# MHA assessment quicker than CTO recall? (Also: definition of hospital) **URL:** \ **Category:** Mental Health Act\ **Tags:** cto, mha-assessment\ **Created:** [9 July 2026 10:55 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890 "2026-07-09T10:55:39Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Joolsleeds](https://forum.mentalhealthlaw.co.uk/user_avatar/forum.mentalhealthlaw.co.uk/joolsleeds/32/56_2.png) [@Joolsleeds](https://forum.mentalhealthlaw.co.uk/u/Joolsleeds)\ **Post date:** [9 July 2026 10:55 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/1 "2026-07-09T10:55:39Z")
> [@CTO, Tribunal and 'necessity' of recall power](https://forum.mentalhealthlaw.co.uk/t/cto-tribunal-and-necessity-of-recall-power/5884/1): > > at present, it would actually be quicker to get the patient into hospital through a MHAA rather than using the power of recall due to bed pressures. Can someone explain this to us lay people please? Why is recall under a CTO more difficult or lengthy than a MHAA? ---
**Author:** ![SarahC](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/s/34f0e0/32.png) [@SarahC](https://forum.mentalhealthlaw.co.uk/u/SarahC)\ **Post date:** [9 July 2026 10:58 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/2 "2026-07-09T10:58:03Z")
I am assuming that it related to allocating bed - it may be that the bed hub in this area priorities new MHA assessments over recalled CTO patients requiring a bed. ---
**Author:** ![emily.cresswell](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/e/b3f665/32.png) [@emily.cresswell](https://forum.mentalhealthlaw.co.uk/u/emily.cresswell)\ **Post date:** [9 July 2026 11:05 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/3 "2026-07-09T11:05:18Z")
Hi Julian, It shouldn’t! The clinical team will often rely on the power of recall to get the patient back into hospital quickly. However, in this case, the RC said in her evidence that a MHAA would be quicker than recalling the patient back to hospital. ---
**Author:** ![ZacSussex](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/z/e8c25b/32.png) [@ZacSussex](https://forum.mentalhealthlaw.co.uk/u/ZacSussex)\ **Post date:** [9 July 2026 12:09 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/4 "2026-07-09T12:09:31Z")
> [@Joolsleeds](#): > > Can someone explain this to us lay people please? Why is recall under a CTO more difficult or lengthy than a MHAA? It’s to do with the Trusts internal processes. Sometimes beds are prioritised for CTO patients, sometimes RCs are fighting for beds for CTO patients and priority is given to urgent MHAAs. There’s no consistency between different areas of the country and I’ve honestly given up trying to understand it. ---
**Author:** ![Dudles](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/d/dc4da7/32.png) [@Dudles](https://forum.mentalhealthlaw.co.uk/u/Dudles)\ **Post date:** [9 July 2026 14:13 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/5 "2026-07-09T14:13:48Z")
The role of the bed manager is to prioritize admissions. Understandably, most will prioritize emergency S2/3 admissions over a CTO recall if the recall does not appear (to them) to be immediately necessary. A complication is that the community RC can’t issue a recall notice if the patient can only be admitted to a bed at a different trust. First, the new trust must accept it has become the “responsible hospital” and has appointed a new RC who can then issue the recall. ---
**Author:** ![Richard\_Rook](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/r/ecb155/32.png) [@Richard\_Rook](https://forum.mentalhealthlaw.co.uk/u/Richard_Rook)\ **Post date:** [9 July 2026 16:48 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/6 "2026-07-09T16:48:21Z")
> A complication is that the community RC can’t issue a recall notice if the patient can only be admitted to a bed at a different trust. First, the new trust must accept it has become the “responsible hospital” and has appointed a new RC who can then issue the recall. That might be the practice (I don’t know), but it’s not actually the law. Section 17E(3) says expressly: > (3) The hospital to which a patient is recalled need not be the responsible hospital." Obviously the RC needs to check that the new Trust will accept the patient, but there’s no need in law to change RCs first. ---
**Author:** ![Dudles](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/d/dc4da7/32.png) [@Dudles](https://forum.mentalhealthlaw.co.uk/u/Dudles)\ **Post date:** [9 July 2026 17:56 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/7 "2026-07-09T17:56:19Z")
Yes I see but I suspect in practice it is quite hard to persuade trust to accept a recalled patient for which they are not responsible. It would be interesting to know if anybody knows of such cases. ---
