Person can be conveyed to psychiatric hospital for a period of assessment (within 48 hours of the medical recommendation)
Once the application has been completed (founded on a medical recommendation) and if the patient is medically well enough to be discharged from the general hospital, the patient may be conveyed to a psychiatric or learning disability hospital. This Application (Form 1 or 2), founded on a properly completed Medical Recommendation (Form 3), together constitute sufficient authority for the compulsory removal and conveyance of the patient to the hospital. Article 8 (1)
The ASW must ensure that both the medical recommendation and application have been properly completed. Care must be taken that the patient's name and address and those of the nearest relative are correct, that both forms are properly dated and signed, the application and medical recommendation has been made to the appropriate Health and Social Care Trust with correct full address of that Trust on both forms and that the name of the hospital is clearly identified in the application. See Appendix list of HSCTs
No. Once the application is made the person is in the legal custody of the applicant, or a patient delegated by him. The detained patient will have a right to appeal to the Mental Health Review Tribunal against his detention in hospital once he is admitted.
In situations where the person is of no fixed abode or is not a resident of the jurisdiction, a bed should be sought in and an application made to the nearest hospital. In situations where the patient is a resident of another Trust area a bed should be sought in and an application made to that Health and Social Care Trust and the appropriate hospital identified.
The Order states that the person must be admitted to hospital within 2 days beginning with the date on which the medical recommendation was made.
Yes, in exceptional circumstances this period can be extended up to 14
days. A Part II doctor must complete Form 4, setting out the exceptional
circumstances that make the extension necessary. LINK TO FORM 4
Article 8 (1) (ii)
Article 8 (i) (ii) states that in exceptional circumstances the period for the conveyance and admission to hospital can be extended from 2 days to a period of no more than14 days from the date of the medical recommendation.
Exceptional circumstances might include difficulty in accessing the assistance necessary to transport the patient safely to hospital or the patient's discharge from the general hospital needs to be delayed because of a sudden deterioration in their physical health.
In this circumstance the applicant (ASW or nearest relative) must get a certificate in the prescribed form, Form 4, from a Part II doctor stipulating the number of days to which it can be extended and giving reasons for the extension. Link to Form 4
If the patient is medically unfit for discharge and requires ongoing inpatient treatment in the general hospital for a significant number of days the Order also allows for the patient to be detained for assessment in the general hospital.
It is recommended that advice continues to be sought through the local liaison psychiatry service including guidance on the detention process.
In this situation the medical recommendation, Form 3 and the application for admission for assessment Form 1 or 2, should be made to the Trust with management responsibility for the general hospital with the general hospital named as the hospital in Form 1 or 2.
A doctor on the staff of the general hospital should immediately consider, and if necessary sign Form 7 which will last for 48 hours in this case. Thereafter a Part II doctor will be required to sign the detention forms. The care of the patient should be managed jointly by the general hospital and the appropriate local psychiatrist. LINK TO FORM 7
The patient should be transferred as soon as he is medically fit to the appropriate mental health or learning disability hospital. In these circumstances consultation should take place between staff in the general and psychiatric or learning disability hospital to agree arrangements for the safe conveyance of the patient when medically fit for transfer. It is expected that the patient will be transferred by ambulance, accompanied by staff from either hospital.
Yes. In exceptional circumstances and if the patient continues to need ongoing medical treatment and care in the general hospital, the patient may be detained for treatment for their mental illness or severe mental impairment in the general hospital.
In this situation the local appropriate Consultant Psychiatrist should assume the responsibilities and role of the Responsible Medical Officer (RMO) in relation to the review of the patient's detention and provision of treatment of the mental disorder.
The patient should be transferred as soon as he is medically fit to the appropriate mental health or learning disability hospital.