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PROTOCOL FOR POLICE ASSISTANCE WHERE
PATIENTS ARE ABSENT WITHOUT LEAVE - AWOL
(Under THE MENTAL HEALTH ACT 1983)
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PROTOCOL FOR POLICE ASSISTANCE WHERE
PATIENTS ARE ABSENT WITHOUT LEAVE - AWOL
(Under THE MENTAL HEALTH ACT 1983)
Memorandum of Understanding between: (insert details of partnership agencies
involved in this protocol).
South Essex Partnership NHS Foundation Trust
Bedford Borough Council
Central Bedfordshire Council
Luton Borough Council
Bedfordshire Police
East of England Ambulance Service
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1. Introduction
This document has been developed following consultation with the Police service, the
Approved Mental Health Professional (AMHP) Leads Network and the Department of
Health; and takes account of Guiding Principles within the Mental Health Code of Practice
(MHA CoP 2008). The protocol provides a framework that will support improved service
delivery and the appropriate use of resources.
2. Auditing and Monitoring of the Document
All parties to this agreement will ensure that it is implemented in accordance with local
procedures that will include provision for auditing the maintenance and the management
of compliance with terms of this document.
Senior managers from signatory
organisations will meet regularly to review compliance and to monitor any difficulties
encountered.
3. General Responsibilities
Hospital managers will ensure that there is a clear written policy about the action to be
taken when a detained patient, or a patient on SCT, goes missing. All relevant staff should
be familiar with this policy. Hospital managers should agree their policy with other
agencies – such as the police and ambulance services.1
If a patient detained, or subject to Supervised Community Treatment, or Guardianship
under the Mental Health Act 1983 (MHA) is Absent without Leave (AWOL) the police will
assist in returning a patient to hospital if necessary under the circumstances.
The situations when it will be necessary to notify the police are where the person is2:
Considered to be particularly vulnerable
Considered to be dangerous
Subject to restrictions under Part 3 of the Act
The persons history may also make it desirable to inform the police that they are
AWOL
When the police are requested to assist, information must be provided with regards to
expiry time/date of power of detention (appendix A).
1 MHA CoP para 22.10
2 MHA CoP: para 22.14.
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Staff at the establishment from which the patient is missing must ensure that a thorough
search of the location has been completed prior to making a request for police assistance.3
Where a person’s whereabouts are known and the police assist with conveying they will be
supported by a suitably qualified and experienced mental health professional in returning
the patient to hospital.4
If a patient who is AWOL returns or is found, the police will be informed immediately by
the agency who identified the patient was missing.5
4.
Informal Patients who are absent without leave
Where the patient missing is an informal patient the hospital continue to have a duty of
care towards that person. Staff should consult their local policy to clarify the actions they
need to take.
Where the person’ whereabouts are known consideration should be given to either
hospital staff or community staff making contact with them.
In certain circumstances eg where the person presents a significant risk to themselves or
others or the person was assessed as lacking the capacity to understand why they needed
to be in hospital, staff may need to consider asking the police for assistance including
where necessary in conveying the person back to the hospital if that is assessed as being
the safest place for them at the time.
If the person lacks capacity to consent to returning to hospital, professionals should
consider whether it is in their best interests for them to be returned and whether the
Mental Capacity 2005 gives them the authority, which is a case by case judgement, or
whether an assessment under the Mental Health Act is now indicated.
5.
The use of s135(2)
3 MHA CoP 22.10 Hospital managers should ensure that there is a clear written policy about the action to be taken when a detained patient,
or a patient on SCT, goes missing. All relevant staff should be familiar with this policy. Hospital managers should agree their policy with other
agencies – such as the police and ambulance services – as necessary.
4 MHA CoP 22.13’ The police should be asked to assist in returning a patient to hospital only if necessary. If the patient’s location is known,
the role of the police should, wherever possible, be only to assist a suitably qualified and experienced mental health professional in returning
the patient to hospital.’
