Councils and CCGs have a joint responsibility to provide or arrange free aftercare for adults, young people, and children until they are satisfied that the person no longer needs it. These responsibilities are set out in the Mental Health Act Code of Practice. They aim to reduce the risk of worsening the person’s mental health condition and reduce the risk of needing further hospital admission.
The Parliamentary and Health Service Ombudsman (PHSO) and the Local Government and Social Care Ombudsman (LGSCO) respond to complaints involving health and social care bodies. They have released new and helpful guidance to tackle common and repeated mistakes seen in the aftercare of patients receiving support under the Mental Health Act.
This guidance brings together common themes seen in their joint investigation work, which include:
- Assessment of needs
- Care planning for patients
- Funding for aftercare
- Accommodation needs
- Ending mental health aftercare.
The guidance includes practical recommendations for councils and Clinical Commissioning Groups (CCGs) to make improvements and avoid the mistakes of others. From July 2022, Integrated Care Boards will replace CCGs for better joined-up health care. This guidance will support practitioners in delivering a continuity of care during this transition.
Key messages to take away:
- Councils and CCGs must ensure that everyone who is entitled to Section 117 aftercare receives a robust assessment of their mental health needs arising from, or related to, the person’s mental health condition.
- Everyone entitled to Section 117 should have their care needs assessed in line with the CPA (Care Programme Approach) framework. Care should be planned in line with the outcome of that assessment, which in most cases will mean care should be provided under CPA.
- Care and support plans should clearly state what services will meet needs arising from the person’s mental health condition under Section 117. The support should ensure it reduces the chance of them being detained under the Mental Health Act.
- The care plan should be recorded in writing, and a copy shared with the person and any other relevant parties.
- Councils and CCGs must not delay arranging Section 117 aftercare. Planning for Section 117 aftercare should start as soon as the person is admitted to the hospital.
- Care and support plans should be regularly reviewed. Reviews should include the person and other relevant parties.
- People should not be paying for services which meet their mental health needs under Section 117, including specialist accommodation.
- The decision to discharge someone from Section 117 should be a joint one (by the council and the CCG).
- The council and CCG should fully involve the person when they decide to end that person’s Section 117 aftercare.
- Organisations should have clear joint working arrangements around Section 117. This should include clearly defined roles about who will commission and/or provide Section 117.
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