‘Black Box’ Thinking for Policing

Introducing Force-Wide Notable Incident Procedures

In Matthew Syed’s great book, Black Box Thinking, he identifies that both airlines and medical systems have well-honed procedures which allow the identification of potential safety issues and the distribution of lessons identified quickly to encourage rapid organisational learning.

My own force C3 Division has successfully introduced a really good system which is similar called a Notable Incident Process. The goal of this process is:

‘To promote an improvement culture where staff are encouraged to report adverse incidents or ‘near misses’ and introduce processes as soon as possible where these can be recorded, assessed and any improvement identified and implemented’.

This is an excellent idea, well executed. It removes the traditional blame culture ethos and ensures staff can be confident that if there are issues then they can raise them and have them acted on for the benefit of all. It’s early days for this in my force and I am sure there will be challenges, but it looks really promising.

Whilst we all have ‘near miss’ procedures in our own organisations I am not sure we are really making the best of what we could when incidents occur. Near misses are recorded inconsistently, if at all and there is little rapid sharing of information to ensure wider organisational learning.

Perhaps it’s time to roll this sort of scheme out force wide for all incidents? I could see a simplified system working as follows:

· An online portal form to allow for rapid information capture across the force.

· A daily review to assess / edit and approve dissemination of Notable Incidents that come in.

· A push email linking each notable incident to frontline supervisors in the relevant work area to ensure the learning is disseminated in a timely fashion and reaches the attention of the right people in the right timescale so they can brief their teams.

Of course there are a couple of pitfalls. We have already seen elements of the Scottish media use the Notable Report Process to try and trash the excellent work of C3 Division in this area. Frankly the quality of journalism surrounding this has been lazy and sensationalist and it requires (as we have seen from the SMT in this area) a robust force level response and the staff to be directly reassured that they are doing the right thing reporting.

It also requires some leaders to reassess their attitude towards errors in the work place and approach these with a less punitive outlook. The system falls at the first hurdle if the leaders within the job don’t get that reporting and subsequent learning is more important in making sure someone is ‘held responsible’. This direction of travel needs to come from the very top.

Finally it requires a relationship with our Police Investigations &  Review Commissioner (PIRC) that endorses and understands what the intention of the force is. This may be the toughest nut to crack. You’d like to think however that this is somehing that the PIRC would encourage and actively support. 

Aspiring to generate fast learning across the Force has to be a no-brainer. We can use the example of our own C3 Division as a model for the rest of us to continually get better at the job.

We take millions of calls a year and make tens of millions of decisions around those calls on top of that. By and large we get them right. But when we don’t a Notable Incident Process gives us a valuable opportunity to identify issues and trends from these calls & improve how we look after both the public and ourselves. 

‘It’s Only a Knife’

You really wouldn’t think you’d need to explain to control room supervisors why a knife presents a lethal threat to officers and that the requests made in response to the above scenario are reasonable and reasoned.

I have to wonder as to the motive of the individual who failed to authorise suitable resources to deal with it.

I can however perhaps give a pass to members of the public I have engaged with over the last week or so via private messaging on Twitter who don’t understand my position that edged weapon threats (knife, axe, machete etc) require an armed response to safely deal with them. Again rather than try and explain piecemeal tweet by tweet let me outline the reasons.

Edged Weapons Characteristics

Lets first deal with why edged weapons are so lethal:

  • They require no training to kill. As demonstrated by the numerous youth deaths across the country, you need no special skill to kill with a knife. Swing, stab and slash wildly and often enough and you’ll hit something critical.
  • They can be used in a continuous attack that is virtually impossible to defend against. Attacking from all angles, fast and repeated strikes mean that knives are a highly efficient means of attacking someone. Edged wapon attacks are never just a single strike like you see in the movies. Youtube knife attacks to see how frighteningly dynamic and fast they are. The risk of death doesn’t stop till the threat is effectively neutralised.

Unarmed Officer Vulnerability

Why are unarmed cops vulnerable to lethal edged weapon threat?