5 MHA CoP para 22.16: Local policies: Where the police have been informed about a missing patient, they will be told immediately if the
patient is found or returns.
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A warrant under s135(2) should be applied for where
6
someone who is detained under the MHA is AWOL, has been located but refuses to
allow staff access to them.
someone who is subject to Supervised Community Treatment has been recalled to
hospital but refused to allow staff access to them or to return to the hospital
access is needed to retake someone subject to Guardianship who has left the place
where they are required to be by their Guardian.
SEPT and Hospital Managers will have local protocols in place with regard to the process of
obtaining a warrant.
A police constable may enter (if necessary by force) the place where the patient is staying
and return them to the place where they ought to be7. A suitably qualified and
experienced mental health professional who knows the patient should accompany the
police when they exercise the warrant.
Where community patients subject to Supervised Community Treatment (SCT) have been
recalled to hospital and failed to return to the hospital to which they have been recalled, it
will be the role of the Responsible Clinician and the Care Co-ordinator to organise their
return. They may be supported by the police, where a risk assessment indicates that this
is required or wherever a warrant under s135 (2) MHA needs to be executed to gain entry
to premises.8
6.
Guardianship
Guardianship allows the Guardian (usually an experienced mental health professional
working on behalf of a Local Social Service Authority) to specify where the community
patient should live. If they leave the place they are required to live, they may be returned
there9.
6 A constable, any officer on the staff of the hospital, any AMHP or any person authorised by the Hospital Managers or in the case of a person
subject to Guardianship any officer on the staff of a local social services authority or any person authorised by the Guardian or a local social
services authority may apply for the warrant
7 S135(2)
8 MHA CoP para 22.7 Local policies:SCT patients.
9 Ref Guide to the MHA: 19.87 A patient who is AWOL in this way may be taken into custody under section 18 and returned to that place by
any officer on the staff of any LSSA, any police officer (or other constable), or any person authorised in writing by the patient’s guardian or
any LSSA.
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Staff should only involve the police where risk assessment indicates that their presence is
necessary, or where their powers under s135(2) are needed. In other cases anyone
working for a local council, or authorised by them, may return the patient to the place
where they are expected to live.
7.
Conveyance
The East of England ambulance service will provide transport from the location where the
person was detained to the designated place of safety and from the place of safety to the
mental health provision if detained under the MHA.10
In exceptional circumstances’ a police officer may decide to expedite conveyance
themselves, this should be in cases of urgency where it is necessary to safely manage a
risk of violence or to prevent escape.11
10 MHA CoP para 11.6: Local protocols; It is for primary care trusts (PCTs) to commission ambulance and patient transport services to meet
the needs of their areas. This includes services for transporting patients to and from hospital (and other places) under the Act.
11 MHA CoP para 11.20: Local protocol; Where it may be necessary to use a police vehicle because of the risk involved. it may be necessary
for the highest qualified member of an ambulance crew to ride in the same vehicle
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Signature Page
Organisation:
South Essex Partnership NHS Foundation Trust
Name:
Amanda Reynolds
Role:
Executive Director of Social Care & Partnerships
Signature:
Organisation:
Bedford Borough Council
Name:
John Bruynseels
Role:
Assistant Director - Community Care Services (Adults & Older People)
Signature:
Organisation:
Central Bedfordshire Council
Name:
Stuart Rees
Role:
Assistant Director, Adult Social Care
Signature:
Organisation:
Luton Borough Council
Name:
Maud O’Leary
Role:
Head of Adult Social Care
Signature:
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Organisation:
Bedfordshire Police
Name:
Nigel Trippett
Role:
Assistant Chief Constable
Signature:
Organisation:
East of England Ambulance Service
Name:
Lewis Andrews
Role:
Clinical General Manager North West Sector (Interim)
Signature:
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Reference Guide to the MH Act:
Appendix A
Table 31.1 - summary of time limits for retaking patients who are absent without
leave or otherwise liable to be retaken
A patient who, at the time of
absconding, was (or is treated as):
May not be retaken after:
liable to be detained on the basis of a
nurse’s record under section 5(4)
6 hours starting at the time the
nurse made the record
liable to be detained on the basis of the
report of a doctor or an approved
clinician under 5(2)
72 hours starting at the time the
doctor or approved clinician
furnished the report, or
72 hours starting at the time a
nurse made a record under section
5(4) if the patient was held under
that power first.
