Policy: I9 · Chapter 2 of the MHA Code of Practice 2008. A copy of the Code can be found on the...

Policy: I9

Informing Patients of their Rights under Section 132

Version: I9/05 Ratified by: Trust Management Team Date ratified: 12 June 2013 Title of Author: MHA Office / Health Records Manager Title of responsible Director Director of Nursing and Patient Experience Governance Committee Patient Safety and Safeguarding Committee

hDate issued: 13 June 2013 Review date: June 2016 Target audience: Clinical staff, MHA Office staff, Managers NHSLA relevant? NO

B Can be disclosed to patients and the public Disclosure Status

EIA / Sustainability

G:\Broadmoor

Implementation Plan

G:\Broadmoor

Appended below Monitoring Plan

Other Related Procedure or Documents:

West London Mental Health NHS Trust of 21 Policy I9 First Date of Issue: May 2007 This is current version I9/05 June 2013


Equality & Diversity statement

The Trust strives to ensure its policies are accessible, appropriate and inclusive for all. Therefore all policies will be required to undergo an Equality Impact Assessment and will only be approved once this process has been completed

Sustainable Development Statement

The Trust aims to ensure its policies consider and minimise the sustainable development impacts of its activities. All policies are therefore required to undergo a Sustainable Development Impact Assessment to ensure that the financial, environmental and social implications have been considered. Policies will only be approved once this process has been completed


I9 – Informing Patients of their rights under section 132 Version Control Sheet

Version Date Title of Author Status Comment I9/01 May 07 MHA Office /

Health Records Manager New Policy

I9/02 Nov 07 MHA Office / Health Records Manager

Trust-wide consultation

Incorporating changes to the Mental Health Act

I9/03 Jan 09

MHA Office / Health Records Manager

Revised policy issued 23/1/09

Revised policy approved by Jan 09 CSSG

I9/04

30.07.10. MHA Office / Health Records Manager

Revised Policy Issued

Improved compliance with NHSLA standards. Revised Policy approved by Trust Policy Review Group following Trust-wide consultation 20th July 2010

I9/05 April 13 MHA Office / Health Records Manager

Review of policy Minimal change. Set in new Trust format. Approved. 12.06.13


Content Page

1. Introduction (includes purpose) 5

2. Scope 5

3. Definitions 5

4.

4.1

4.2

4.3

4.4

4.5

Duties

Chief Executive

Accountable Director

Managers

Specific Staff for Policy

All Staff

6

5. Information Given to Detained and CTO Patients 7

6. Information Given to Informal In-patients 9

7. Voting Rights 9

8. When and How Information will be Given 9

9. Recording the Giving of Patients’ Rights Information 10

10. Use of Interpreters 10

11. Special Needs / Learning Disability 11

12. Advocacy Service, Patient Advice & Liaison Service & Other Agencies

11

13. Information Given to the Patient’s Nearest Relative 11

14. Training 12

15. Monitoring 12

16. References 12

17. Supporting documents 13

18. Glossary of Terms/Acronyms 13

19. Appendices

• Section 132 form

• Patients Section 132 Rights

• Informing Patients of their rights under section 132 MHA

13 14 16 19

20. Monitoring Template 20


1. INTRODUCTION 1.1 The policy sets out the Trust’s statutory duty to take all practicable steps to ensure all

detained and Community Treatment Order (CTO) patients are given both general and specific information as required under Section 132 and 132A of the Mental Health Act 1983 (MHA) (as amended by the Mental Health Act 2007). If the patient consents, information will also be given to the patient’s Nearest Relative as required by Section 133 of the MHA.

1.2 Patients have a statutory right to be informed about the section of the MHA under which they are detained (or are subject to) and the effect of the provisions of that section. Patients have specific statutory rights under the MHA. It is good practice for patients to be kept as fully informed about and involved in their care plan and this includes all statutory matters that have a bearing on their care and rehabilitation within the Trust and upon discharge from detention or CTO.

1.3 Statutory information must be given to each patient in a language and manner that best enables the patient to understand it. When there is concern about the patient’s ability to understand the information, further attempts must be made to give the information.

