Mental Health Act 1983 Scheme of Delegation

Publication: 27/05/2014  
Next review: 31/01/2025  
Clinical Policy
CURRENT 
ID: 3849 
Supported by: Adult Safeguarding Steering Group
Approved By: Chief Nurse / Deputy Chief Executive 
Copyright© Leeds Teaching Hospitals NHS Trust 2022  

 

This Clinical Policy is intended for use by healthcare professionals within Leeds unless otherwise stated.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

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.

 

 

 

FUNCTION

 

PERSON/S WHO ARE AUTHORISED TO CARRY OUT THE DELEGATED FUNCTION

 

MENTAL HEALTH ACT PRIMARY/SECOND ARY REFERENCE (or other as indicated)

 

CODE OF PRACTICE REFERENCE (or other as indicated)

1.

 

Review of patient’s
detention

 

Panel of  Associate Managers and/or LTHT Non-Executive Board Members

 

 

MHA Section 20(3)

Memorandum of Understanding
LTHT/LYPFT

 

 

Chapter 31

2.

 

Discharge of unrestricted patients

Panel of LTHT Non- Executive Board Members and/or Associate Managers

 

 

MHA Section 23

 

 

Chapter 31

FUNCTIONS DELEGATED TO OFFICERS OF THE TRUST

3.

 

Review the Trust’s operation of the Act & governance arrangements

Head of Mental Health Legislation

Lead Professional for MHA/MCA

 

 

 

Chapter 30

4.

Formal Receipt
and First Scrutiny of statutory forms for relevant section

  • Ward Sister or Nurse in Charge of Ward
  • LTHT MHA/MCA Team members

 

MHA Sections 11 and 15
Regulations 3, and
25

 

Chapter 13

5.

 

Completion of relevant statutory forms as itemised in each Section SoP: Record of detention, Checklist for receiving papers.

  • Ward Sister or Nurse in Charge of Ward
  • LTHT MHA/MCA Team members

 

 

 

Regulations 4 and 6

 

 

 

Chapter 13

6.

 

Duty of managers to give information to detained patients

  • Ward Sister or Nurse in Charge of Ward
  • LTHT MHA/MCA Team members

 

MHA Sections 20(3) and
132

 

Chapter 2

7.

 

Duty of managers to give information to patient’s nearest relative

LTHT MHA/MCA Team members

 

MHA Section 25(2), 132(4)
and133

 

Chapter 2

8.

 

Duty to securely store original statutory forms in patient medical
notes and securely send relevant copies to LTHT Mental Health
Act Administrator as per Standard Protocols

 

 

Ward Sister or Nurse in Charge of Ward

 

 

LTHT Standard Protocols for Mental Health Act Sections
2, 3 and 5(2)

 

9.

 

Arrange and pursue timely scrutiny of medical grounds for detention from identified Consultant Psychiatrist

 

LTHT MHA/MCA Team members

 

 

 

MHA Section15(2)

 

 

 

Chapter 13

10.

 

Deciding if, when and where a Hospital Managers Hearing should take place

 

Head of mental Health legislation

 

 

 

Chapter 31

11.

 

Arrangements for rectification of applications and recommendations

 

LTHT MHA/MCA Team members

 

 

MHA Section 15

 

 

Chapter 13

12

 

 

 

Medical practitioner/approved clinician ‘holding power’ under section
5(2)

 

Doctor in charge (Consultant) of the treatment of an informal in-patient or the doctor's nominated deputy. (Duty On Call Doctor is considered as nominated delegate.)
Above Grade F2

 

 

LTHT Section 5(2) Procedure

 

MHA Section 5(3)

 

 

 

 

Chapter 12

13.

 

Arrangements for an assessment to
consider an application under section 2 or section 3 of the Act – By contacting Relevant Pschiatry service /  Approved Mental Health Professional, following use of Section 5(2)

Doctor in charge
(Consultant) of the treatment of an informal in-patient or the doctor's nominated deputy. (Duty On Call Doctor is considered as nominated delegate.)
Above grade F2

 

 

 

MHA Section 5(3)

 

 

 

Chapter 12

14.

 

Organisational, or Inter-agency escalation regarding deviation from Standard Operating Procedures, MHA Joint Protocol and Scheme of Delegation

 

Head of mental Health Legislation

 

 

15.

 

Training Needs Analysis, Education and guidance package production, dissemination, review and monitoring

 

Head of Mental Health Legislation

Lead Professional for MHA/MCA

 

 

16

 

Duty to maintain accurate electronic record of all information and secure storage of MHA patient information

 

MHA Administrator

 

 

 

Chapter 18

17

 

 

Duty to refer cases to Mental Health Review Tribunal

 

Head of Mental Health Legislation

Lead Professional for MHA/MCA

 

 

 

MHA Section 68
23.1-23.15

 

 

Chapter 30 and
32

18

 

Reporting, Liaising with Tribunal Service, Care Quality Commission and Coroner

 

Head of Mental Health Legislation

Lead Professional for MHA/MCA

MHA/MCA Administrator

 

 

19

 

Responsible for alerting Responsible Clinician in advance of 3 month consent rule for medication under Part 4 of the Act.

Responsible for liaising with treating team to ensure adequate alert and notification of 3 month rule and relevant treatment certificates are on Patient record

 

 

LTHT MCA/MHA Administrator

MCA/MHA team members

 

 

Chapter 24/25

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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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Provenance

Record: 3849
Objective:
Clinical condition:
Target patient group: Subject to Mental Health Act
Target professional group(s): Secondary Care Doctors
Secondary Care Nurses
Adapted from:

Evidence base

8. References

Care Quality Commission (Registration) Regulations 2009

Health and Social Care Act 2008 (Regulated Activities) Regulations 2010

Mental Health Act (1983) as Amended (2007). TSO: London

Mental Health Act, Code of Practice (2008). TSO: London

Reference Guide to the Mental Health Act (2008). TSO: London

Mental Capacity Act Code of Practice (2005). TSO: London

Deprivation of Liberty Code of Practice (2009). TSO: London

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Approved By

Chief Nurse / Deputy Chief Executive

Document history

LHP version 2.0

Related information

Not supplied

Equity and Diversity

The Leeds Teaching Hospitals NHS Trust is committed to ensuring that the way that we provide services and the way we recruit and treat staff reflects individual needs, promotes equality and does not discriminate unfairly against any particular individual or group.