|
| |
|
“the community treatment order”, in relation to such a patient, |
| |
means the community treatment order in force in respect of |
| |
| |
“the responsible hospital”, in relation to such a patient, means the |
| |
hospital in which he was liable to be detained immediately |
| 5 |
before the community treatment order was made, subject to |
| |
| |
| |
(1) | A community treatment order shall specify conditions to which the |
| |
patient is to be subject while the order remains in force. |
| 10 |
(2) | But the order may only specify conditions which the approved mental |
| |
health professional mentioned in section 17A(4)(b) above agrees should |
| |
| |
(3) | The conditions which may be specified include— |
| |
(a) | a condition that the patient reside at a particular place; |
| 15 |
(b) | a condition that the patient make himself available at particular |
| |
times and places for the purposes of medical treatment; |
| |
(c) | a condition that the patient receive medical treatment in |
| |
accordance with the responsible clinician’s directions; |
| |
(d) | a condition that the patient make himself available for |
| 20 |
examination (for the purposes, in particular, of section 20A(4) |
| |
below or of enabling a Part 4A certificate (within the meaning of |
| |
section 64H below) to be given in his case); |
| |
(e) | a condition that the patient abstain from particular conduct. |
| |
(4) | The responsible clinician may from time to time by order in writing |
| 25 |
vary the conditions specified in a community treatment order. |
| |
(5) | He may also suspend any conditions specified in a community |
| |
| |
(6) | If a community patient fails to comply with a condition specified in the |
| |
community treatment order, that fact may be taken into account for the |
| 30 |
purposes of exercising the power of recall under section 17E(1) below. |
| |
(7) | But nothing in this section restricts the exercise of that power to cases |
| |
where there is such a failure. |
| |
17C | Duration of community treatment order |
| |
A community treatment order shall remain in force until— |
| 35 |
(a) | the period mentioned in section 20A(1) below (as extended |
| |
under any provision of this Act) expires, but this is subject to |
| |
sections 21 and 22 below; |
| |
(b) | the patient is discharged in pursuance of an order under section |
| |
23 below or a direction under section 72 below; |
| 40 |
(c) | the application for admission for treatment in respect of the |
| |
patient otherwise ceases to have effect; or |
| |
(d) | the order is revoked under section 17F below, |
| |
| |
|
| |
|
| |
|
17D | Effect of community treatment order |
| |
(1) | The application for admission for treatment in respect of a patient shall |
| |
not cease to have effect by virtue of his becoming a community patient. |
| |
(2) | But while he remains a community patient— |
| |
(a) | the authority of the managers to detain him under section 6(2) |
| 5 |
above in pursuance of that application shall be suspended; and |
| |
(b) | reference (however expressed) in this or any other Act, or in any |
| |
subordinate legislation (within the meaning of the |
| |
Interpretation Act 1978 (c. 30)), to patients liable to be detained, |
| |
or detained, under this Act shall not include him. |
| 10 |
(3) | And section 20 below shall not apply to him while he remains a |
| |
| |
(4) | Accordingly, authority for his detention shall not expire during any |
| |
period in which that authority is suspended by virtue of subsection |
| |
| 15 |
17E | Power to recall to hospital |
| |
(1) | The responsible clinician may recall a community patient to hospital if |
| |
| |
(a) | the patient requires medical treatment in hospital for his mental |
| |
| 20 |
(b) | there would be a risk of harm to the health or safety of the |
| |
patient or to other persons if the patient were not recalled to |
| |
hospital for that purpose. |
| |
(2) | The responsible clinician may also recall a community patient to |
| |
hospital if the patient fails to comply with a condition imposed under |
| 25 |
| |
(3) | The hospital to which a patient is recalled need not be the responsible |
| |
| |
(4) | Nothing in this section prevents a patient from being recalled to a |
| |
hospital even though he is already in the hospital at the time when the |
| 30 |
power of recall is exercised; references to recalling him shall be |
| |
| |
(5) | The power of recall under subsections (1) and (2) above shall be |
| |
exercisable by notice in writing to the patient. |
| |
(6) | A notice under this section recalling a patient to hospital shall be |