1.4 This policy outlines what information will be given to patients and relatives, by whom, in what manner and at what intervals of time. The policy draws upon the guidance in Chapter 2 of the MHA Code of Practice 2008. A copy of the Code can be found on the MHA page of the Exchange, the Trust intranet.

2. SCOPE 2.1 This policy covers all detained patients within the Trust. This includes detained

patients in hospital, the patients on Community Treatment Orders and those on leave (MHA section 17). Patients who were initially detained under the MHA but have since been discharged from their section also fall within this policy as they must be informed of the change of legal status.

3. DEFINITIONS

3.1 Detained Patient: The MHA uses “patient” to mean a person who is, or appears to be, suffering from mental disorder. In most Trust policies the term “service user” or “client” is preferred. In this policy the wording of the MHA will be replicated, thus the term “patient” is used. A detained patient is a patient who is subject to some form of compulsory detention under the MHA. This may be in hospital or the community and may be under the MHA or one of the insanity Acts (less frequently used). The patient has a right to appeal against detention.

3.2 Informal Patient: A patient who is in hospital on a voluntary (informal) basis and has the right to leave hospital at any time.

3.3 COMMUNITY TREATMENT ORDER (or CTO) Patient: The patient is subject to compulsory powers of the MHA whilst living in the community (whilst on a Community Treatment Order). The CTO has to be renewed at regular intervals and the patient has the right to appeal against this order.


3.4 Nearest Relative: The person who fulfils the role of a patient’s Nearest Relative is defined in section 26 of the MHA. The Nearest Relative has certain powers and rights under the MHA. This includes the right to certain statutory information (unless the patient requests otherwise).

3.5 Mental Health Tribunal: This is an independent legal body which will hear applications from patients (and in some cases, Nearest Relatives) against detention under the MHA, including Community Treatment Orders. It can discharge patients from detention under the MHA or make recommendations.

4. DUTIES 4.1 Chief Executive

The Chief Executive is responsible for ensuring that the Trust has policies in place and complies with its legal and regulatory obligations.

4.2 Accountable Director

The accountable director is responsible for the development of relevant policies and to ensure they comply with NHSLA standards and criteria where applicable. They must also contain all the relevant details and processes as per P3. They are also responsible for trust-wide implementation and compliance with the policy. The accountable director for this policy is the Director of Nursing and Patient Experience.

4.3 Managers

Managers are responsible for ensuring policies are communicated to their teams / staff. They are responsible for ensuring staff attend relevant training and adhere to the policy detail. They are also responsible for ensuring policies applicable to their services are implemented.

4.4 Policy Author

The Policy Author is responsible for the development or review of a policy as well as ensuring the implementation and monitoring is communicated effectively throughout the Trust via Clinical Service Unit / Directorate leads and that monitoring arrangements are robust.

4.5 Local Policy Leads

Local policy leads are responsible for ensuring policies are communicated and implemented within their CSU / Directorate as well as co-ordinating and systematically filing monitoring reports. Areas of poor performance should be raised at the CSU / Directorate Senior Management Team meetings and the local MHA Groups.

4.6 Specific Staff for Policy

4.6.1 The Hospital Managers (defined in s.145, MHA) must ensure detained patients, CTO patients and, where appropriate, nearest relatives are provided with information regarding their rights under the Act. The duty of the Hospital Managers is enacted through the Trust Board.

4.6.2 The Trust Board delegates specific responsibilities under the MHA to Officers of the Trust (as documented in Board paper Mental Health Act Managers Annual Report to the Board 2008/09, ratified in October 2009).


4.7 MHA Administrators

The MHA Administrators in the site MHA Offices have responsibilities to ensure that written information is given to detained and CTO patients, particularly on admission. This must be documented in the patient’s paper health record (if there is one) and on the electronic patient record, RiO.

4.8 All Staff

4.8.1 Clinical team members have responsibilities to ensure that written and oral information is given to all patients immediately following detention under the Act and at regular intervals thereafter. This staff group includes Responsible Clinicians, Approved Clinicians in charge of treatment, Approved Mental Health Professionals, Social Workers, Primary Nurses and Care Co-ordinators. Other team members and support staff may also provide this information.

