Police, December 2025
The IOPC recommends that Staffordshire Police amend their Missing Persons Procedure to ensure that the Force Control Centre (FCC) pro-actively notifies the Local Operations Inspector (LOI) whenever a new missing person is recorded on the COMPACT system (a missing persons’ …
Recommendations - Sussex Police
The IOPC recommends that Sussex Police amend its missing persons policy to clearly reflect the College of Policing Authorised Professional Practice for notifying the British Transport Police of when a missing person may potentially use the rail network. This follows …
Recommendations - Sussex Police
The IOPC recommends that Sussex Police reviews its missing persons policy and relevant training and guidance, to ensure vulnerabilities in individual missing persons cases are acknowledged, assessed, and graded appropriately. This follows an IOPC investigation in which a 15-year-old child …
Recommendations - Sussex Police
The IOPC recommends that Sussex Police takes steps to ensure the responsibility of sergeants to actively supervise medium risk missing persons cases is complied with. This follows an IOPC investigation in which a 15-year-old child was found deceased, having taken …
Response to missing person’s report - Metropolitan Police Service, June 2015
It is recommended that the MPS consider the need to remind despatch operators of their collective responsibility to highlight or challenge the grade of a call if required. Do you accept the recommendation? Yes
Response to missing person’s report - Metropolitan Police Service, June 2015
It is recommended that the MPS consider the need for despatch operators to review the Computer Aided Dispatch (CAD) when information is acknowledged to ensure that they are aware of the context of the information. Do you accept the recommendation? …
Response to missing person’s report - Metropolitan Police Service, June 2015
It is recommended that the MPS consider the deployment of officers to an informant’s current location (if they are not at home) when a missing person incident is graded as a ‘Immediate’ or a ‘Significant’. Do you accept the recommendation? …
Response to missing person’s report - Metropolitan Police Service, June 2015
It is recommended that the MPS ensure that when a call is graded, risks and vulnerability factors are prioritised over officer response time. Do you accept the recommendation? Yes
Woman reported as missing found dead - Metropolitan Police Service, August 2018
The IOPC recommends that the Metropolitan Police Service ensures that it is possible to identify who is (or was) responsible for progressing actions under the Revised Missing Persons Investigation Protocol, and consider how this is recorded on MPS systems to …
Woman reported as missing found dead - Metropolitan Police Service, August 2018
The IOPC recommends that the Metropolitan Police Service (MPS) ensures that all Local Resolution Team members across the MPS are aware of their roles and responsibilities under the Revised Missing Persons Investigation Protocol. This follows an investigation where two missing …
Police search for missing man -Greater Manchester Police, August 2021
The IOPC recommends Greater Manchester Police issues a reminder, to all police officers and police staff whose role includes working with communications date as part of missing persons investigations, of what resources are available within GMP to assist with analysing …
Recommendation - West Mercia Police, March 2020
The IOPC recommends that West Mercia Police revises its risk assessment to consider the availability and distribution of water kits, including whether they may be carried in response vehicles. As a result of reviewing a DSI investigation it became apparent …
Recommendations - Sussex Police, March 2020
The Sussex Police and Sussex NHS Partnerships should also review the ‘Missing Persons Police – Appendix E – Absent Without Leave (AWOL)’ with a view to establishing which agency is responsible for conducting checks to ascertain the wellbeing and whereabouts …
Recommendations - Sussex Police, March 2020
The IOPC recommends Sussex Police should review ‘Missing Persons Police – Appendix E – Absent Without Leave (AWOL)' policy with specific reference to the below; The ‘Missing Persons Police – Appendix E – Absent Without Leave (AWOL)’ appears to be …
Investigation into police response to a report that a person was missing …
The IOPC recommends that Northumbria Police update the ‘Investigations of Missing Persons’ procedure to include the consideration of CCTV strategy. This should include consideration of potential CCTV opportunities at the last known sighting of the missing person.
Investigation into police response to a report that a person was missing …
The IOPC recommends that Northumbria Police revise the ‘Northumbria Procedure – Investigations of Missing Persons’ document to ensure that the following are clear: • Who is responsible for appointing (and communicating) a single point of contact for the family, during …
Investigation into police response to a report that a person was missing …
The IOPC recommend that Northumbria Police consider expanding the ‘Search Management’ section of the ‘Northumbria Procedure – Investigations of Missing Persons’ document to provide further detail as to the required level of record keeping in relation to both PolSA and …
Contact with man before his death – North Wales Police, November 2021
The IOPC recommends that North Wales Police allocates a dedicated Single Point of Contact (SPOC) to families/next of kin during Missing Person Investigations where possible. The SPOC should ensure the family know who their SPOC is, provide regular, meaningful updates …
Contact with man before his death – North Wales Police, November 2021
The IOPC recommends that North Wales Police take steps to understand supervisors’ experiences of carrying out risk grading for missing persons cases, to determine whether further training may be required to ensure that the investigative actions carried out are consistent …
Contact with man before his death – North Wales Police, November 2021
The IOPC recommends that North Wales Police should incorporate the dangers of confirmation bias, encourage critical questioning, challenging assumptions, and the importance of exercising professional curiosity in matters of concern for welfare and Missing Person investigations. The force should ensure …
Recommendations - Surrey Police, April 2020
The IOPC recommends that Surrey Police training and/or policy on the use of mobile data terminals is reviewed to ensure officers are aware of the practical uses this piece of equipment can provide. Surrey Police provide a three hour training …
Recommendations - Surrey Police, April 2020
The IOPC recommends that Surrey Police considers developing and issuing a forcewide communication or bulletin in order to highlight the practical uses of this piece of equipment. When responding to the initial report, an officer reviewed a large number of …
Recommendations - Sussex Police, March 2020
If such a situation arises, a review should take place after proactive measures to allocate responsibility have been taken, as opposed to at the material time of the patient being absent in order to avoid delay in resourcing a response. …