**Author:** ![GuyDavis](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/g/eb9ed0/32.png) [@GuyDavis](https://forum.mentalhealthlaw.co.uk/u/GuyDavis)\ **Post date:** [9 July 2026 18:39 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/8 "2026-07-09T18:39:53Z")
Bearing in mind of course that the criteria for recall and an application for detention, are different. Also, recall does not necessarily equal inpatient admission, hence why the need to exercise the power of recall is not measured against how quickly an application takes to arrange. ---
**Author:** ![CaptainWalker](https://forum.mentalhealthlaw.co.uk/user_avatar/forum.mentalhealthlaw.co.uk/captainwalker/32/159_2.png) [@CaptainWalker](https://forum.mentalhealthlaw.co.uk/u/CaptainWalker)\ **Post date:** [10 July 2026 18:06 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/9 "2026-07-10T18:06:00Z")
> [@Joolsleeds](#): > > Why is recall under a CTO more difficult or lengthy than a MHAA? The main issue there is territoriality and in-fighting. Of course all that is related to shortage of resources caused by that entity that we are not allowed to name. > [@Joolsleeds](#): > > Can someone explain this to us lay people please? On of the key issues is in **Section 17E** — recall is exercised by written notice to the patient – “_The power of recall under subsections (1) and (2) above shall be exercisable by notice in writing to the patient._“ Each word in that is another source of in-fighting and misunderstanding, though it reads simple enough. The part about ‘in writing’ came alive to me in a real case. ‘People’ were really scared in a certain LD case who was drugged up to the eyeballs for god-knows-what. P was very brittle and costed about £1 million to place in a purpose-built facility in ‘the community’. So the big issue is what would happen if on a Friday around 16:00 P kicks off and needed to be recalled. Who is transporting a recall notice ‘in writing’. Same for Saturday or Sunday. One might have thought that a courier or Uber driver taking a photograph of delivery to the patients live-in carers would be enough. Nope. Massive debates about it being delivered to the patient’s hands etc etc. Row, row, row your boat - you know the song. Come on - sing along. So in the end no CTO. It was straight discharge to the community. [Caution: I unable to give more details in case anyone want’s to go down the ‘I would have thought’ route. I cannot give more details. To do so will make the Trust and the patient identifiable.] ---
**Author:** ![Karen](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/k/7feea3/32.png) [@Karen](https://forum.mentalhealthlaw.co.uk/u/Karen)\ **Post date:** [14 July 2026 11:27 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/10 "2026-07-14T11:27:59Z")
In Kent they never recall CTO patients to anywhere other than the responsible hospital whereas fresh admissions can be sent to OOA beds. This can result in patients on CTOs waiting literally months for a bed and I have obtained two MHT discharges for patients on CTOs who were waiting for beds on the basis that the CTO was actually preventing their timely admission. One problem is that they need to have a bed even if they are only intending to recall to give depot and then discharge. ---
**Author:** ![GuyDavis](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/g/eb9ed0/32.png) [@GuyDavis](https://forum.mentalhealthlaw.co.uk/u/GuyDavis)\ **Post date:** [14 July 2026 11:57 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/11 "2026-07-14T11:57:20Z")
> [@Karen](#): > > One problem is that they need to have a bed even if they are only intending to recall to give depot and then discharge. Who decided that because it is not necessary? The person could be recalled to a unit where there are no inpatient facilities. ---
**Author:** ![Dudles](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/d/dc4da7/32.png) [@Dudles](https://forum.mentalhealthlaw.co.uk/u/Dudles)\ **Post date:** [14 July 2026 12:04 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/12 "2026-07-14T12:04:04Z")
Yes I suspect that this reluctance is a frequent occurrence . Does anybody know of a trust that accepts recall patients for which they are NOT responsible. Who is the RC between recall and revocation? Thanks for your help. ---