4.8.2 Trust staff must keep written records of what information is given to the patient and his/her nearest relative. This will be in the patient’s health record and in the MHA Office.

4.8.3 Trust staff must give every assistance to patients to exercise their statutory rights. This will be achieved by responding to any questions that the patient may ask about their rights under the MHA, by offering assistance with the completion of application forms for hearings against detention and by helping the patient make contact with a solicitor, a Commissioner from the Care Quality Commission (CQC) or a general or specialist advocate (IMHA).

5. INFORMATION GIVEN TO DETAINED AND CTO PATIENTS 5.1 Specific information, as outlined in paragraph 5.2 below, will be given to each patient

as part of the admissions process. It is necessary to ensure that the patient understands their legal rights. Information will also be given about other matters which are not strictly patients rights information but is nevertheless important to provide at the earliest opportunity (e.g. welfare and financial arrangements, information about any on-going legal proceedings, how to request access to records). Sometimes the giving of information on admission is not possible due to the patient’s disturbed state (see paragraph 8.5 below) and further attempts must be planned, documented and followed through.

5.2 Sections 132 and 132A provide that information must be given to detained and CTO patients verbally and in writing. The MHA Code of Practice (chapter 2) recommends that the following information is given:

• The section of the Act that authorises their detention in hospital or compulsion in the community and the effects of that section, including the maximum period the section can last for.

• A copy of his/her detention or community treatment order document/s

including any subsequent renewals, extensions or change in statutory circumstances.


• A patient’s right to access legal representation under the legal aid scheme (a list of solicitors qualified for MHA work is available on the ward or from the MHA Administrator).

• A patient’s right to appeal against further detention or CTO to the Hospital

Managers and/or the Mental Health Tribunal (MHT).

• The Hospital Managers/Secretary of State’s duty to refer certain cases to the MHT.

• The patient’s nearest relative’s right to apply to the Hospital Managers and/or

the MHT for the patient’s discharge from detention or CTO.

• The Trust complaints process.

• The role of the CQC and how a patient may complain to the Commission. Patients must be informed about a planned ward visit by a Commissioner and their right to talk to the Commissioner in private. A patient information leaflet about the role of the Care Quality Commission is available on the MHA page of the Exchange.

• The role of the Independent Mental Health Advocate (IMHA) and how to

contact this service. 5.2.1 These points are covered in the Department of Health statutory information leaflets

which must be given to patients on admission. Additional copies of the leaflets can be obtained from the site MHA Office. Refer to paragraph 8 of this policy regarding documenting the process of giving of this statutory information.

5.3 The Trust has the additional responsibility under Section 132(2) to take all practicable steps to ensure that the patient understands the following:

• The powers of the Responsible Clinician (RC), the Hospital Managers and Nearest Relative in relation to discharging him/her from section (Sections 23, 25 and 66(1)(g) ).

• The right to information regarding the likely effects of treatment and the on-

going right to give or withhold consent to part or all of their treatment at any time during detention. The circumstances where treatment may be given without consent, subject to the second opinion process and other safeguards (Part 4 and 4A Act). This will be documented in the progress notes in the patient’s paper or electronic file. The CQC monitor compliance when they inspect statutory documentation and patient health records.

• How to access to the MHA Code of Practice which offers guidance on best

practice and provision of services in relation to compulsory admission to hospital and CTO. Every ward/unit must have a copy of the Code of Practice.

• The powers available to the Secretary of State and the CQC to safeguard patients’ rights under the Act.


• The powers under Section 134 to restrict outgoing mail in certain circumstances and incoming mail in high secure hospitals only (refer to the Trust Mail Policy M6). The CQC monitors the withholding of patients’ mail.

6 INFORMATION GIVEN TO INFORMAL IN-PATIENTS

6.1 Though Section 132 is specific to detained and CTO patients, more general information regarding rights must also be given to informal patients so that if they wish to leave hospital, this is discussed with their Consultant Psychiatrist and other clinical team members in order that appropriate arrangements are put in place for their discharge from hospital. This must be documented in the patient’s health record.

