What do we think about this hypothetical situation where a person is recalled to Hospital A but turns up/brought by police/LAS/self presents at A&E in Hospital B (with or without a physical health issue).
Can we reissue a CTO3 to Hospital B?
Can we reissue a CTO3 to A&E?
Can Hospital B complete the CTO4 because the patient has already been recalled albeit to Hospital A not B.
Can we use s18 to transport the patient to Hospital A from A&E?
How long can Hospital B lawfully hold the patient in A&E?
Is the patient under a section in Hospital B? If not, I don’t see why CTO3 would need to be reissued or why Hospital B would need to complete the CTO4 if the patient hasn’t been formally recalled there? Again, if not under section then s18 would be fine to use, but if the patient is detained then s19 should be used.
I think a bit more clarification is needed before the question can be answered.
The following is not advice even if so construed. I can be totally wrong at times.
Can we reissue a CTO3 to Hospital B? — Yes, in principle, if Hospital B is named as the hospital of recall.
Can we reissue a CTO3 to A&E? — No, not as “A&E” as such; the recall is to a hospital.
Can Hospital B complete the CTO4 because the patient has already been recalled albeit to Hospital A not B? — No, not if the recall notice names Hospital A rather than Hospital B.
Can we use s18 to transport the patient to Hospital A from A&E? — No, not as the ordinary route if the patient is already detained after recall in Hospital B; the transfer provisions are the better route.
How long can Hospital B lawfully hold the patient in A&E? — Yes, but only up to 72 hours if the recall has been lawfully effected to Hospital B; otherwise no clear MHA holding power merely because they are in A&E.
Can MCA help? — Yes, but only in a limited way for immediate capacity-based physical health or necessity issues; no as a substitute for the MHA recall detention framework.
It cannot be reissued or amended informally to another hospital.
The original recall to Hospital A still stands
Hospital B is not automatically authorised to detain.
Should either facilitate transfer to Hospital A or Consider fresh detention powers at Hospital B - S2 or S3 if needed.
2 Can we reissue a CTO3 to A&E? - No. A&E is not normally a ‘’ hospital’’ for MHA detention purposes. A CTO recall must be to a hospital where the patient can be received for treatment under an RC.
3 Can Hospital B complete a CTO4? - CT04 is a revocation of CTO and usually patient becomes detained under S3.
But the recall was to Hospital A and the legal authority flows from that hospital.
Therefore, Hospital B does not automatically gain authority to detain the recall or revoke CT04 EXCEPT if the patient is physically received and accepted by Hospital B as acting on behalf of Hospital A and the RC takes responsibility but this is legally grey and risky.
4 Can we use S18 to transport from A&E to Hospital A?
Yes S18 MHA allows conveyance of a recalled patient to hospital and therefore provides authority to
move the patient to Hospital A which is the place of detention.
5 How long Can Hospital B hold the patient in A&E?
As Hospital B does not have full detention powers, they can only hold briefly and lawfully to arrange
transfer There is no prescribed time limit but it Must be reasonable and proportionate usually meant to
be short holding period of hours than prolonged detention.
6 Can MCA Help?
Yes, but only in a limited and supportive way if the patient lacks capacity AND Holding him will be in his best interests justifying preventing him from leaving A& E temporarily and basic restraint to prevent harm. But MCA cannot be used to enforce psychiatric detention where MHA should apply