05:06, January 30 73 0 theguardian.com

2021-01-30 05:06:04
NHS drops virtual assessments used to section patients

Hospital trusts in England have been told to stop using virtual assessments to section people under the Mental Health Act after a judge ruled them unlawful.

An NHS trust sought a court judgment on remote assessments after the Department of Health and Social Care issued guidance in November indicating that this method could be used as part of an evaluation during the pandemic.

Experts said that a “small but significant” number of people may have been sectioned this way.

Following the judgment, an email was sent to mental health professionals from NHS England saying “immediate action required”. It added that anyone detained via remote assessment would need to be notified.

The message read: “Stop using remote methods for any new or ongoing assessments for detention or section renewals under Part II of the Act.”

“All mental health providers should identify and reassess individuals who are currently detained under Part II of the MHA following a remote assessment as soon as possible if ongoing detention is deemed necessary.”

The government had originally advised that it believed remote assessment could be used but said only the courts could provide a definitive interpretation of the law, setting out the circumstances under which such assessments could take place.

Devon NHS trust asked for clarity on the legality of the practice, resulting in a ruling on 22 January requiring “the physical attendance of the person in question”.

Mental Health Act assessments usually take place where someone lives, or in a public place, a police station or in hospital. The approved mental health professional (AMHP) should introduce themselves, and the doctors, to the person being detained.

While some assessments carried out to detain someone under the Mental Health Act may have taken place online in recent months, there is still a requirement for an assessor to be physically present for other parts of the process.

Alexander Ruck Keene, a barrister, said: “Trusts could be sued but I don’t think we will see cases en masse. In crude terms, someone would have to prove they should not have been detained as they did not meet the criteria and suffered harm as a result.”

Steve Chamberlain, the chair of the AMHP leads network, said he believed a “small but significant” number of people would have been assessed for detention, in part, remotely.

“The big problem, I think, is health and safety. One of the issues is that with Mental Health Act assessments quite a few are done in places where social distancing is difficult. It remains a real issue around the pandemic and risk to service users and the risk of infection,” he said.

He added that many mental health workers had been reluctant to do remote assessments due to ongoing doubts about their legality. “Additionally, there were significant concerns around the ethics; can you complete an adequate assessment given the enormity of the decision, essentially taking away someone’s liberty?”

David Somerfield, the medical director at Devon Partnership NHS trust, welcomed the judgment “to achieve clarity about the legality of conducting Mental Health Act assessments remotely during the pandemic on those rare occasions when it may be safer, for reasons of infection prevention and control, to do so.

“While the helpful national guidance suggested remote assessments may be lawful in some exceptional cases, it also caveated this by saying only a court could ultimately confirm the lawfulness or otherwise of this approach.

“We felt that this was an important issue that required legal clarification for mental health professionals everywhere, in terms of providing certainty about the legal status of remotely-conducted assessments.”

An NHS spokesperson said: “Our priority has always been and remains providing safe, accessible care for patients throughout this pandemic, including those patients who are most unwell and may require assessment and treatment under the Mental Health Act. We have reviewed the judgement from the high court and issued rapid guidance asking trusts not to use virtual assessments.”