6.2 It is important that information is immediately given to patients when their status is changed from detained or CTO to informal status. This must happen whether the change in status is planned or not, for example, if detention papers are found to be invalid or a section inadvertently lapses. This will be recorded in the paper healthcare file and on RiO. In Broadmoor Hospital there is an Informal Patient Policy (I3) which must be followed. This can be found on the Exchange.

7. VOTING RIGHTS 7.1 Changes in the law introduced in the Representation of the People Act 2000 reflect

the widened voting rights of detained patients. There are still voting restrictions on patients who are detained under Part 3 of the MHA (patients concerned in criminal proceedings or under sentence).

7.2 The Trust staff will give information about voting rights to patients and assist them in the exercise of this right when possible (e.g. through Section 17 leave or guidance on postal votes). The Managers / Administrators in the MHA Offices must provide guidance to Trust staff and can do this by raising the matter through the CSU Mental Health Act groups (or an equivalent forum).

8. WHEN AND HOW INFORMATION WILL BE GIVEN 8.1 Each CSU must have in place local procedures to ensure that the correct information

is given to the patient on or soon after admission or commencement on CTO. The hospital MHA Administrator will ensure that suitable arrangements are in place to support the local procedures. Information will be given by an experienced member of staff which may be the RC, Nurse in Charge, MHA Administrator or other appropriate professional. Completion of the forms in Appendix I and 2 and the patient RiO record will demonstrate compliance with this policy requirement.

8.2 Information must be provided orally and in writing and documented as above.

8.3 The allocated nurse/other professional should provide this information at a suitable time in a private area/room and in a quiet and helpful manner. Information should be given in advance of the event to which it relates (for example, explaining to the patient how a Managers Hearing can be requested and how it is conducted). The information needs to be given at a time when the patient is most likely to be able to understand it. This is particularly important if a patient’s mental capacity fluctuates, often as a result of the mental disorder. (See the Mental Capacity Policy, M9)


8.4 The allocated nurse/other professional will explain again any points that the patient may not have understood and, once a verbal explanation has been given, hand the patient the appropriate rights leaflet and any other useful information.

8.5 Sometimes it may not be possible to read the patient’s rights at the time of admission or recall from CTO. If for example, the patient is disturbed and would be unable to understand the information being given, an attempt should be deferred until the patient is calmer and thinking more clearly. This will be recorded on the Trust forms (Appendix 1 or 2) and in the patient’s health record.

8.6 Re-Reading Of Patients Rights

8.6.1 It is good practice to re-read a patient’s rights at any time and a record should be made of each occasion (see Appendix 2). Re-reading of patients’ rights should occur at least six-monthly and more frequently in acute services. Periodic re-reading establishes a continued understanding by the patient of their rights. Rights should always be re-read if a patient has not understood their rights. They must also be re-read each time consent for treatment is sought or there is a change of detention status under the MHA.

8.6.2 For patients detained under Section 3 who have not appealed 3 months after the commencement of the Section, the allocated nurse or other professional should remind them of the right to appeal against detention and record this in the patient record.

9. RECORDING THE GIVING OF PATIENTS’ RIGHTS INFORMATION 9.1 A record that the patient’s rights have been given will be made on

• The Section 132 Form in use at Broadmoor Hospital (Appendix 1) or • Patients’ Rights Monitoring Form, London sites (Appendix 2)

9.2 The form will be kept in the patient’s ward or community file (in the MDT legal file if there is one). A copy of the Patient’s Rights Monitoring form must be sent to the MHA Administrator. The provision of patients’ rights information can also be recorded by the MHA Administrators on the MHA screen of RiO, the patient electronic record.

10. USE OF INTERPRETERS 10.1 If a patient is prevented from understanding by a language barrier, the Trust will

obtain the services of a professional interpreting or translating service. This can be done by contacting the Patient Services Department (London sites) or the Security Department in Broadmoor Hospital.

