RCPsych President Professor Wendy Burn has issued a statement on behalf of the College, responding to the Government’s Coronavirus Bill for England and Wales, published 19 March 2020, which is not yet in force.
Professor Burn said: “We support the Government's targeted proposals to ensure that the NHS is equipped to deal with this unprecedented crisis. This is about enabling patients suffering from serious mental illnesses continue to receive the treatment they need in a safe environment. If people are at risk, we have to be able to get them into hospital.
“These include changes that would mean that Approved Mental Health Professionals (AMHPs) would be able to apply to detain someone under the Mental Health Act with the agreement of just one registered medical professional rather than two, extend time limits on nurse, doctor, police and magistrate holding orders and amend second opinion and appeal procedures.
“These changes are about keeping patients and others safe and making sure people can get the treatment they need.
“If people are at risk then supporting them must be a priority. If these measures need to be used, they must be the minimum reduction for the briefest time, to allow services to be maintained and they must be reviewed frequently.”
See our section Responding to COVID-19.
Emergency legislation and the Mental Health Act 1983 England and Wales – not yet in force
The Coronavirus Bill plans to temporarily change the Mental Health Act 1983 (MHA) to allow certain functions relating to the detention and treatment of patients to be carried out by fewer doctors’ opinions or certifications. It will also temporarily allow for the extension or removal of certain time limits relating to the detention and transfer of patients.
The Bill has not yet become a law and even when it has most of the measures will not necessarily come into effect straight away. Local areas will have the ability to trigger the provisions when necessary due to extreme shortage. Further information and guidance about local implementation will be provided here as soon as it is made available, this will includes guidance on the operation of Mental Health Tribunals.
Until the measure are implemented in your area the existing legal guidance should be followed.
Full details of the legislation and the explanatory notes are available:
This legislation applies to England and Wales only we will update this page with guidance from Scotland and Northern Ireland in due course.
Quick read summary of changes to the MHA for clinicians
- Section 5(4) - emergency detention power extended from 6 to 12 hours
- Section 5(2) - emergency detention power extended from 72 to 120 hours. Can be any RMP (registered medical practitioner) or AC (approved clinician). Does not need to be the doctor or AC in charge of the patient’s care.
- Sections 2 and 3 - one medical recommendation by a s12 approved doctor required, where involving two is impractical or would involve undesirable delay
- Sections 135 and 136 – detention extended from 24 to 36 hours
- Sections 35(7) and 36(6) extends the period a person accused of a crime can be remanded to hospital by removing the rule that a person cannot be remanded for more than 12 weeks in total. It will remain that a person cannot be remanded to hospital for more than 28 days at a time
- Sections 36(1), 37(1), 38(1), 45A(3), 51(5) Courts can send an accused or convicted person to hospital on the advice of one doctor where involving two is impractical or would involve undesirable delay.
- Sections 47(1) or 48(1) Secretary of State can make transfer to move person from prison to hospital on advice from one registered medical practitioner
- Sections 35(9), 40 (1) and (3), 45B(1)removes time limits for taking an accused or convicted person to hospital after decision to admit, instead to be taken “as soon as is practicable”
Consent to treatment
- Section 58(3)(b) - the Approved Clinician in charge of medical treatment can authorise treatment after 3 months for non-consenting/incapacitous patients if impractical or involve undesirable delay to obtain view of SOAD (Second Opinion Appointed Doctor). AC Must carry out the required consultations but only needs to consult one other person, if complying with the requirement with two other persons is impractical or would involve undesirable delay.