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Today, the 14th June is Cupcake Day. A day where the Alzheimer’s Society invite people to raise money for dementia research, by hosting a cupcake bake. Since 2016, Cupcake Day has raised 1.4 million and is supported by some well-known celebrities, including Paul Hollywood, Ruth Langsford and Great British Bake Off winner Candice Brown.

Last year on Cupcake Day in support of our colleagues in our central Mental Health Unit we got together and produced some mighty fine cupcakes. Whilst many were finely baked and decorated by hand, a fair proportion looked a bit too good to be true, almost like they had originated from well-known supermarkets. I suspect that our police commitment to honesty and integrity buckled slightly at the thought of producing in excess of 120 cakes. The reason we needed so many cakes was not so much to raise money, but to begin the process of making our police service ‘Dementia Friendly’, and to launch our force version of the Herbert Protocol.

Police officers from all London boroughs, colleagues in the London Fire Brigade, the London Ambulance Service London, British Transport Police, City of London Police and the NHS, were invited to attend a presentation by the Alzheimer’s Society and become ‘Dementia Friends’. Many must have been watching their calories, for whilst the attendance was good, we had a fair few cakes left (not that we minded). Our objective was that this selected group of people would return to their own units, to promote dementia awareness to others. It was the first step in making our police service completely dementia friendly. Those present were also introduced to the Herbert Protocol, a simple risk reduction tool to be used in the event that an adult living with dementia is reported missing. This allows police access to vital information to enhance the chances of locating a person quickly and safely.

In this article we look at the protocol, what it is and how it works.

 What is the Herbert Protocol?

 The Herbert Protocol is a scheme adopted by several police forces within England & Wales in partnership with Local Authorities and other agencies. It is a simple risk reduction tool to be used in the event that an adult with care and support is reported missing. It is named after George Herbert, a war veteran of the Normandy landings, who lived with dementia. Whilst commonly associated with dementia, it can be used for other vulnerabilities.

The protocol consists of a simple form that contains valuable information about the person that can be passed to the police at the point they are reported missing. It is not designed to replace existing safeguarding and security measures. Recording this information ahead of time and keeping it regularly updated will greatly reduce stress associated with trying to recall detailed information in an emergency. It will also save valuable time. Police research shows that fatalities decrease significantly when a person is found within 12 hours of the ‘last time seen’. Delays in initiating a search can be affected by several factors:

  • the time it takes for the family/caregiver to notice or realise the person is missing
  • the time it takes to contact the police
  • the intimal police response
  • the time it takes to gain the information about the person and intelligence about where they may have gone (this will inform the search parameters)
  • the time that police take to initiate a formal planned search
  • the time it takes to commence the search

When someone with dementia goes missing, the safeguarding clock is ticking. The protocol can help reduce delays in mounting an effective search response.

What goes on the form?

Whilst there will be some regional variations between forms, the content rarely differs. Information that will be required includes:

  • basic details – including full name, nicknames, age, gender, race and ethnicity
  • physical description – including build, height, weight, hair colour and style and distinguishing features
  • physical capabilities and mobility – including eyesight, hearing, ability to communicate, physical disabilities, mobility aids and access to vehicles
  • medical history – including health conditions, essential medication, effects if medication not taken
  • life history – including previous occupations, hobbies and interests
  • places – including favourite places frequented, routes taken and significant places in the past
  • technology – whether they have on them a tracker, other GPS enabled device or a mobile phone
  • significant people – including important contacts e.g. carer, family, friends and professional such as GP
  • additional information – including whether they have any fears, how are they with being touched, how they may react to loud noise, the best way to approach them when found etc

The form should be completed and regularly updated, so that all the information is as relevant as possible. It is essential that a recent photograph of the person is attached.