10.2 Interpreters may be sought to:

• Assist in explaining a patient’s rights and other specific information about detention

• Attend a Hospital Managers or Tribunal hearing • Other occasions as necessary

10.3 Statutory leaflets in many other languages and formats (e.g. Braille) are available from the MHA Administrator and should be requested by nursing staff for patients who


need them. The patient’s first language must be recorded in the ward file and on the Trust patient database.

11. SPECIAL NEEDS / LEARNING DISABILITY 11.1 It is accepted that staff may have difficulty in achieving a level of understanding in a

patient who has a learning disability. It is important therefore to ascertain the patient’s level of capacity in order to be able to provide information in a suitable manner. In addition, the involvement of an advocate/other independent professional may be helpful. (Refer to Trust Mental Capacity Policy, M9)

11.2 Every effort must be made to help an incapable patient that might wish to do so to apply to a Tribunal for discharge. This is particularly relevant to Section 2 where there is no ‘automatic referral’ by the Hospital Managers. The Responsible Clinician may wish to consider requesting the Secretary of State for Health to refer the case to the Tribunal. (This advice stems from the Court of Appeal case ‘MH v Health Secretary [2005] UKHL60). The MHA Office can provide further advice on this process.

12. ADVOCACY SERVICE, PATIENT ADVICE & LIASION SERVICE (PALS) & OTHER AGENCIES

12.1 As part of the reading of rights, the allocated nurse will also inform patients of the local Advocacy Service, the Trust Patient Advice & Liaison Service and the Independent Mental Health Advocate service.

12.2 Advocates may attend patient appeal hearings (against detention) at the patient’s request or, where the patient is not capable of making this decision, at staff’s request.

12.3 Leaflets about the availability of the advocacy services and other such support organisations must be readily available to patients on the wards and from the MHA Office.

12.4 Regard must be given to patient confidentiality if the patient is able to give informed consent. Unless consent is given by the patient, no clinical information will be given to an advocate or any other person. If the patient cannot give informed consent, staff may act in the patient’s best interests. Guidance on the role of IMHAs can be found in the MHA Code of Practice, Chapter 20. The Department of Health has also issued guidance on the sharing of patients records with IMHAs: ‘Independent Mental Health Advocates, Supplementary guidance on access to patient records under section 130B of the MHA 1983’ (on Department of Health website).

13. INFORMATION GIVEN TO THE PATIENT’S NEAREST RELATIVE 13.1 Upon admission under the MHA, unless the patient objects, the nearest relative will be

informed of the patient’s detention and be sent the relevant section information leaflet by the MHA Administrator.

13.2 Under Section 133 of the MHA, unless the patient objects, the Trust has a duty to inform the nearest relative of a patient’s discharge from Section and this will normally be done by the MHA Administrator. Unless the nearest relative requests not to be


informed, they may also be given by the ward team, details of any care that will be provided once discharged from hospital.

13.3 If the patient objects to information regarding their detention or other statutory information being sent to their nearest relative then this must be indicated on the Patient’s Rights Monitoring Form or communicated directly to the MHA Administrator.

14. TRAINING 14.1 The MHA Code of Practice requires staff members who are responsible for giving

information to patients to receive sufficient training and guidance. The Trust will include Section 132 training in the Trust induction /refresher training on Mental health law. The training will be delivered in line with the training matrix as outlined in the mandatory training policy.

14.2 Compliance with training will be monitored in regular management supervision. M12 Mandatory Training Policy will be followed for staff who persistently fail to attend training.

15. MONITORING 15.1 Local ward or unit audits of compliance with Section 132 should take place at regular

intervals and findings should be reported to the Clinical Audit Team and Clinical Improvement Groups. An annual Trust-wide audit will be carried out as part of the Clinical Governance framework. The audit findings will be reported to the CSUs and action plans will be prepared to address points of concern. The CSU Director must ensure the action plans are completed.

Refer also to the embedded monitoring template on page 1 of the policy.

16. REFERENCES (EXTERNAL DOCUMENTS) This policy should be read in conjunction with the following:

Mental Health Act 1983 (as amended by the MHA 2007).