  • Their armour covers some vital organs but even at a quick count, at least 6 arteries are on show as targets for the edged weapon attacker (2 each of the carotid, brachial and femoral).
  • They receive NO training as to how to disarm a knife attacker, and even if they did, they couldn’t possibly become proficient with the techniques in the time that they get to practice operational safety. As a young lad I spent a number of years teaching soldiers how to undertake last resort disarms of knife attackers as part of an unarmed combat program. They are LOW percentage techniques even for the trained individual.

Defensive Equipment Capability

Why can’t our normal issued defensive equipment deal with it?

  • Empty Hand Tactics. I have covered this above, youtube knife attacks and tell me that an officer with a day’s refresher or so every year where they practice 50 plus techniques for a couple of minutes each has any hope of stopping a determined edged weapon attacker.
  • Baton. It’s too short, requires us to be within the fighting arc of the edged weapon, exposes the vital officer target areas listed above and it’s effectiveness, even on unarmed offenders, depends heavily on the capability of the officer (remember, one training session a year, for a few minutes a technique).
  • Irritant Spray. Again requires us to be under 2 metres from the attacker, way too close to the edged weapon and even if the offender is partially affected by the spray, they remain just as dangerous wildly swinging and stabbing out at the officer. Spray is also unreliable as an incapacitant.
  • Taser. The MAXIMUM range of the Taser is 21 feet, though the effective range is practically less than that. Again, youtube Tueller’s 21 feet rule to see how quickly an edged weapon attacker can cover this distance. As we have seen recently with the terrible hammer attack on officers, Taser can and does fail. When it does what is an officer to escalate to in order to protect themselves and members of the public from lethal attack?

I just completed my annual refresher in operational safety. Our own force experts, and I bet yours, make it clear that edged weapons present a lethal threat to officers. The only tactic taught to us is a baton flick technique designed to buy us some distance in order to allow us to RUN AWAY.

Likelihood Versus Impact – Assessing the Risk

Coming back to the motivation of the control room supervisor in the tweet at the top of the blog…

When we assess risk we generally measure likelihood of an event versus it’s impact. It’s often argued that knife attacks on officers are rare, and that may be the case. However it’s just as reasonable to suggest that the impact of these attacks can be catastrophic – we recall the axe attack on the UK officer last year that caused her serious injury – only being saved by a member of the public dragging her into his flat.

This imbalance would be guaranteed to require mitigation to lower the risk to an acceptable level. I would respectfully submit that asking officers to simply acknowledge a ‘stay safe’ message fails to effectively mitigate the risk.

So given the all of the above, and the fact that UK Police Operational Safety Experts are teaching edged weapons as being lethal threats, why do we continue to send unarmed officers to deal with them?

I can come up with three possible explanations off the top of my head, but am happy to be corrected:

  1. Supervisors are ignorant to the real threat – in that case send them this blog.
  2. Forces have failed to ensure there is sufficient resource to deal with the number of these calls and so are forced to send unarmed officers.
  3. Supervisors would rather risk an unarmed officer get cut or stabbed than risk the deployment of the correct resource and the impact of a knife offender being shot for continuing to prosecute their attack.

I am sure the truth is somewhere in the middle…..


The Edged Weapon Blind Spot

How we are putting unarmed cops at risk

Over the past few days I’ve enjoyed some great twitter exchanges with folk about routine arming of officers and of late, specifically the use of unarmed officers to deal with edged weapon threats.

I was saddened, but not surprised to learn in a twitter poll I published that 88% of the 450 odd officers that had voted had been required to arrest an offender when it was known they were in possession of edged weapons. Some may have no issue with this, I very much do (having done it a number of times myself).

I have conveyed my views piecemeal over 147 characters but today want to lay out clearly why I feel as I do. So best start with my premise and work from there:

Armed officers should attend any call where there is an edged weapon suspected to ensure the safety of officers attending.

Let me outline my rationale for this as succinctly as I can:

  • Edged weapons pose a lethal threat to officers.
  • There is presently no authorised tactic for an unarmed officer to arrest an offender armed with an edged weapon.
  • Unarmed officers are not equipped with any option to stand off outside the reactionary arc of an armed offender yet retain control of the situation, whether the edged weapon threat is active or passive at the time of officer contact.

I don’t think the above rationale is particularly controversial but very happy to be challenged on it. Yet despite the above we consistently send officers to these calls.

