Government to make emergency changes to Mental Health Act

Several senior NHS sources told HSJ that temporary changes are likely to include reducing the number of appropriate psychiatrists needed to urgently assess whether someone should be sectioned, in case of staff shortages.

Currently two doctors are required under the Act to carry out an assessment, one of which has to be a “section 12” approved doctor, but new legislation is likely to allow for just one doctor.

This is due to concerns that the number of doctors available to make assessments is likely to reduce as coronavirus spreads, as there is an assumption that significant numbers of NHS staff will have to self-isolate if they have symptoms.

Professor Wendy Burn, president of the Royal College of Psychiatrists, said: “We’re supportive of this during this time of crisis. This is about keeping patients safe. This is to make sure people who are in danger of harming themselves or someone else are cared for in a safe environment. If people are at risk you have to be able to get them into hospital.”

The changes will be included as part of emergency legislation due to be introduced this week.

The government today said that the legislation would also provide for it to “temporarily allow extension or removal of time limits in mental health legislation to allow for greater flexibility where services are less able to respond”.

“These temporary changes would be brought in only in the instance that staff numbers were severely adversely affected during the pandemic period and provide some flexibility to help support the continued safe running of services under the Mental Health Act,” it said.

Meanwhile, mental health trusts’ chiefs have also been told to find spaces in which to cohort patients diagnosed with covid-19, as part of national plans for the sector.

In a letter sent to all trust chief executives in the country, NHS England said mental health, learning disability and autism providers will need “to identify areas where covid-19 patients requiring urgent admission could be most effectively isolated and cared for (for example single rooms, ensuite, or mental health wards on acute sites).”

It added: “Case by case reviews will be required where any patient is unable to follow advice on containment and isolation.”

Staff within mental health trusts will also need to have “refresher” training on physical health care, vital signs and deteriorating patients, the national commissioner said.

NHS England and NHS Improvement have also said there will be bespoke guidance developed for mental health trusts in a number of areas, including standing down clinics and non-essential activity, digital solutions for remote working, and to support self-isolated patients.

The guidance adds trusts should identify at risk patients, which would likely include young people with an eating disorder, patients who are taking the drug Clozapine and thus requiring frequent blood tests, or people with a learning disability who have a higher risk of respiratory issues.

This article was changed at 10:30 to ammend guidance on section 12 doctors.