Mental Health Act Code of Practice 2008, Chapter 2 (on the Exchange)

Mental Health Act Reference Guide 2008 (on the Exchange)

Human Rights Act 1998, Article 5(2) (being informed of reasons for detention) and

Article 5(4) (timely court/MHRT proceedings)

Mental Health Act Manual – 15th Edition, 2012 (R Jones, Sweet and Maxwell)

Care Quality Commission leaflet for detained patients (on the Exchange)

MIND - Leaflets about patients rights under the Mental Health Act

17. SUPPORTING DOCUMENTS (TRUST DOCUMENTS) WLMHT Policy C7 Consent to Examination or Treatment


WLMHT Policy E1 Electro-convulsive Therapy

WLMHT Policy D5 Confidentiality and Data Protection

WLMHT Policy C19 Copying Letters to Patients

WLMHT Policy I3 Informal Patient Policy (Broadmoor Specific)

WLMHT Policy C2 Care Programme Approach

WLMHT Policy C1 Management of Complaints, Concerns, Compliments & Suggestions

WLMHT Policy M6 Patients’ Mail and Postal Packages (Broadmoor Specific)

WLMHT Policy S24 Community Treatment Order

WLMHT Policy M9 Mental Capacity Act

WLMHT Policy M12 Mandatory Training

18. GLOSSARY OF TERMS /ACRONYMS MHA Mental Health Act

MCA Mental Capacity Act

CTO Community Treatment Order

RC Responsible Clinician

AMHP Approved Mental Health Professional

IMHA Independent Mental Health Advocate

NR Nearest Relative

CSU Clinical Service Unit

CQC Care Quality Commission

MHT Mental Health Tribunal

NHSLA National Health Service Litigation Authority

19. APPENDICES. Appendix 1 Section 132 Form (Broadmoor Hospital)

Appendix 2 Patients Rights Monitoring Form

Appendix 1

SECTION 132 FORM

Surname: _______________________________


Record of statutory information given Forename: ______________________________

to a detained patient or on Supervised community Hospital No:_____________________________

RIO No: _________________________________ treatment as required by NHS No: ________________________________

Section 132 of the Mental Health Act 1983 Ward: __________________________________

MHA Section: ___________________________

Date Type of Information

(See categories on reverse) Given in Writing (W) Verbally (V)

Given by Level of Understanding (Print name & 1) Good profession) 2) Fairly Good

3) Poor * 4) Not at all * (Add any relevant comments)

*PLEASE STATE REVIEW DATE IF THE PATIENT’S LEVEL OF UNDERSTANDING IS POOR / NOT AT ALL

Date: ……………………………………………………………… Date: ……………………………………………………..

Date: ……………………………………………………………… Date: ………………………………………………………

Revised June 2011 printshop ref: M149 File in MDT legal file


RECORD OF INFORMATION GIVEN TO PATIENTS UNDER SECTION 132

Notes to assist the completion of the Section 132 form Section 132 of the MHA 1983 requires specific information to be given to all detained patients. Informal patients should also be given relevant information about their rights to leave hospital. The Code of Practice (2008), chapter 2 provides guidance to practitioners. Note also the Trust Policy I9, Informing detained patients of their rights under Section 132. Informing patients of their rights consists of two main tasks. The first is to provide the information both in writing and orally, the second is to be satisfied that the patient understands the information. This information will include:-

a) The section and the provisions of the section under which the patient is detained.

b) Any changes to the section.

c) How to seek discharge (relevant to the patient’s section).

d) MHT rights including the MHA Managers & Ministry of Justice referrals of patients to the

Tribunal

e) Appeal to MHA Managers for discharge.

f) Information about renewal of detention.

g) Consent to Treatment - Information and rights.

h) Role of the Care Quality Commission.

i) Transfer/Discharge information.

j) The hospital’s complaints policy.

k) Right to legal representation.

l) Nearest Relative - function and powers.

m) Advocacy services.

n) Monitoring of patient mail in a High Secure Hospital.

o) Access to health records.

p) IMHA (Independent Mental Health Advocate) It is important to record the giving of information and the patient’s level of understanding at the time. The information should be repeated at suitable intervals and the level of understanding checked. Information can be given to the patient in writing or verbally by any member of the clinical team and should be recorded on the form. If a full record of any interview is made in the patient’s health records, it is sufficient to make reference to this note, identifying its placement and date. If written statutory information is sent from the MHA Office or Patient Services Department, again this should be noted on the form when it is given to the patient by a member of the clinical team. The giving of information (specific to the individual and general) is a statutory function and will be monitored by the Hospital Mental Health Act Managers and the Care Quality Commission.