| 35 |
sufficient authority for the managers of that hospital to detain the |
| |
patient there in accordance with the provisions of this Act. |
| |
17F | Powers in respect of recalled patients |
| |
(1) | This section applies to a community patient who is detained in a |
| |
hospital by virtue of a notice recalling him there under section 17E |
| 40 |
| |
(2) | The patient may be transferred to another hospital in such |
| |
circumstances and subject to such conditions as may be prescribed in |
| |
regulations made by the Secretary of State (if the hospital in which the |
| |
|
| |
|
| |
|
patient is detained is in England) or the Welsh Ministers (if that hospital |
| |
| |
(3) | If he is so transferred to another hospital, he shall be treated for the |
| |
purposes of this section (and section 17E above) as if the notice under |
| |
that section were a notice recalling him to that other hospital and as if |
| 5 |
he had been detained there from the time when his detention in |
| |
hospital by virtue of the notice first began. |
| |
(4) | The responsible clinician may by order in writing revoke the |
| |
community treatment order if— |
| |
(a) | in his opinion, the conditions mentioned in section 3(2) above |
| 10 |
are satisfied in respect of the patient; and |
| |
(b) | an approved mental health professional states in writing— |
| |
(i) | that he agrees with that opinion; and |
| |
(ii) | that it is appropriate to revoke the order. |
| |
(5) | The responsible clinician may at any time release the patient under this |
| 15 |
section, but not after the community treatment order has been revoked. |
| |
(6) | If the patient has not been released, nor the community treatment order |
| |
revoked, by the end of the period of 72 hours, he shall then be released. |
| |
(7) | But a patient who is released under this section remains subject to the |
| |
community treatment order. |
| 20 |
| |
(a) | “the period of 72 hours” means the period of 72 hours beginning |
| |
with the time when the patient’s detention in hospital by virtue |
| |
of the notice under section 17E above begins; and |
| |
(b) | references to being released shall be construed as references to |
| 25 |
being released from that detention (and accordingly from being |
| |
| |
17G | Effect of revoking community treatment order |
| |
(1) | This section applies if a community treatment order is revoked under |
| |
section 17F above in respect of a patient. |
| 30 |
(2) | Section 6(2) above shall have effect as if the patient had never been |
| |
discharged from hospital by virtue of the community treatment order. |
| |
(3) | The provisions of this or any other Act relating to patients liable to be |
| |
detained (or detained) in pursuance of an application for admission for |
| |
treatment shall apply to the patient as they did before the community |
| 35 |
treatment order was made, unless otherwise provided. |
| |
(4) | If, when the order is revoked, the patient is being detained in a hospital |
| |
other than the responsible hospital, the provisions of this Part of this |
| |
Act shall have effect as if— |
| |
(a) | the application for admission for treatment in respect of him |
| 40 |
were an application for admission to that other hospital; and |
| |
(b) | he had been admitted to that other hospital at the time when he |
| |
was originally admitted in pursuance of the application. |
| |
(5) | But, in any case, section 20 below shall have effect as if the patient had |
| |
been admitted to hospital in pursuance of the application for admission |
| 45 |
for treatment on the day on which the order is revoked.” |
| |
|
| |
|
| |
|
(3) | After section 20 (the cross-heading immediately above which becomes |
| |
“Duration of authority and discharge”) insert— |
| |
“20A | Community treatment period |
| |
(1) | Subject to the provisions of this Part of this Act, a community treatment |
| |
order shall cease to be in force on expiry of the period of six months |
| 5 |
beginning with the day on which it was made. |
| |
(2) | That period is referred to in this Act as “the community treatment |
| |
| |
(3) | The community treatment period may, unless the order has previously |
| |
ceased to be in force, be extended— |
| 10 |
(a) | from its expiration for a period of six months; |
| |
(b) | from the expiration of any period of extension under paragraph |
| |
(a) above for a further period of one year, |
| |
| and so on for periods of one year at a time. |
| |
(4) | Within the period of two months ending on the day on which the order |
