CTO Patient Informal Admission

A new client has been on a CTO since April, albeit for the majority of it ‘informally’ staying at various different hospitals for months at a time.
It doesn’t sit right with me. Four different hospitals have accepted him throughout this period, yet still it is felt the CTO is necessary throughout that time.
How can his current RC & AMHP agree to renewal when the CTO provides no benefit whatsoever. Just days after this his CTO is then revoked and from what I can gather there has been no particular reason for it.
It seems so unnecessary and backward! I thought I would share this to see whether anybody had any thoughts?


As an AMHP, making a decision detain a person who is willing to consent to an informal admission should not be the norm: informal admission under s131 should be the preferred option, as this keeps inline with the Guiding Principles. The COP also points the AMHP towards informal over being detained (COP 14.14). A CTO can offer more than merely returning a patient who has been recalled (and later revoked), it can form part of their care plan to remain well in the community. Without knowing the full details of the case its difficult to give a detailed answer. (I’m not seeking more details, just an observation there is often more to these types of cases).

I have had several cases like this where the patient has been informal whilst on a CTO.

Generally I’ve advised them to apply to the Tribunal and been successful every time in having the CTO discharged on the basis that the power of recall isn’t necessity when they are perfectly capable, even whilst unwell, of consenting to informal admission.


If the patient wins the Tribunal. Can you please enlighten if possible, of the unwell case example, about what necessary safeguards such a patient had in place to survive safely in the Community without hospitalisation. I am keen to understand the setup arrangements outside the CTO powers which may have prevailed to sustain the patient in the Community without need for recall.

I don’t think I fully understand the question @Burman_Mavhunduse - could you possibly rephrase it? Thanks.