Hi
Please can anyone clarify can a patients be on a S3 and a DOL’s at the same time.
I have heard of a CTO & DOL’s but not S3 and a DOL’s.
The patient is being treated for his physical condition in a general hospital under S17 leave. They want to put a DOL’s in place to treatment him and stop him from leaving.
When the DOL’s is in place do we have to rescind the S3 or can they work together.
Any advice asap would be very much appreciated.
Many thanks
Under s 17(3), a clinician can direct the patient to remain “in custody” of a person, which could potentially amount to a deprivation of liberty.
Under s 17(3), the MHA can be used to authorise the patient’s deprivation of liberty outside hospital, whether they have capacity or not.
The MHA cannot deprive P of their liberty under s 17 leave, unless it is authorised by the responsible clinician using s 17(3) – this applies whether P has capacity, or not.
It is also possible to use s 17 leave and DOLS alongside each other, for example a trial placement in a care home or where leave is granted to another hospital for treatment of physical disorder.
Thank you, you couldn’t point me anywhere such as in the code of practice where it states that, my RC is asking and i cant find anything
Chapter 27 of the code of practice
Sorry i have read S27 but still cant see where it says S17 and DOls can be used together.
I might be being really thick here 
Has your RC got access to a copy of the relevant section of Jones, so they can read the wording of s17(3) for themselves? Our local acute hospital expects us to use this where it is predicted that the patient will try to leave their care, as it authorises them to take necessary action to keep the patient in their custody if the RC specifies that is to happen
I agree with earlier comments. Treatment for the physical condition could not be done against the p’s wishes unless they lack capacity and you have obtained a court order
The following is opinion - not advice - no liabilities accepted for misconstruing or misapplying my opinions. I owe no duty of care to the patient or staff involved. [Dissertation on difference between opinion and advice withheld because it would be 5000 words - not joking.]
That is appropriately lawful.
DOLS does not provide powers to treat - but I’m happy to be corrected with a sound reference.
DOLS is unnecessary as far as I am concerned because:
It seems to me that ‘they’ have confused and conflated ‘treatment’ with ‘not leaving’ - and further got kerfuffle in the Cartesian dualism that splits everybody into ‘physical’ and ‘mental’. ‘They’ need to seek legal advice.
‘Have to’? What might direct or compel such actions? Nothing in law says that DOLS drives cancellation of any section of the MHA 1983 (Amended 2007).
I note a repeated theme in the health services - biased by my own history of ‘encounters’ - where Trusts and their ‘people’ avoid seeking contracted sound legal advice.
Heather
Agree with others that s17(3) might well be sufficient. But of you’re still looking for something in black and white saying s17 and DOLS can co-exist, see para 4.51 of the MCA DOLS Supplementary Code of Practice:
4.51 People on leave of absence from detention under the Mental Health Act 1983 or subject to supervised community treatment or conditional discharge are, however, eligible for the deprivation of liberty safeguards if they require treatment in hospital for a physical disorder.
Agree with others - you cannot do this and should not.
Dols is about constant supervision and containment not treatment. Constant supervision and containment is covered by section 3 here (even on leave).
Dols does not cover treatment of any kind.
Physical treatment can be given under MCA in this circumstance. Or if the physical treatment is connected to mental disorder (or the refusal to accept treatment is due to mental disorder) then the physical treatment can be given under MHA.
HI Heather, yes this is possible in principle, if the person is on Section 17 leave. However, it would be best to take legal advice on the specific circumstances in your case. You may want to read the case of A Hospital NHS Foundation Trust v KL [2023] EWCOP 59 as an example.
Thank you for your help
Circumstances where both the MHA and MCA can be applied in a hospital setting
In cases where a person is detained in hospital under the MHA, but needs treatment for a physical health problem, in certain cases the MCA (and even DoLS) could potentially be applied alongside the MHA. The MHA code of practice for England provides the most up-todate guidance relevant to this area, which can be found in chapter 13: