Notes

Forms to be used in making medical recommendations for admission to hospital under the Mental Health Act 1983

• First and second medical recommendations must be made on the relevant statutory forms. 
• There are different forms for separate and joint medical recommendations and care should be taken that the correct form is completed in each case. An incorrectly completed form may make an application for detention invalid.
• The second medical recommendation may be completed before the first but the medical examinations must be completed within 5 clear days of each other.
• The Code of Practice states that "unless there are good reasons for undertaking separate assessments, assessments should be carried out jointly by the ASW and doctor(s)". When this is not possible a doctor may undertake the examination, make the recommendation and, where clinically appropriate, leave the scene. However, he/she must make arrangements for the form to be given to the ASW or to the admitting hospital in those instances where the patient is already an in-patient. But "it is essential that at least one of the doctors undertaking the medical assessment discusses the patient with the applicant (ASW or nearest relative) and desirable for both of them to do this". (Code of Practice, para 2.3). 
• Primary Care Trusts (under the umbrella of their respective Strategic Health Authorities) are required to maintain and provide lists of doctors approved under section 12 of the Mental Health Act 1983 as having special experience in the diagnosis or treatment of mental disorder. 

Clean and sample copies of these forms are attached at Appendix 1 to the Department of Health's 'Guidance for GPs: Medical Examinations and Medical Recommendations under the Act'.  It can be accessed at http://www.doh.gov.uk/mhact1983.htm.

Key Action Points for GPs in making Assessments and Recommendations for Admission

These can be accessed at Appendix 2 of the above Guidance.

The role of the “nearest relative”:

The nearest relative has powers to:

• make an application for detention of the patient
• object to an application for the detention of a patient (an application can be made to the county court for the functions of the nearest relative to be transferred to the local Social Services authority or another person if relative objects unreasonably)
• apply to the Hospital Managers for the discharge of the patient (application must be made in writing giving 72 hours notice, patient must be discharged unless within the 72 hours, the RMO reports to Managers that patient is likely to be a danger to self or others)
• receive information about the detention and treatment of a patient.

Payment and claiming fees

• Currently the fees payable are £162.70 for section 12 approved doctors, and £50.45 for other registered practitioners excluding travel expenses.   

Last edited: 2/2/2004

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