Forms & Guidance

Information for Healthcare & Social Care professionals

Applications for a hearing
Pre-Hearing Procedure
Providing pre-hearing medical reports
How do you request not disclosure of all or part of a report to the patient?
How do you apply to change the date of the hearing?
Can the patient withdraw the application prior to the hearing?
What is the purpose of the medical member’s examination?
The hearing
Postponements
Post-hearing procedure
Adjournments
Other guidance for Healthcare & Social Care professionals

Applications for a hearing

Most Tribunal hearings are the result of an application made by or on behalf of the patient and in some cases by the nearest relative or displaced nearest relative.

The Mental Health Act 1983 also requires hospital managers to refer to the Tribunal any patient admitted for treatment under Part II of the Act, who on renewal of the section has not had a Tribunal hearing within the previous 6 months. In addition, hospital managers must refer any non-restricted patient who at the time of renewal of the section has not had a Tribunal hearing within the previous 3 years.

In a restricted case, the Home Office is required to refer to the Tribunal any patient who is subject to a restriction order/direction and has not had a Tribunal hearing for 3 years. The application forms section of this website lists all the information required. Once completed, return the form to the local office address as stated on the form. See application forms.

Pre-hearing procedure

Tribunal staff are responsible for acknowledging receipt of applications/references, requesting reports (ensuring all reports from hospitals and the Home Office are received within the statutory time scales), for arranging hearings and distributing Tribunal decisions.

It is crucial that the relevant caseworker for the patients' hospital at the Tribunal office in Leicester, is aware of any special requirements such as the need for an interpreter for the patient. The caseworker should be notified as soon as the hospital administration is aware of the application/reference.

Providing pre-hearing medical reports

The Mental Health Review Tribunal Rules place a statutory responsibility on the Responsible Authority to provide the Tribunal with a statement, a medical and social circumstances report, for restricted and non – restricted cases (other than section 2) within 3 weeks of receipt of the Tribunal's request. The Tribunal offices require 6 copies of the, signed and dated, statement, medical and social work reports.

In a restricted case, it is essential that, in addition, copies of all reports are sent directly from the responsible authority to the Home Office.

The Mental Health Unit at the Home Office provides updated lists of contacts for receipt of reports.

Section 2 reports (6 copies of the statement, medical and social circumstance reports) together with copies of the section papers, should be made available to the Tribunal members and patient's representative at least half an hour before the hearing is due to commence. Patients not represented, must also have sufficient opportunity to read the reports before the hearing begins.

In a restricted case, if the opinion of the Responsible Medical Officer RMO or social worker changes from what was in the original Tribunal report(s), it is vital that this is communicated in writing, prior to the hearing, to the Tribunal office and the Home Office to allow the Home Secretary the opportunity to prepare a supplementary report.

Those responsible for completion of reports should be made aware of the statutory time scales and requirements as to the content of Tribunal reports. Social circumstances reports should always contain a post-discharge care plan, if only in skeleton form.

The Human Rights Act leaves Trusts and hospitals vulnerable to challenge where the statutory time scales as to the provision of reports are not met, particularly where the hearing is delayed or adjourned for late or non–receipt of reports. Regional Chairmen may direct Senior Managers to appear before the Tribunal to explain why reports are late.

Details of the information required for reports, in accordance with the 'Tribunal Rules', can be found in the Guidance and Information section.

How do you request non disclosure of all or part of a report to the patient?

Any document/report not for disclosure to the patient should be annotated clearly and a written explanation attached as to the reasons for requesting non–disclosure. A separate document, which can be shown to the patient, should be submitted to the Tribunal Office in Leicester

The Tribunal will consider carefully the request for non–disclosure and all the issues involved before deciding whether to override the wishes of the author of the report. The Tribunal will only agree to non–disclosure where there are compelling reasons to do so, and where they are convinced that "disclosure would adversely affect the health or welfare of the patient or others".

All reports will however be made available to the patient's legal representative although he/she will be bound by any ruling of the Tribunal.

Please see Guidance for the Preparation of Social Circumstances Reports, can be found in the Guidance and Information section.

How do you apply to change the date of the hearing?

Usually once a date has been fixed it will not be changed by the Tribunal office, however you can apply to the Tribunal to request a change of date. All applications to postpone the hearing/change the date must be forwarded to the Tribunal Office in writing with reasons for making the request. If there are exceptional reasons to do so, the Regional Chairman's consent will be sought to offer another date within target/statutory time scales.