| 15 |
would cease to be in force in default of an extension under this section, |
| |
it shall be the duty of the responsible clinician— |
| |
(a) | to examine the patient; and |
| |
(b) | if it appears to him that the conditions set out in subsection (6) |
| |
below are satisfied and if a statement under subsection (7) |
| 20 |
below is made, to furnish to the managers of the responsible |
| |
hospital a report to that effect in the prescribed form. |
| |
(5) | Where such a report is furnished in respect of the patient, the managers |
| |
shall, unless they discharge him under section 23 below, cause him to |
| |
| 25 |
(6) | The conditions referred to in subsection (4) above are that— |
| |
(a) | the patient is suffering from mental disorder of a nature or |
| |
degree which makes it appropriate for him to receive medical |
| |
| |
(b) | it is necessary for his health or safety or for the protection of |
| 30 |
other persons that he should receive such treatment; |
| |
(c) | subject to his continuing to be liable to be recalled as mentioned |
| |
in paragraph (d) below, such treatment can be provided |
| |
without his being detained in a hospital; |
| |
(d) | it is necessary for his health or safety or for the protection of |
| 35 |
other persons that he should continue to be liable to be recalled |
| |
to hospital for medical treatment; and |
| |
(e) | appropriate medical treatment is available for him. |
| |
(7) | The statement referred to in subsection (4) above is a statement in |
| |
writing by an approved mental health professional— |
| 40 |
(a) | that it appears to him that the conditions set out in subsection |
| |
(6) above are satisfied; and |
| |
(b) | that it is appropriate to extend the community treatment period. |
| |
(8) | Before furnishing a report under subsection (4) above the responsible |
| |
clinician shall consult one or more other persons who have been |
| 45 |
professionally concerned with the patient’s medical treatment. |
| |
|
| |
|
| |
|
(9) | Where a report is duly furnished under subsection (4) above, the |
| |
community treatment period shall be thereby extended for the period |
| |
prescribed in that case by subsection (3) above. |
| |
20B | Effect of expiry of community treatment order |
| |
(1) | A community patient shall be deemed to be discharged absolutely from |
| 5 |
liability to recall under this Part of this Act, and the application for |
| |
admission for treatment cease to have effect, on expiry of the |
| |
community treatment order, if the order has not previously ceased to |
| |
| |
(2) | For the purposes of subsection (1) above, a community treatment order |
| 10 |
expires on expiry of the community treatment period as extended |
| |
under this Part of this Act, but this is subject to sections 21 and 22 |
| |
| |
(4) | Schedules 3 and 4 (which contain further amendments) have effect. |
| |
30 | Relationship with leave of absence |
| 15 |
(1) | The 1983 Act is amended as follows. |
| |
(2) | In section 17 (leave of absence from hospital), after subsection (2) insert— |
| |
“(2A) | But longer-term leave may not be granted to a patient unless the |
| |
responsible clinician first considers whether the patient should be dealt |
| |
with under section 17A instead. |
| 20 |
(2B) | For these purposes, longer-term leave is granted to a patient if— |
| |
(a) | leave of absence is granted to him under this section either |
| |
indefinitely or for a specified period of more than seven |
| |
| |
(b) | a specified period is extended under this section such that the |
| 25 |
total period for which leave of absence will have been granted |
| |
to him under this section exceeds seven consecutive days.” |
| |
(3) | In Part 2 of Schedule 1 (patients subject to special restrictions), in paragraph 3 |
| |
after paragraph (a) insert— |
| |
“(aa) | subsections (2A) and (2B) shall be omitted;”. |
| 30 |
| |
(1) | Part 4 of the 1983 Act (consent to treatment) is amended as follows. |
| |
(2) | For section 56 substitute— |
| |
“56 | Patients to whom Part 4 applies |
| |
(1) | Section 57 and, so far as relevant to that section, sections 59 to 62 below |
| 35 |
| |
(2) | Subject to that, this Part of this Act applies to a patient only if he falls |
| |
within subsection (3) or (4) below. |
| |
(3) | A patient falls within this subsection if he is liable to be detained under |
| |
| 40 |
|
| |
|
| |
|
(a) | he is so liable by virtue of an emergency application and the |
| |
second medical recommendation referred to in section 4(4)(a) |
| |
above has not been given and received; |
| |