How did we get to a situation so at odds with the rest of the Western world when it comes to dealing with edged weapons as a threat? And let’s be clear, we are definitely swimming against the officer safety tide on this one in my experience.

If you only have a hammer every problem looks like a nail….

When you only have officers armed with spray and baton then who else are you going to send to edged weapon calls? The paucity of armed coverage across the wider UK is well documented. Added to this we have allowed the armed policing debate to revolve around a firearm threat, completely ignoring that arguably the greater threat to officers comes from edged weapons.

Dangerously, we are now allowing public opinion to form that issuing Taser alone to officers would be a solution to edged weapon threats. This needs to be challenged. Taser is certainly an option to attempt to resolve an edged weapon incident (as are excellent public order tactics when time / circumstances allow) but if it fails it must be supported by firearms, less the officers involved are exposed to a lethal threat.

Additionally, despite having the best trained armed officers available to deploy to these incidents (UK training for AFO / ARV exceeds the bulk of international routinely armed training), we trust them the least to deploy and actually do their  job. This mystifies me. We are highly reluctant to send armed officers to calls initially, preferring to send unarmed officers to ‘confirm’ the presence of weapons.

In employing this model we are saying that risking an unarmed officer is more acceptable than having a highly trained armed officer, equipped to deal from the outset, attend and get the job done, or stand down immediately on assuring it is safe to do so. To my mind there can be no justification for this.

I am always cognisant that when the control room asks me to acknowledge a ‘Stay Safe’ message it shouldn’t be an unarmed officer call.

What to do?

You’ll probably not be surprised to know I am a supporter of routine arming (I will cover my thoughts on this in a following blog).

But for now perhaps its time to rapidly revise our views on this and provide specific guidance for our control rooms and Tactical Firearms Commanders that changes our deployment model. We should ensure that the safety of officers and members of the public come before concerns about the potential outcome or image of sending firearms officers to edged weapons calls. Armed officers should be the default resource  considered to attend edged weapon incidents.

I trust our exceptional AFOs to make the right decisions on arrival knowing they will keep my officers and I safe at these calls, standing down when suitable and allowing us to get on with the job.

Who knows? Perhaps UK policing is right on this and the rest of the Western world wrong when it comes to edged weapon threat? From my experience both before this job and now within it, we are sitting on the wrong side of the ledger.

Nobody Gets the Jail at Christmas….

Christmas is a pretty different time in a police office.

The conflicting sensory experience of Christmas decorations and custody sounds for one make it unique. But that’s not the only thing.

Its busy… I mean really busy! Cops work hard all year round but the week towards Christmas can be quite exhausting. Not necessarily with big things, but just a lot of anti-social behaviour and alcohol related violence to deal with.

All those office tensions from the year and romantic triangles bubbling up at the end of the office Christmas party resulting in people not normally coming to the attention of police standing face to face with a sober, unimpressed police officer (and getting indignant with us at the circumstances of them having come to be there).

Invariably throughout all this though there are cops whose Christmas spirit is unbreakable! In my own shift I have a probationer who since the 1st of December (the generally acceptable time for these things) has not stopped singing Christmas Songs in the car, the writing room and the corridor – and singing loudly! What makes it even more special is that her tutor is the biggest Grinch on the shift. (He loves it really….).

Shift nights out that have been planned and paid for for months will happen all over, secret Santa’s will be conducted and Christmas jumpers will make an appearance over uniforms (and snapchat / whatsapp groups)

Christmas Day in itself is quite special. Some might be surprised to hear that there aren’t a lot of cops on duty, with many forces looking to balance the minimum number needed to manage call volume to ensure overtime costs remain under control. This can make for a ‘calm before the storm’ feeling. 

Like many, I have worked more of these days than I have had off in the cops and I will make a confession here… I don’t mind working them. There is a genuine camaraderie about it which I enjoy.

Oh and the Food!!

Everyone brings in more food than you can imagine. Christmas songs are put on the TV in the piece (break) room and, where we can manage it post the Christmas Eve handover work, we engage in what we cheekily refer to as ‘Fire Fighter Policing’ ie we only go out when called to respond (with apologies to the amazing folk at Scottish Fire and Rescue Service… we love you really, well, not as much as the Scottish Ambulance Service but you get the sentiment… Merry Christmas to you too!).