Appendix 2

St Bernard’s Hospital, Uxbridge Road, Southall, Middlesex, UB1 3EU

PATIENT’S SECTION 132 RIGHTS It is important that detained patients are made aware of their rights, and if the patient does not understand English please ensure and Interpreter is arranged to visit the ward to read the patient their 132 Rights. A record is kept in case notes and on RiO when detained patients are informed of their rights at key stages in their detention period that is when: • A New Section begins • Just before the period of treatment without consent expire: • Three months have passed since the patient was first given medication • They have gained capacity to consent to treatment • When a Section is renewed • When a patient is transferred from another area or from another hospital • When the patient is considering applying to the Tribunal/Hospital Managers • The patient requests the hospital managers to consider discharging them • Warrant recalling patient • At regular intervals as a matter of good practice

I would be grateful if the patient could be informed of their rights at some point during the next seven days, and a Section 132 Form completed to records that this has been done. The completed form must be forwarded to the Mental Health Act Office, and a clear copy retained in the patient’s case notes.



St. Bernard’s Hospital

SECTION 132 INFORMING PATIENT OF THEIR RIGHTS UNDER THE MENTAL HEALTH ACT 1983

Patient Name: ………………………………………….. Date of Birth: ………………… Section…………………

Ward: ………………………………………..…………… RiO Number ………………… NHS No………………….

Responsible Clinician: ………………………………… Named Nurse: ………………………………………….

The patient has indicated that s/he 1) understands or 2) does not understand (please circle one that applies) - Did they require an interpreter yes/no If patient does not understand please state the reason:- ………………………………………………………………………………………………………………………….… ……………………………………………………………………………………………………………………………. Please record repeated efforts below: First repeat date:………………………………………….Understood Yes / No Second repeat date:……………………………………….Understood Yes / No Third repeat date:………………………….......................Understood Yes / No

Would the patient like to see a representative from the Independent Mental Health Advocacy (IMHA) Service? This is in addition to any legal representative they may wish to have. Yes / No (This section does not apply to anyone detained on a Section 4, Section 5(4) Section 5(2) Section 135 or Section 136)

Does the patient wish their nearest relative to be informed of this admission Yes / No

Is there anyone else they would like to have informed of their admission Yes / No if yes please give name and address:

Name:……………………………………………………………………Relationship……………………………………

Address:………………………………………………………………………………………Post Code:………………...

Is the patient’s nearest relative not known ( ) Is the patient’s nearest relative not communicating: ( )

I hereby confirm that the above patient was and has been informed of his/her legal Rights as defined by Section 132 of the Mental Health Act 1983 both written and verbal communication. Name of Nurse :…………………………………………… date/time Rights given …..…………@........................... (PRINT NAME IN BLOCK CAPITALS) I can confirm that I have been informed of and understand my rights under the Mental Health Act Signature of Patient ………………………………………………………..………… Date: …………………………. Please send this completed form to the Mental Health Act Office. A clear copy should be placed in case notes and entry made in RiO. A new form should be completed if a new section is implemented or following transfer from another hospital – another ward or at the renewal of a section.


continued/………………….

SECTION 132 PATIENTS RIGHTS

NOTES TO ASSIST THE COMPLETION OF THE SECTION 132 PATIENTS RIGHTS Section 132 Patients Rights of the Mental Health Act requires specific information to be given to all

detained patients. Informal patients should also be given relevant information about their rights to

leave hospital. The Code of Practice (CoP) 2008) provides guidance to practitioners. Note also the

Trust Policy 19, informing detained patients of their rights under Section 132.

