Mental Health Act 1983 Scheme of Delegation

1. Purpose
2. Scope
3. Definitions/Abbreviation
4. Scheme of Delegation to be followed
5. Roles and Responsibilities
6. Link to other documents
7. Monitoring Arrangements
8. References

1. Purpose

The Mental Health Act 1983 was amended by the Mental Health Act 2007, with the main changes taking effect from 3rd November 2008. There is a new consolidating Code of Practice and
Chapter 30.9 sets out guidance that the Trust should have a Scheme of Delegation to determine who can make decisions under the Mental Health Act and to whom these decisions can be delegated.

The purpose of this document is to clearly identify to whom the ‘Hospital Managers’ delegate responsibilities under the Act, in compliance with the MHA 1983 Code of Practice paragraph 30.9. These duties cannot be further delegated to more junior staff.
Within the meaning of the Act, the term “Hospital Managers” should be read to mean the Trust.

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2. Scope

This Scheme of Delegation applies to the Leeds Teaching Hospitals NHS Trust, Executive Board, Medical Staff and Non-Medical Staff.
It gives clear duties relating to patients who are or may become subject to compulsion under the
Mental Health Act (1983) whilst receiving care at Leeds Teaching Hospitals NHS Trust.
The Procedure is derived in the greater part from the Act and the Code of Practice and therefore any deviation from the Procedure must be discussed and clarified with the Head of Mental Health Legislation

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3. Definitions/Abbreviation

Discharge: Unless otherwise stated, a decision that a patient should no longer be subject to detention.
Discharge from detention is not the same as being discharged from hospital. The patient might already have left hospital on leave of absence, or might agree to remain in hospital as an informal patient.

Holding Powers: The powers in section 5 of the Act which allow hospital in-patients to be detained temporarily so that a decision can be made about whether an application for detention should be made.
There are two holding powers: under section 5(2), doctors and approved clinicians can detain patients for up to 72 hours.

Hospital Managers: The organisation (or individuals) responsible for the operation of the Act in a particular hospital (e.g. an NHS Trust, an NHS foundation trust or the owners of an independent hospital). Hospital managers have various functions under the Act, which include the power to discharge a patient.

In practice, most of the Hospital Managers’ decisions are taken on their behalf by individuals (or groups of individuals) authorised by the hospital managers to do so. This can include clinical staff. Hospital managers’ decisions about discharge are normally delegated to a “managers’ panel” of three or more people. This document sets out these delegated powers.

Mental Disorder: Any disorder or disability of the mind, apart from dependence on alcohol or drugs. This includes all learning disabilities.

Mental Health Act 1983 (MHA): Legislation mainly about the compulsory care and treatment of patients with mental health problems. It covers detention in hospital for mental health treatment, supervised community treatment and guardianship.

Nearest Relative: A person defined by section 26 of the Act who has certain rights and powers under the Act in respect of a patient for whom they are the nearest relative.
LTHT MCA/MHA TEAM: Head of Mental Health Legislation, Lead Professional for MHA/MCA, Practitioner MCA/MHA/LD, MCA/MHA Administrator

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4. Scheme of Delegation to be followed

It is the Hospital Managers who have the authority to detain patients under the Act. They have the primary responsibility for ensuring that the requirements of the Act are followed. In particular, they must ensure that patients are detained only as the Mental Health Act allows, that their treatment and care accord fully with its provisions and they are fully informed of, and supported in exercising their statutory rights.

The Mental Health Act, its regulations and Code of Practice allow for most of these functions to be delegated to other professionals.

The following table sets out the Hospital Managers’ functions under the Mental Health Act and to whom these functions are delegated within Leeds Teaching Hospitals NHS Trust.
Where appropriate the table also sets out references to relevant parts of the Act, its regulations and the Code of Practice.

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5. Roles and Responsibilities

As above at 4. Table 1-19 

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6. Link to other documents

Mental Health Act 1983 (as amended) Protocol for joint working between the Leeds Teaching
Hospitals NHS Trust and the Leeds and York Partnership NHS Foundation Trust;

Mental Health Act 1983 Standard Operating Procedures – Section 5(2), 2 and 3 Leeds  Teaching
Hospitals NHS Trust

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7. Monitoring Arrangements

See table

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