Diverted from hospital A to Hospital B

Dear All, a patient has 2 med recs and an application for admission to hospital under s2 of the MHA. Hospital A has a bed on a general adult ward. The patient is frail and diverted to hospital B which has an older adults ward. Both Hospitals are under the same Management. Hospital A is named on the application form. Is an new application and med recs needed or is the original one sufficient?

best wishes
Adnan Sharaf

First of all one may ask who authorised a change of admission once the first hospital had accepted the patient. However, that wasn’t the question.
The med recs are valid for 14 days after the second examination, and for s2 are not dependent on the hospital.
A new application would be needed as the current one specifies the wrong hospital.
The Code of Practice anticipates a situation similar to this (but not identical) at 14.99.

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Sadly, this type of sceario has become increasingly common over the years. Usually caused by one of the following factors, or a combination: massive pressure on beds meaning that a ‘more urgent’ admission request means the bed which was available 20 minutes ago (when the application was signed) suddenly isn’t any more, bed is agreed, application signed and then there is a very long delay waiting for transport, and the bed cannot be ‘held’, or there is a change in circumstances meaning that the bed is no longer appropriate- i.e the person suddenly requires admission to a more secure setting, or suddenly requires urgent physical healthcare. Twenty plus years ago when I first started being an ASW, the applicant would remain with the person until they were admitted, so they would be on scene should a new application be required. But there has been a paradigm shift in AMHP practice since then caused by increased demand for assessments and longer and longer waiting time between signing an application and admission. Increasingly frequently AMHPs will not remain with the person until admission. And that means ward staff and ambulance crews are being put in the uncomfortable position of having to act on applications which are potentially invalid/unlawful. People usually act pragmatically and accept that everything is being done in good faith, but it can take a while to organise a new application, and hospitals are left with difficult decisions about the start time/date of the section, and of being responsible for a potentially unlawful period of detention.

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