MHA Receipt & Scrutiny Training for Qualified Nurses & MHPs

1. MHA Receipt & Scrutiny Training for Qualified Nurses & MHPsPresented by: Sharon LongDeputy MHA ManagerVersion 1

2. The Statutory Forms • The Mental Health Act 1983 requires the completed statutory forms provide the authority to detain a patient as per Code of Practice Chapter 13 paragraph 13.7 ‘Hospital Managers should formally delegate their duties to receive and scrutinise admission documents to a limited number of officers, who may include clinical staff on wards.’

3. The Statutory Forms • Checklists for receiving admission documents Administrative_Checklist_S_2__Website_Version_1.4_Sept_12.doc ..\2011-12\Administrative_Checklist_S_3__Website_Version_1.4_Sept_12.doc Administrative_Checklist_S_5(2)_Website_Version_1.2_Sept_2012.doc Administrative_Checklist_S_4_Website_Version_1.2__Sept_12.doc to ensure there are no invalidating errors and to assist with the correction of invalidating errors – the AMHP should stay during this processsee para 13.9 of CoP

4. Non Remedial Errors • Form is not signed (medical recommendation(s) or application) • Failure to comply with time limits ie doctors must examine patient within 5 clear days of each other, admission must occur within 14 days of second medical recommendation

5. Non Remedial Errors • Neither of the doctors is section 12(2) approved (where one is required to be) • When accepting section papers the patient MUST physically arrive on the unit or currently be an inpatient on the unit receiving the papers.

6. Non-Remedial Errors: Admitting the Patient • For section 3 only: the first admitting unit must be named by BOTH doctors on the medical recommendations AND by the AMHP on the application • After admission, according to the patient’s needs, they may be transferred to another hospital within the Trust

7. Invalid Medical Recommendations Applications (s 2 and s 3) are “founded” on 2 medical recommendations, so: • If one or more recommendation is invalid, a new one must be provided, and; • A new application will be required from an Approved Mental Health Professional (AMHP)

8. Invalid Detention? Immediate action should be taken as statutory forms with invalidating errors do not provide the authority to detain In office hours: • Contact your MHA Administrator or Trust MHA Manager (or another SHFT MHA Administrator if neither are available)immediately

9. Invalid Detention? Out of hours: • Immediate consideration must be given to invalidating errors, and the appropriate rectifying action must be taken without delay, do not wait until the MHA Administrator returns/normal office hours

10. Invalid Detention? • The team (including out of hours managers, in accordance with local policy) must decide on an appropriate course of action, this may mean: • Using s 5(4) or s 5(2) (if the patient has been admitted) • Holding the patient under common law (for a very short time only and if the patient has not been admitted)

11. Remedial Errors • “Clerical errors” ie spelling mistakes, wrong date entered • Minor omissions – address lines, middle names etc • Use of abbreviations

12. Remedial Errors • Blank spaces – other than a missing signature • Failure to delete alternatives where only one option can be correct • Identify immediately and request correction if possible

13. Deleting Alternatives Papers to be scrutinised to ensure that alternatives that do not apply are deleted: • I am the Registered Medical Practitioner (RMP)/Approved Clinician (AC) responsible for the patient’s treatment orthe nominee of the RMP/AC

14. Deleting Alternatives • Risk factors: for the patient’s health, safety and/or protection of others • Consultation with nearest relatives alternatives on AMHP application forms

15. Common Errors • Full names and addresses not given (if middle name is shown on one form it must be added to all forms) • Name and address of patient differing – must agree on all forms • Use of abbreviations – not acceptable, all words to be written in full medical or otherwise

16. Common Errors Insufficient clinical information: • Description of patient’s mental state inadequate • Information concerning risk to patient’s health, risk to patient’s safety or risk to others not given

17. Common Errors • Explicit reasons why informal treatment is not appropriate not given • Handwritten text unclear – needs to be clear and legible

18. R&S: Process • All original papers must be delivered with the R&S checklist to the MHA Administrator as soon as possible (retain copies on the ward) if off site papers should be faxed immediately • The patient should be given their rights under s132 and informed of their right to access IMHA services in line with Trust standard

19. Record of Detention in Hospital – Form H3 – Part 1 • Must be completed for new sections 2, 3 and 4. • ..\..\New Statutory Forms\H Forms - Finals\Form H3 - Record of Detention HPFT Final May 09.pdf

20. Record of Detention in Hospital – Form H3 – Part 1 • Part (a) Complete if patient is being admitted under the new section • Part (b) Complete if the patient was already in hospital prior to the new section being applied • Time and date should reflect the actual time the section started so form must be completed as soon as papers received

21. Record of Detention in Hospital – Form H3 – Part 2 • Complete actual time 2nd medical recommendation was received • Converts s4 to s2 • ‘Converted’ s2 runs for 28 days from start time of s4

22. Section 5(2) Report on hospital Inpatient : Form H1 Part 2 to be signed on receipt of form • Should always be delivered in person to someone authorised to formally receive statutory forms

23. Section 132: Responsibilities of Nurse & MHP • Duty to provide information and ensure understanding using the appropriate leaflet / DVD • Section_132_&_Section_130~te_Version_1_Nov_10_.doc

24. Section 132: Responsibilities of Nurse & MHP • All attempts to provide information (including failed attempts and reason) must be recorded on the Section 132 / IMHA Form • Time and date should reflect the actual time the section started so form must be completed as soon as papers received

25. Section 132: Responsibilities of Nurse & MHP • The Code of Practice states: ‘ The Act requires hospital managers to take steps to ensure that patients who are detained in hospital under the Act, or who are on supervised community treatment (SCT), understand important information about how the Act applies to them. This must be done as soon as practicable after the start of the patient’s detention or SCT. This information must also be given to patients who are recalled to hospital’ para 2.8 Chapter 2

26. Section 132: Responsibilities of Nurse & MHP • At the start of compulsion • 10 days later (patients in hospital only) • At regular intervals (3 monthly as a guide) • On transfer to a new unit (internal & external) • Whenever the patient requests it

27. Section 132: Informing the NR • Discuss whether or not the patient agrees that we may contact the NR • Decide if the patient has capacity to make that decision • If the patient understands the decision they are making, record the objection on the Section 132 / IMHA Form

28. Additional Information There are many sources of information about the Act and its application: • MHA Administrators • SHFT MHA Website www.southernhealth.nhs.uk/departments-and-directories/mha

29. Additional Information • The Code of Practice (available in hardcopy and electronically from the website) • Reference Guide (available electronically from the website) • The MHA Manual (Jones) NB Your next MHA Reciept & Scrutiny update is due in 2 years