When we do attend calls cops around the country will dash off in patrol cars (and yes sometimes wearing Santa hats), restore order and convey in various shapes and forms a message to the parties along the lines of: “It’s Christmas, nobody wants to get arrested huh? Can’t we maybe all get along?’.

Nobody gets the jail at Christmas…

Except, unfortunately sometimes they do. As the day goes on and alcohol flows the calls do start to come in.  By the time late shift comes on we are back in full flow. The resilience of cops during these times is something to be proud of. Out, take call, deal with call, back, eat more, out again and repeat! All the while doing their best to retain a cheery outlook.

Sadly sometimes the calls are serious. I’m not sure anything could be worse for a family than having a tragedy befall them on Christmas Day. When this happens we see cops at their absolute best. Providing comfort and support to those that need it at what should be the happiest of times.

Despite all of this at the end of their shift cops will head off into the night or early morning with smiles on their faces wishing each other a great Christmas with families, or what’s left of it! They’ll be tired but happy and no doubt fall asleep on a sofa somewhere after a few drinks and swapping of presents – oh and eating more food of course!

For me? I have one more shift left before I actually take time off for Christmas this year, enjoying Christmas Day with my brother (also a cop) who just happens to have the day off too, and the rest of our family.

For those of you who are going to be working over the time (and especially my own shift) I wish you all a safe, happy and restful Christmas with your own team members and loved ones. Merry Christmas to you all!

Preparing to Police

Reflections on Occupational Training versus Tertiary Education

I have two degrees…. a Bachelor of Arts in South East Asian Politics & History which I got on company time when I was in a former life, and a Masters in Criminology and Criminal Justice which I did on my own time, albeit sponsored, in a former jurisdiction.

Add to that a Diploma, an Associate Diploma, A  couple of certificates and a certificate I am studying for in my own time on Coaching (and will follow up with a Certificate of Mentoring to round out a diploma) and I’d consider myself reasonably well versed with tertiary education.

I’ve also been lucky enough over the years to have had some great occupational training experiences including 18 months of straight leadership, occupational fitness and tactics training, another 8 months of dedicated staff and command training and initial training in 3 different policing jurisdictions. Plus of course the myriad of courses that you do in ours and related trades. I like to think I can spot good training as well when I see it.

So when the College of Policing in England and Wales announce a variety of Degree pathways as they did today which will see a new constable earn a degree by the end of a 3 years period (or indeed join with one to start with), it got me thinking of the utility of my, mostly enjoyable, tertiary education experiences versus the utility of great training and how they can impact on initial policing and in subsequent police specialist and leadership training.

So looking back I can say I learned some important things from my tertiary education over the years. The key things that have held me in good stead are as follows:

  • An understanding that somewhere out there someone has probably solved the problem you are working on or a problem like it… and how to find it.
  • An understanding of qualitative and quantitative data.
  • How to write (in a style…).
  • A love of history and a surprising love of Shakespeare (it was an Arts degree after all..).

I also took a lot of things with me from my occupational training too:

  • Initial technical proficiency.
  • Fitness and an understanding of how to train.
  • How to train others.
  • An understanding of my personal physical and mental limits and how to exceed them.
  • (In the best training) Regular simulated practice of leadership and technical skills under pressures closest to the real thing.

Interesting enough a couple of my tertiary qualifications came directly from completion of vocational training based solely on course content… a nice bonus.

Unfortunately my tertiary education experiences came with some not so useful aspects:

  • A lot of the material simply didn’t relate to what I needed to know to be a better cop: I didn’t really need a history of criminology, knowledge of feminism in criminality or a detailed understanding of the higher concepts of policing structures and how a force is held accountable at government level. This took up a great proportion of my degree / diploma time.
  • I ended up doing a lot of ‘evidence’ documenting to show I had met qualification requirements – mostly to folk who had never actually done the job and despite the fact that I was being supervised daily by officers who could judge my performance. As an example I am mid 6000 words into writing my probationary Sergeant’s ‘Log’ as I write this. Time taken doing this is time I am not doing the job, learning specifically new aspects of the job or dare I say it.. resting between jobs.
  • I heard from few if any people actually doing my job. They had all studied it in detail. All bar one had ever been a cop. They simply couldn’t relate to me or my motivations. The time I did hear from cops, they were delivering academic course content as it was given to them – not sharing their experiences.