Informing patients of their rights consists of two main tasks. The first is to provide the information both in writing and orally, the second is to be satisfied that the patient understands the information. THIS INFORMATION WILL INCLUDE:

a. the section and the provisions of the section under which the patient is detained

b. any changes to the section i.e. from section 2 to section 3

c. how to seek discharge - relevant to the patient’s section

d. the Mental Health Tribunal rights including the Mental Health Managers

– Ministry of Justice referrals of patient’s to the Tribunal

e. appeals to the Mental Health Managers for discharge

f. information about Renewal of detention

g. consent to treatment – information and the patients 132 rights

h. role of the Care Quality Commission i. transfer/discharge information

j. the hospital’s complaint’s policy

k. right to legal representation

l. nearest relative – function and their powers

m. Independent Mental Health Advocacy (IMHA) n. access to health records

It is important to record the giving of information and the patient’s level of understanding at the

time. The information should be repeated at suitable intervals and the level of understanding checked.

Information can be given to the patient in writing or verbally by any member of the Clinical Team and

should be recorded on the Form/RiO. If a full record of any interview is made in the patient’s health records, it is sufficient to make

reference to this note, identifying its placement and date.

If written statutory information is sent from the Mental Heath Act Office or Patient Services Department, again this should be noted on the Form when it is given to the patient by a member of


the Clinical Team. The giving of information (specific to the individual and general) is a statutory

function and will be monitored by the Hospital Managers and the Care Quality Commission.

West London Mental Health NHS Trust of 21

Policy I9 First Date of Issue: May 2007 This is current version I9/05 June 2013

Person recalled to hospital or admitted from prison

Appendix 3 Informing Patients of Their Rights under Section 132 of the MHA

Flowchart

Status change from informal to FORMAL

or New Admission under MHA

Primary Nurse /clinical team members to provide patient with s.132 information

MHA office to check above

Consultant and clinical team to ensure patient understands Informal status

Patient does not understand s.132 rights information

Person is in the community

Patient discharged from MHA and remains in hospital informally (back to top box)

Patient given rights information at regular intervals and also when specific events occur eg section change, New CTO, renewal, tribunal, ward change etc

Person is admitted to hospital INFORMALLY (not under MHA)

MHA Administrators and CSU Directors to monitor process and undertake audits.

Make record of s.132 actions in RiO and case-notes

RC – Part 4 MHA (treatment, consents)

All members of CT

PN / other CT members to re-read s.132 information


POLICY / PROCEDURE: I9, Informing Patients of their Rights under Section 132

MONITORING TEMPLATE

Minimum Requirement to be Monitored

WHO (which staff / team / dept)

HOW MONITORED (Audit / process / report / scorecard) - list details

HOW MANY RECORDS (No of records / % records)

FREQUENCY (monthly / quarterly / annual)

REVIEW GROUP (which meeting / committee)

OUTCOME OF REVIEW / ACTION TAKEN (Action plan / escalate to higher meeting)

Ward audit using Patient Safety Audit Form

Clinical Nurse Manager / Ward Manager

Trust Audit Tool All in-patient records

Monthly CSU audit group Reviewed at Trust level by Clinical Effectiveness and Compliance Committee

Section 132 information given to new detained patients

CSU MHA Administrators

s.132 form completed and entry on RiO

All detained in-patient records

Following each new admission under MHA

MHA Administration to provide report to CSU MHA group (or equivalent)

Action plan drawn up if report is not satisfactory

Regular re-provision of s.132 information

CSU clincal audit team

Audit process Recommend 25% of detained patient records

Annual CSU audit group SMT to approve audit and endorse action plan following audit

Relevant staff to complete Trust mental health law training (specified in Mandatory training matrix)

Human Resources CSU and Trust mandatory training scorecard

All relevant staff Monthly SMT of each CSU Training needs reviewed and managed by Head of Learning and Development

Policy: I9 · Chapter 2 of the MHA Code of Practice 2008. A copy of the Code can be found on the...

Documents

Transcript of Policy: I9 · Chapter 2 of the MHA Code of Practice 2008. A copy of the Code can be found on the...