Summary: We will not investigate Miss Y’s complaints. She has already appealed the decision to detain her under Section 3 of the Mental Health Act to the First Tier Tribunal (Mental Health). Also, the Parliamentary and Health Service Ombudsman is better placed to consider her complaints about transfer between hospitals and care and treatment under Section 3.

The complaint

1. Miss Y complains about the way organisations carried out a Mental Health Act assessment in April 2023. Specifically:
1. An Approved Mental Health Professional (AMHP) for Derby City Council (Derby Council) did not properly complete the Mental Health Act paperwork, when she recommended detaining her under Section 3.
2. The AMHP and Section 12 doctors (on behalf of Leicester, Leicestershire and Rutland Integrated Care Board) had no good reason to recommend detaining her.
3. After re-assessing her, an AMHP for Leicester City Council (Leicester Council) wrongly recommended continuing her detention under Section 3.
4. The way Derbyshire Healthcare NHS Foundation Trust (Derby Healthcare Trust) transferred her to Leicester Partnership NHS Trust (Leicester Trust).
5. She is also unhappy at the care and treatment the Leicester Trust has provided to her under Section 3.
2. Miss Y says she has suffered financial loss and also physical and mental harm.
3. Miss Y says the organisations should take action to stop others suffering similar fault. That includes reviewing relevant policies and procedures. They should also apologise to her, acknowledge mistakes were made and pay her for out-of-pocket expenses.

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The Ombudsmen’s role and powers

4. The Ombudsmen may decide not to investigate a complaint if:
• it is unlikely we could add to any previous investigation by the bodies
• it would be reasonable for the person to ask for a review or appeal
• there is another body better placed to consider this complaint

(Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

5. I considered information provided by the complainant and the organisations.
6. I considered the Ombudsman’s Assessment Code.
7. Miss Y had an opportunity to comment on a draft decision. I have considered her comments before making my final decision.

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What I found

Relevant legislation

8. Under the Mental Health Act 1983 (MHA), when someone has a mental disorder and is putting their safety or someone else’s at risk they can be detained in hospital against their wishes. This is sometimes known as ‘being sectioned’. Usually three professionals need to agree that the person needs to be detained in hospital. These include an Approved Mental Health Professional (AMHP) and usually (but not always) two doctors who have been specially approved in Mental Health Act detentions (Section 12 doctors).
9. The AMHP is responsible for deciding whether to go ahead with the application to detain the person and for telling the person. Any admission should be in the best interests of the person and they should not be detained if there is a less restrictive alternative.
10. When Section 12 doctors make recommendations under sections 2, 3 or 4 of the MHA, they are acting under powers which have been given to them under the MHA. But sometimes those doctors make those recommendations under an NHS contract. In this complaint, NHS Leicester, Leicestershire and Rutland Integrated Care Board (the ICB) was responsible for the actions of those doctors because it paid them for that work. This explains why the ICB is an organisation in this complaint.
11. People who have been detained under the MHA can apply for a hearing to the First-Tier Tribunal (Mental Health) if they disagree with the decision. The Tribunal must discharge the person from detention if, on the day of the hearing, they do not meet the criteria needed for detention.

Background

12. In April 2023, Miss Y approached an Acute Trust in Derby (not subject to this complaint) for physical health support. During that admission, staff had concerns about Miss Y and asked the Derby Healthcare Trust to carry out a MHA assessment. The MHA assessment, which included an AMHP from Derby Council and two Section 12 doctors recommended detaining Miss Y under Section 3 of the MHA.
13. Derby Healthcare Trust agreed to transfer Miss Y to the Leicester Trust because she was already a patient there. After a delay in transfer, Miss Y moved to the Leicester Trust. On arrival, it re-assessed Miss Y under the MHA. That was because the Derby AMHP had not appropriately completed the relevant forms to detain Miss Y. Leicester Trust agreed to carry over the recommendations from the Derby Section 12 doctors. So an AMHP for Leicester Council recommend continuing the detention under Section 3 of the MHA.
14. Miss Y later appealed her detention her under Section 3 to the Tribunal.

My assessment

Part a)

15. I do not consider we should investigate this part of Miss Y’s complaint.
16. I agree the AMHP for Derby Council acted with fault. The AMHP did not complete the appropriate paperwork when she recommended detaining Miss Y under Section 3. That would have been frustrating for Miss Y.
17. However, I am satisfied Derby Council has accepted it acted with fault, and appropriately remedied Miss Y’s injustice. While it did not formally record apologising to Miss Y, a senior member of staff recalled speaking with the staff member who verbally apologised to her. On the balance of probabilities, I am persuaded the Council has apologised to Miss Y. I also consider the Council has taken action to ensure similar fault does happen again. It has shared evidence that it made staff aware how to properly complete the statutory MHA paperwork following Miss Y’s case.
18. I am not persuaded an investigation by the Ombudsmen could achieve anything more for Miss Y.

Parts b) and c)

19. Both these parts of Miss Y’s complaint concern the recommendation to detain her under Section 3.
20. Miss Y has already appealed her detention under Section 3 to the Tribunal. I consider that appeal was the most reasonable way to address these parts of her complaint. Therefore, I do not consider we should investigate these parts of her complaint.

Parts d) and e)

21. For part d), the hospital managers of the Derby and Leicester Trust were responsible for coordinating the transfer of Miss Y between hospitals following her detention.
22. For part e), the Leicester Trust was solely responsible for providing care and treatment to Miss Y under Section 3.
23. The councils subject to this complaint would not have been responsible for either part above. Therefore, I consider the Parliamentary and Health Service Ombudsman (PHSO) would be better placed to consider these parts of her complaint.

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Final decision

24. I will not investigate Miss Y’s complaints. I am unlikely to be able to achieve more for her complaint about the AMHP for Deby Council. The Tribunal was the best way to consider her complaints about the decision to detain her under Section 3. Also, PHSO are better placed to consider her complaints about the transfer between hospital and care and treatment under Section 3.

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Investigator's decision on behalf of the Ombudsman