Training wasn’t all roses either of course. I am a particular critical of training and have little tolerance for training that wastes my time. My best experiences have been immersive, scenario based learning experiences that minimise theory and maximise time to get skills right.

Training time is too valuable to waste on extraneous stuff, be it academic or poorly delivered vocational work. We need to be ruthless, absolutely ruthless, in seeking to improve training content, delivery and experiences. We are too busy in the job to waste folks time and the work is too important to deliver second-rate training. We need to invest in tools to make us more effective and instructors to ensure they are current and can deliver. There is little room for ‘nice to haves’ in mandatory police training.

So here are my concerns about the proposals today given my experiences over the last 27 years of education and training:

  • We will spend too much time on extraneous subjects that don’t deliver what the officers need to be effective cops in order to demonstrate academic rigour.
  • We will spend too much time documenting these requirements in order to be assessed and qualify for degree level qualifications.
  • Education will be delivered by folk who have never policed and have limited understanding of the work officers will undertake. If it is delivered by cops they will be delivering and academic syllabus by rote.
  • Will will do too little simulation and practical skills work to give a confident foundation to launch into on the job training continuation.
  • We will spend too much time with officers abstracted from shift for ‘study time’, leaving an already stretched team even further short-staffed.

I essence, cops will come to shift with plenty of ‘nice to knows’ but very few ‘need to knows’ which will need to be picked up by overworked tutors and with members of the public used as guinea pigs.

I have other concerns with regards to how many funded routes will be offered versus pre-join qualified posts (I mean why would a small force say, wanting 15 officers, NOT require the pre-join degree candidate when they CAN specify that and reduce training costs?).

But sticking to training I feel we may be missing a trick.

I’d prefer to see us take a different route of investment: Super-charging vocational training to make it as cutting edge and as superb as some of our very best and most effective policing courses: Public order, negotiators, firearms, driving. These are impressive training experiences that produce first class outcomes. We’d be better off pouring our energy (and money) into modelling this into initial (and other specialist and leadership) training to provide cops to the frontline who are smart, robust, practiced in physical skills and with useful qualifications such as driving, initial enhanced public order quals, initial volume scene examination, open source investigation and a working knowledge of police systems, so they can contribute from day one on arrival in the shift.

If these qualifications happen to map across to the awarding of a tertiary qualification (minus having to do extra, extraneous work or ‘evidence’ anything) then that’s great, award it for free as a bonus for getting through a hard couple of years training.

If not? Well… perhaps tertiary qualification isn’t what we are looking for….

‘It’s Our Protocol’

Challenging the Hospital ‘Missing Person’

Question: When is a missing person not really a missing person?

Answer: Well, that’s a little more complicated but am sure by the end of this blog we can agree on at least one thing:

If the only reason an agency is reporting a person ‘missing’ is because of a ‘protocol’ then they are probably not missing…. and we should be robust enough to challenge that.

A number of agencies report people ‘missing’ in accordance with a protocol: Care homes when children miss their designated curfew, drug and alcohol counsellors when they can’t get in contact with a service user, and the agency we will deal with today, the NHS when they can’t find a patient.

Let me say from the off, there are times when the NHS report genuine missing persons to us. Detained patients that have managed to abscond from their ward for instance, or suicidal patients that have waited so long to be seen that they have gotten frustrated and walked out and are reported to us to now find.

Essentially it comes down to us risk assessing each circumstance as to whether they are really ‘missing’ or not. It would be good however if this policy on assessing risk was perhaps done by the NHS before attempting to pass responsibility for these individuals to the police.

Because there is a particular category of NHS ‘missing’ that we need to push back against: Those that are reported because ‘it’s protocol’. These involve some combination of the following:

  • Voluntarily absconded from a ward.
  • Checked out without signing discharge paperwork
  • Left with a cannula still in their arm.

The police are requested to ‘Bring them back to the ward’.

The observant amongst you will start to see the issue here:

Where is the risk? And more importantly….

What can or should the police do about it?

Lets deal with risk first. More often than not the call log doesn’t offer enough information to assess risk. This requires the frontline leader to call the reporter to ask questions about the patient.

