Doctors and NHS staff need to work with police more effectively to prevent terror attacks says Met's counterterrorism head

By Reena Kumar

Doctors and health professionals need to work with the police more effectively to help officers prevent potential terror attacks by patients with mental illness, who may be at risk of being radicalised, the Met's Assistant Commissioner has said.

In an interview with the BMJ, Mark Rowley, the national lead on counter terrorism policing said that the involvement of the NHS in the government's Prevent strategy was more important now than it has ever been.

NHS workers are obliged by law to report those they fear are at risk of becoming terrorists under the government legislation.

However, data collected by the BMJ has revealed low levels of referrals. Out of 59 trusts in England, only 75 people were referred to the programme between 2105 and 2016.

Out of 23 mental health trusts who provided data, 254 referrals were made to Prevent.

Rowley said that clinicians were able to deal with mental health issues but could not protect patients from the influence of others trying to radicalise them.

“If some of the risk is not simply about the mental health condition but is about somebody else revving them up and trying to exploit it, then however good the mental health professional is, the mental health team on its own is probably insufficient,” he said.

“That’s why we have to work together, and it requires a bit more trust and collaboration between us . . . If we don’t intervene soon enough, that victim becomes a very serious perpetrator, and if they are about to go and kill people we then have to intervene with a different hat on and prosecute people.

“If we are willing to share information and work together then we can keep this as a preventive response, which is what we all believe in. Waiting for people to try to commit serious offences then putting them in prison for ever is not as elegant a solution.”

Despite Rowley's comments, the BMJ report found a mixed picture in terms of staff receiving Home Office approved training.

At St George’s University Hospitals NHS Foundation Trust, in south west London, just 4.5 per cent have been trained, but at Barts Health NHS Trust, in east London, 94 per cent reported receiving adequate coaching.

Clinicians have expressed frustration at the unwillingness of the Home Office and police to share information, such as providing feedback on the outcomes of their referrals of patients and publishing data to ensure that NHS involvement in Prevent is based on evidence.

A recent report by the US Open Society Justice Initiative warned of the threat the duty poses to the doctor-patient relationship and called for its repeal in both the health and education sectors.

However, the GMC’s updated confidentiality guidance makes it clear that in certain circumstances such as assisting in the prevention, detection or prosecution of serious crime, doctors would be “justified in disclosing information about patients in the public interest.”

The Royal College of Psychiatrists has also questioned the “variable quality of the evidence” underpinning the Prevent strategy and has called for it to be published in full.

Rowley described the accusations of a lack of transparency as “a fair challenge,” adding that in most cases there is no reason why the police should not provide feedback on what has happened after a referral, just as they would share information on a suspected case of child abuse with other agencies. “We can absolutely do that . . . We obviously need to do more. I will speak to my colleagues about that,” he added.