(b) | he is so liable by virtue of section 5(2) or (4) or 35 above or |
| |
section 135 or 136 below or by virtue of a direction under section |
| 5 |
| |
(c) | he has been conditionally discharged under section 42(2) above |
| |
or section 73 or 74 below and he is not recalled to hospital. |
| |
(4) | A patient falls within this subsection if— |
| |
(a) | he is a community patient; and |
| 10 |
(b) | he is recalled to hospital under section 17E above.” |
| |
(3) | In section 61 (review of treatment), in subsection (1)— |
| |
(a) | before “a report on” insert “, or by virtue of section 62A below in |
| |
accordance with a Part 4A certificate (within the meaning of that |
| |
| 15 |
(b) | in paragraph (a) for “or 21B(2) above renewing the authority for the |
| |
detention” substitute “, 20A(4) or 21B(2) above in respect”. |
| |
(4) | After section 62 insert— |
| |
“62A | Treatment on recall of community patient or revocation of order |
| |
(1) | This section applies where— |
| 20 |
(a) | a community patient is recalled to hospital under section 17E |
| |
| |
(b) | a patient is liable to be detained under this Act following the |
| |
revocation of a community treatment order under section 17F |
| |
| 25 |
(2) | For the purposes of section 58(1)(b) above, the patient is to be treated as |
| |
if he had remained liable to be detained since the making of the |
| |
community treatment order. |
| |
(3) | But section 58 above does not apply to treatment given to the patient |
| |
| 30 |
(a) | the certificate requirement is met (within the meaning of section |
| |
| |
(b) | as a result of section 64B(4) or 64E(4) below, the certificate |
| |
requirement would not apply (were the patient a community |
| |
patient not recalled to hospital under section 17E above). |
| 35 |
(4) | In a case where this section applies, the certificate requirement is met |
| |
| |
(a) | the Part 4A certificate expressly provides that it is appropriate |
| |
for one or more specified forms of treatment to be given to the |
| |
patient in that case (subject to such conditions as may be |
| 40 |
| |
(b) | a notice having been given under subsection (4) of section 64H |
| |
below, treatment is authorised by virtue of subsection (7) of that |
| |
| |
(5) | Subsection (4)(a) above shall not preclude the continuation of any |
| 45 |
treatment, or of treatment under any plan, pending compliance with |
| |
section 58 above if the approved clinician in charge of the treatment |
| |
|
| |
|
| |
|
considers that the discontinuance of the treatment, or of the treatment |
| |
under the plan, would cause serious suffering to the patient. |
| |
(6) | In a case where subsection (1)(b) above applies, subsection (3) above |
| |
only applies pending compliance with section 58 above. |
| |
(7) | In subsection (4) above— |
| 5 |
“Part 4A certificate” has the meaning given in section 64H below; |
| |
| |
“specified”, in relation to a Part 4A certificate, means specified in |
| |
| |
| 10 |
(1) | After Part 4 of the 1983 Act, insert the following Part— |
| |
| |
Treatment of community patients not recalled to hospital |
| |
64A | Meaning of “relevant treatment” |
| |
In this Part of this Act “relevant treatment”, in relation to a patient, |
| 15 |
means medical treatment which— |
| |
(a) | is for the mental disorder from which the patient is suffering; |
| |
| |
(b) | is not a form of treatment to which section 57 or 58A above |
| |
| 20 |
64B | Adult community patients |
| |
(1) | This section applies to the giving of relevant treatment to a community |
| |
| |
(a) | is not recalled to hospital under section 17E above; and |
| |
(b) | has attained the age of 16 years. |
| 25 |
(2) | The treatment may not be given to the patient unless— |
| |
(a) | there is authority to give it to him; and |
| |
(b) | if it is section 58 type treatment, the certificate requirement is |
| |
| |
(3) | But the certificate requirement does not apply if— |
| 30 |
(a) | giving the treatment to the patient is authorised in accordance |
| |
with section 64G below; or |
| |
(b) | the treatment is immediately necessary and— |
| |
(i) | the patient has capacity to consent to it and does consent |
| |
| 35 |
(ii) | a donee or deputy or the Court of Protection consents to |
| |
the treatment on the patient’s behalf. |
| |
(4) | Nor does the certificate requirement apply in so far as the |
| |
administration of medicine to the patient at any time during the period |
| |
of one month beginning with the day on which the community |
| 40 |
treatment order is made is section 58 type treatment. |
| |
|
| |
|