Patient detained to an out of area private hospital under s2. He went AWOL a couple of days after admission.
ICB in home area wants the patient discharged from section in his absence so they don’t have to fund the bed.
Mental Health Trust in home area wants private provider to transfer his s2 back to them under s19 so they can report him AWOL and have patient return to them.
After part 1 of the H4 is signed by the private provider will the patient become our responsibility to have him returned to the Trust under s18?
Is it possible for the Trust to sign part 2 of the H4 before actual admission takes place or is it to be completed only after patient is found and returned to the Trust before s2 expires?
My understanding is that a transfer cannot be completed without physical receipt of the ‘person’. So in theory the original hospital could complete part 1 of the H4 but it won’t take effect until the patient is physically admitted to the 2nd hospital.
Surely the point of s19 is to actually move a human being from one place to another - not to engage in theoretical bureaucracy with a view to easing costs and making re-admission easier once the patient turns up?!
Nothing prevents the Trust working quickly upon re-detention to mean the patient is taken somewhere other than the private hospital.
Jones MHA Manual does state there is nothing preventing the H4 transfer authority being completed whilst the patient is AWOL but physical admission of the patient will need to take place to the hospital named in part 1 of the form within 28 days of the form being completed (signed/dated). There is also nothing explicit within the MHA or Code that says the patient can’t then be taken to the hospital named in part 1 of the H4 within 28 days/or before the s2 expires (by those authorised to do so) and then for the receiving hospital to receipt the patients physical admission by completing part 2 of the H4 and sending a copy to the original detaining authority.
Firstly it is not for the ICB to state that they want the patient discharged on the basis of costs. If s.23 has not be invoked nor any Manager’s Hearing or MHRT. Then the patient continues to require assessment/treatment.
I have know patients to be discharged in their absence if they cannot be tracked/supervised.
For H4, you will need the physical body. No hospital will be accepting a patient if there is nothing for them to accept but a piece of paper. Besides, if a patient has gone AWOL, their risk factor has also risen. There maybe a question of a requirement of one-to-one or a more secure facility depending on the circumstances or context of how the patient went AWOL in the first place.