**Author:** ![SarahC](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/s/34f0e0/32.png) [@SarahC](https://forum.mentalhealthlaw.co.uk/u/SarahC)\ **Post date:** [14 July 2026 12:35 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/13 "2026-07-14T12:35:21Z")
Hi Guy, the Code of Practice states that recall must be to a hospital, although treatment can be given as an outpatient. For me that states that a unit without inpatient facilities is not appropriate. Policy in my Trust has always been that a patient is recalled to a bed with their name on it, so that if they do need to stay beyond what is planned, then the arrangements are there. Karen, I was not aware of Trusts that didn’t accept recall patients they weren’t responsible for. The MHA states clearly that a patient can be recalled to a hospital other than the one which is their responsible hospital. Standard practice for us has always been that the RC for the ward where they are admitted fulfils the role of RC until either the CTO is revoked or the patient returns to the community. ---
**Author:** ![Dudles](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/d/dc4da7/32.png) [@Dudles](https://forum.mentalhealthlaw.co.uk/u/Dudles)\ **Post date:** [14 July 2026 12:45 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/14 "2026-07-14T12:45:13Z")
Oh yes that’s interesting. Have you accepted recall patients from other providers and if you did the “other provider” allocate the RC? Thanks for your interest. ---
**Author:** ![GuyDavis](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/g/eb9ed0/32.png) [@GuyDavis](https://forum.mentalhealthlaw.co.uk/u/GuyDavis)\ **Post date:** [14 July 2026 12:56 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/15 "2026-07-14T12:56:19Z")
> [@SarahC](#): > > the Code of Practice states that recall must be to a hospital, although treatment can be given as an outpatient. For me that states that a unit without inpatient facilities is not appropriate. That’s not correct Sarah, see the definition of hospital in s.145. ---
**Author:** ![GuyDavis](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/g/eb9ed0/32.png) [@GuyDavis](https://forum.mentalhealthlaw.co.uk/u/GuyDavis)\ **Post date:** [14 July 2026 13:02 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/16 "2026-07-14T13:02:43Z")
…also, s.17E does not require that the patient is ‘admitted’ to hospital in the same way that ss.2 and 3 do. ---
**Author:** ![SarahC](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/s/34f0e0/32.png) [@SarahC](https://forum.mentalhealthlaw.co.uk/u/SarahC)\ **Post date:** [14 July 2026 13:03 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/17 "2026-07-14T13:03:37Z")
> “hospital” means— > > (a) any institution for the reception and treatment of persons suffering from illness, > > (b) any maternity home, and > > (c) any institution for the reception and treatment of persons during convalescence or persons requiring medical rehabilitation, > > and includes clinics, dispensaries and out-patient departments maintained in connection with any such home or institution, and “hospital accommodation” must be construed accordingly, I went down the rabbit hole Guy… if you follow it far enough, it takes you to section 275 of the NHS Act 2006, which is copied above. I would read clinic, dispensaries and out patient depts as being those you would find attached to most NHS acute and psychiatric inpatient units / hospitals. ---
**Author:** ![GuyDavis](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/g/eb9ed0/32.png) [@GuyDavis](https://forum.mentalhealthlaw.co.uk/u/GuyDavis)\ **Post date:** [14 July 2026 13:07 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/18 "2026-07-14T13:07:27Z")
and the definition means that it would include i.e. a stand-alone CMHT where depot medication is administered. ---
**Author:** ![SarahC](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/s/34f0e0/32.png) [@SarahC](https://forum.mentalhealthlaw.co.uk/u/SarahC)\ **Post date:** [14 July 2026 13:32 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/19 "2026-07-14T13:32:23Z")
We can argue the toss for ever Guy, but in my area, CMHTs are not attached to hospitals - they are stand alone units, out in the community. And with regard to your other comment, Section 17E (6) begs to differ: A notice under this section recalling a patient to hospital shall be sufficient authority for the managers of that hospital to detain the patient there in accordance with the provisions of this Act ---
**Author:** ![Karen](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/k/7feea3/32.png) [@Karen](https://forum.mentalhealthlaw.co.uk/u/Karen)\ **Post date:** [14 July 2026 14:17 UTC](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890/20 "2026-07-14T14:17:25Z")
You both may well be correct but the fact is within our local trust CTO patients are never recalled out of area and recall for depot is only ever to a hospital. I have to say I can’t see how you could safely recall someone to a facility where they can’t be detained if it is necessary to revoke. [Next page](https://forum.mentalhealthlaw.co.uk/t/mha-assessment-quicker-than-cto-recall-also-definition-of-hospital/5890.md?page=2)