Dependent on regional variation, some forms may contain a short separate section to record details of the current missing episode. This section can be completed by the individual who is reporting the person missing. However, this does not mean that there should be a delay in contacting police. Alerting the police as soon as possible will maximise the chances of locating the person quickly and safely. It is useful to also tell the police operator that there is a Herbert Protocol person profile available and the location of the document. Information that the police will want to know when they attend includes:

  • time and location person last seen and by whom
  • clothing - what they were wearing - anything distinctive or easily identifiable
  • possessions – have they taken anything significant with them, e.g. mobile, travel card, cash etc.
  • triggers – is there anything that may have prompted the person to go such as a recent significant date (anniversary – birth/death), any recent conversation by the person indicating that they have been thinking or reminiscing about a particular place/person

Past Memories - It is extremely important to establish where possible, any potential motivations for a person’s wandering.  Many people living with dementia rely heavily on past memories. This means they could be more actively engaged with a different time period of their lives. This can impact on where they may travel to, for they may be intent on heading to a place they previously lived or to visit a friend or relative who may now be deceased. Many of the goal-driven individuals in this group are quite capable of achieving their goals. Information about places of significance can include:

  • previous addresses
  • previous places of work
  • places of worship
  • places where they have an interest e.g. parks, beauty spots, railways, transport hubs, airports, football stadium
  • cemeteries where relatives are buried or favourite places to spend their free time
  • previous locations where they have been found if previously been wandering

Who is responsible for completing the form?

 The Herbert Protocol form should be completed by the individual(s) who know the person best. This may be either a care provider, a family member, a close associate, or in some cases by the person themselves. In a care setting, the care provider should seek permission from either the person at risk or their next of kin. If this isn’t possible then the care provider should make a ‘best interests’ assessment. The form should be updated on a regular basis, whenever there is a change to the person’s circumstances.

Where should the form be kept?

 The form should be kept in a safe place within the care setting, but where it is easily accessible and can be found quickly. A common place for the protocol and similar forms to be kept is behind the person’s front door or attached to their fridge. It is only necessary to provide the form to the police at the point the person is reported missing. There is no need to hand it to police before then and the form should be returned once the person is found. It is a tool for the police to help find the person safely and any information obtained by the police is subject to data protection principles.

 How do I find out if the Herbert Protocol exists in my area and how do I get the form?

 The protocol operates within many police and local authority areas, but not all. The best way to find out if a scheme operates in your area is to type in ‘The Herbert Protocol’ and your local police into a search engine. All forces that operate the scheme should have forms that can be downloaded. For those people without printers, we advise that you contact your local police and arrange for one to be sent, collected or dropped off to you. In some areas they will also be available at GP surgeries, libraries and local authority offices.

Bedfordshire

Cheshire

Cleveland

Derbyshire

Devon & Cornwall

Durham

Essex

Gloucestershire

Hampshire

Humberside

Kent

Lincolnshire

London (MPS)

Norfolk

North Yorkshire

South Yorkshire

West Mercia

This list is not exhaustive. To establish if the Herbert Protocol exists in your area, please contact your local force.

Do other schemes exist?

Yes, there are similar schemes in existence. These generally fall into 2 categories – those that mimic the Herbert Protocol and are generally for use for missing people; and those that are schemes around the care of the person with dementia.  Examples of the latter schemes are:

  • This is Me - A tool produced by the Alzheimer’s Society for people with dementia that lets health and social care professionals know about their needs, interests, preferences, likes and dislikes.
  • Lifebook - a free leaflet designed by Age UK where a person records important and useful information about their life, invaluable to a family member, friend or police if they need to find important information in an emergency.
  • Life Story Work - is a leaflet produced by Dementia UK which involves developing a biography to help care providers understand more about the individual’s previous experiences.
  • Local schemes - For example in the London Boroughs of Southwark and Lewisham, there is a scheme operating called SAIL - Safe and Independent Living, which is a partnership between Age UK and the Local Authorities which utilises a leaflet similar to those described above.

Whilst these are not specifically designed for people that are missing with dementia, they may still be a valuable tool in locating someone quickly and safely. Where a person has information for carers and social care staff within their home, we would advise that a Herbert Protocol form is also completed (where relevant) so that the specific information that is required by the police is captured correctly.

The use of pre-incident information is a developing area. Our colleagues in Kent in association with Kent Search & Rescue (KSAR) have developed and improved on many of the Herbert Protocol forms that are out there. They have produced a Herbert Protocol ‘At Risk of Going Missing’ form which is  the best we have seen , and well worth a look. It can be found at  www.ksar.co.uk, on their community initiative page.

Thanks for reading and we wish you well, whether you are baking or not.

 


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