Can the patient withdraw the application prior to the hearing?

An application can be withdrawn at any time by the patient/applicant subject to the Tribunal accepting the withdrawal. The request should be made in writing to the Tribunal Office. Where the withdrawal is received directly from the patient and that patient is represented, the representative will be approached by the Tribunal and encouraged to make contact with their client to discuss the request.

Patients not represented, must also have sufficient opportunity to read the reports before the hearing begins.

The Tribunal Office will advise where a hearing has been cancelled, for whatever reason.

Hospitals should never cancel Tribunal hearings without reference to the Tribunal Office.

What is the purpose of the medical member’s examination?

The Tribunal medical member has a statutory duty to examine the patient prior to the hearing and is entitled to see any case/nursing notes as well as taking copies of them for the purposes of the application/reference.

The medical member will contact the ward to make arrangements to see the patient before the hearing, explaining to the nurse in charge who he or she is, the purpose of the visit, and time and date. It is important that the patient is told of the visit in advance and is present on the ward when the medical member visits. If the patient is on leave of absence the ward should make arrangements for the patient to return to the ward for the medical examination.

The Tribunal Office should be informed immediately of the patient's discharge from section. At present, notification should be made within normal office hours to the Tribunal Office in Leicester.

Where a patient refuses to be examined by the medical member of the Tribunal, he or she should advise the Regional Business Manager who will contact the Tribunal President.

The hearing

The hearing is conducted in private unless the patient requests a public hearing and the Tribunal accepts the request. The Tribunal will seek to avoid formality to help put the patient at ease. Normally the patient will be present throughout the hearing, unless one of the parties request otherwise and the Tribunal agree and accept that the presence of the patient at a particular stage will adversely affect the patient's health or the welfare of the patient or others. The patient's representative will however be entitled to be present throughout the hearing.

The Tribunal will expect to see the Responsible Medical Officer (RMO) or a deputy who knows the patient, and in the opinion of the RMO, has sufficient knowledge and experience of the patient and psychiatry to represent the responsible authority. It is essential that an appropriate social worker attends the hearing to give further, up to date information about the patient including home circumstances and after-care facilities in the event of a decision to discharge. Failure by the hospital to ensure that the appropriate people attend the hearing, as above, will be treated by the Tribunal as a serious matter, requiring an explanation by the Trust's Chief Executive Officer.

Increasingly Tribunals find it helpful to speak to a nurse, particularly a key worker or primary nurse.

The Tribunal expects a nurse to accompany the patient to the hearing especially when the patient is not represented and the Tribunal decide to announce the decision following the hearing.

It is helpful if the Mental Health Act Administrator is present on the day of the hearing to advise the Tribunal assistant, Caseworker or Business Manager of the Tribunal office of any potential problems. Hospital, medical and nursing notes should be made available to the Tribunal on the day.

Postponements

An application to postpone a hearing must be made at the earliest possible opportunity in writing to the Tribunal Office marked for the attention of the Regional Chairman, giving reasons for the request. The relevant Regional Chairman will decide all pre-hearing matters relating to postponements and will do so on the individual merits . Late postponement of a hearing is unlikely to be granted unless there are wholly exceptional circumstances. See Listing Policy and Case Postponements.

Post-hearing procedure

Tribunals are encouraged to announce the decision immediately after the hearing. On occasions where the patient has gone back to the ward, the decision may be conveyed to their Solicitor, who is expected to communicate this to their client the same day. It is important that where the patient is discharged, that he/she and a representative of the hospital is also advised. Copies of the decision can be left at the hospital on the day of the hearing. A copy must be left where the patient is discharged.

Hospital Managers and all parties to the hearing should receive a copy of the written reasons for the Tribunals' decision within 3 days of a Section 2 hearing, and within 7 days for all other cases.

If the Tribunal makes statutory recommendations e.g. for transfer to another hospital or for leave of absence etc, the hospital is not legally obliged to follow them; but the Tribunal can reconvene at a later stage to find out why their recommendations have not been followed, and rehear the matter as appropriate.

Adjournments

The Tribunal has the power to adjourn a hearing. This may be for further information in the form of reports or for a witness to attend a reconvened hearing. Directions may be made as to when and how the information should be provided, and for the issuing of a subpoena if necessary. A Tribunal cannot adjourn to monitor a patient's progress.

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