This quick call to the reporter, often the charge nurse on the reporting ward, regularly establishes the following:

  • No immediate concerns for the misper.
  • No risk to life.
  • No chance of catastrophic bleeding if they remove the cannula.
  • No requirement for police to call an ambulance to get them medical treatment when found.
  • No issue of capacity.
  • No order in place to require a return to hospital.

The conversation invariably leads to the question: ‘Why are you reporting them missing?’ to which the answer is:

‘It’s our protocol..’

What do we think of this? Is this sounding like a missing person that should have police asset assigned to locate?

Turning to what the police can do about it. Well, not much really. There is no order in place to return the patient. There is no requirement for medical treatment. So essentially the NHS are asking us to find a patient that has decided to leave the hospital and has the capacity to make that decision and ask them to return…….

Is this really what we would consider a missing person? Those non-police reading the blog probably think the circumstances I have outlined above are few and far between. Not the case. The above example and variations of it make up a high percentage of missing person calls we receive from the NHS.

Police NHS liaison officers would do well to work with their local trusts to review these policies in order to tighten up the reporting circumstances and require a reasonable risk assessment to be conducted prior to reporting with a clear idea of what actions police are requested to take, mindful of the limitations of police involvement.

Until then frontline police leaders should be robustly challenging and documenting discussions with the NHS reporters rather than simply accepting the misper call and actioning limited police resources to it.

There will always be times when we move rapidly to establish the whereabouts of missing patients when the risk presents. However a policy to report patients who have voluntarily left the hospital due to protocol wastes everybody’s time and resources.


Mention in Dispatches

A shout out to my Controllers…..

“Mate I’ve got no one to send you… but I have you on CCTV and I will monitor you and your neighbour till I can get stations to you… as soon as I can..”

Simple words through my earpiece at a chaotic scene where my neighbour and I were in a little bit of bother… they made a big difference to me at the time. Cooly delivered, they got me taking a breath and reassessing.. ‘Yeah we’ve got this…’

Dispatchers, Controllers, whatever you call them in your force, the good ones are simply worth their weight in gold. I have been lucky over the years to have been looked after by some great ones (and lets get straight to the point – that’s what they do, look after us). I have two at the moment that I wouldn’t trade for anything.

Lets take a couple of highlights for me:

  • Calmly dispatching multiple units from across the Division to attend urgent assistance calls, all the while speaking to the station requesting assistance and reassuring them that cars are on the way…
  • Coordinating the initial search pattern for high risk missing persons based off the maps on their screen and some rudimentary guidance from us on the road with no map in front of us..
  • Finding missing persons from their control screen and phone though getting a number from systems checks and getting hold of the misper, all the while still dispatching!

Really high class, genuinely life saving stuff.

But its the day to day work as well that we simply couldn’t do without. I chatted to my cops about this not too long ago and they were a little surprised how much interaction the Sergeants had with our controllers on a daily basis. My controllers are experts at:

  • Call prioritisation. “Sarge this is pish I am going to downgrade it if that’s okay with you.” or conversely “Sarge this has been sitting for a while but I’m not happy with it, can I get you to take a look for me and see what you think?” (Which invariably involves me quietly swearing to myself and politely asking for a car to be dispatched!).
  • Resource Management. My controllers do the above while they manage the whole Division. Multiple sub divisions, 50-70+ assets (conservatively) of varying types. Multiple ‘risk’ incidents. Their ability to juggle this flawlessly is truly impressive.
  • Value Adding. Despite the resources needing to be managed they are still somehow able to proactively run multiple checks for cops, call complainers to get more info, point to point officers that want to chat, liase with service overview…. and still answer the radio in seconds for a station shouting up.

They do all of this while still having a laugh with us when we speak them on the phone & laughing with cops on the radio at the more bizarre calls we attend (and the witty banter of my shift!). I reckon I must speak to them over a dozen times a shift on the phone alone. They are an indispensible part of our team.

We send all our probationers to meet them  (taking cakes of course) and I love the key bit of advice they give every single one:

“All you need to do if you get in trouble is tell us where you are, we will take care of the rest.”

So a quick shout out to my excellent controllers and to controllers / dispatchers everywhere. You are very much appreciated!

We couldn’t do the job without you.