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Purpose -- The purpose of this paper is to appraise local absent without leave/missing persons policy in use across the nine NHS mental health trusts providing services across the Greater London region. Design/methodology/approach -- A review of the literature on best practice management was conducted, evidence collated and an appraisal tool produced. This tool was used to systematically appraise individual policies. Findings -- Despite some core consistency in policy, there was some notable variability in guidance. Novel and unique approaches to management were also identified. Research limitations/implications -- It is recognised that policies often arise from pragmatic approaches using local multi-agency agreements and therefore some variability across London was expected. It is also recognised that the audit tool produced is unvalidated but does reflect the best available evidence. Practical implications -- The authors have shown policy variability in the management of what is a common psychiatric problem across a relatively homogenous population. Standardisation of policy is likely to improve the efficiency in managing these incidents as well as encourage sharing of innovative practice. The authors also illustrate practical implications for local policy benchmarking in the absence of clearly defined national standards. Originality/value -- This study has shown the variability of policy in managing a common problem faced on psychiatric wards. It also highlights issues related to policy development on a local and regional level. [ABSTRACT FROM AUTHOR]