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Published 7 June 2016
We look at the impact of a recent case which clarifies the options open to Trusts where there is concern about a Hospital Managers' Panel decision to discharge a patient.
The case of South Staffordshire and Shropshire Healthcare NHS Foundation Trust v Hospital Managers of St George's Hospital (2016) involved a Trust seeking to challenge a Hospital Managers' Panel decision to discharge a patient from detention under the Mental Health Act despite the concerns of his Responsible Clinician and despite a recent Mental Health Tribunal decision that he should remain in hospital.
The key points arising from this case are:
The case related to a man in his sixties who had a long history of involvement with mental health services. He had a diagnosis of bi-polar affective disorder and personality disorder. He had lived with his parents (now in their '80s) most of his life and there was history of aggressive behaviour towards them.
The patient was detained under Section 3 of the Mental Health Act ('MHA') in September 2015. He appealed to the Mental Health Tribunal in March 2016 and the Tribunal decided that he should not be discharged in light of concerns about whether he would comply with treatment in the community and the risk of aggression/violence towards his elderly parents. Then, in April 2016, the Trust's Hospital Managers' Panel (consisting of a non-executive director of the Trust and two lay members) met to consider whether to exercise the power delegated to it by the Trust to discharge the patient. The Panel decided that the patient should be discharged, having concluded that he would engage with community-based treatment and that the risk to his parents was balanced against other factors. This was despite the Responsible Clinician's concerns about discharge and the recent Tribunal decision.
The Trust applied for judicial review of its own Hospital Managers' Panel decision on the grounds that (a) the Panel had failed to treat the Tribunal decision as a 'relevant consideration' (i.e. a matter which must be taken into account if the decision is to be lawful) and (b) the Panel's decision was 'irrational' (i.e. not within the range of reasonable decisions open to it) in light of the evidence available and the reasons it gave.
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