being conveyed to hospital on the basis
of an application for admission for
assessment or treatment under section
2 or 3
14 days starting with the day the
patient was last examined by a
doctor for the purposes of a
medical recommendation in
support of the application
being conveyed to hospital on the basis
of an emergency application under
section 4
24 hours starting at the time the
patient was last examined by a
doctor for the purposes of the
medical recommendation in
support of the application
detained on the basis of an emergency
application under section 4, where the
second medical recommendation has
not yet been received
72 hours starting at the time the
patient was admitted (or treated
as admitted) to the hospital on the
basis of the emergency application
detained on the basis of an application
for admission for assessment under
section 2 (or under section 4, where
the second medical recommendation
has since been received)
28 days starting with the day the
patient was admitted (or treated
as admitted) on the basis of the
application
detained on the basis of an application
for admission for treatment under
section 3
the later of:
six months starting with the day
the patient went absent; or
the date on which the authority
under which they were detained at
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A patient who, at the time of
absconding, was (or is treated as):
May not be retaken after:
liable to be detained on the basis of an
unrestricted hospital order, hospital
direction or transfer direction under
Part 3
the time they went absent is due
to expire (ignoring any possibility
of it being renewed or replaced by
a different authority and any
extension allowed because of the
patient’s absence)
an SCT patient who had been recalled
to hospital
the later of:
six months starting with the day
the patient went absent; or
the date on which the community
treatment order is due to expire
(ignoring any possibility of it being
extended or revoked and any
extension allowed because of the
patient’s absence).
subject to a restriction order, limitation
direction or restriction direction
(whether or not conditionally
discharged).
the restriction order, limitation
direction or restriction order
ceases to have effect (which may
not be until the patient dies).
subject to guardianship on the basis of
an application for guardianship under
Part 2
the later of:
subject to a guardianship order under
Part 3
detained in a place of safety under
section 135 or 136
six months starting with the day
the patient went absent; or
the date on which the authority
under which the patient was
subject to guardianship at the
time the patient went absent is
due to expire (ignoring any
possibility of it being renewed and
any extension allowed because of
the patient’s absence).
the earlier of:
72 hours from the time the patient
absconded; or
the period for which the patient
may be detained, ie 72 hours’
from the start of the patient’s
detention in the place of safety.
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A patient who, at the time of
absconding, was (or is treated as):
May not be retaken after:
subject to a remand under section 35
No time limit is specified. The
or 36 or an interim hospital order under patient may be arrested by any
section 38
police officer (or other constable),
and when arrested must be
brought before the court that
made the remand or interim
hospital order as soon as
practicable.
being conveyed in England or Wales en
route to Scotland, Northern Ireland,
the Isle of Man or any of the Channel
Islands, in accordance with a transfer
warrant
the period during which the
patient could be retaken if no
transfer was being attempted.
(This is because, until the transfer
is complete, they remain subject
to detention or guardianship in
England)
being conveyed in England or Wales en
route from detention in Scotland,
Northern Ireland, in accordance with a
transfer warrant (or its equivalent) or
from the Isle of Man under section 84,
but yet to arrive at the hospital to
which they are to be admitted
the end of the period during which
the patient could be retaken if
they had already been admitted to
hospital in England or Wales and
had then gone AWOL. This will
vary depending on the type of
application, order(s) or
direction(s) to which they would
be treated as subject on
completion of the transfer.
the end of the period during which
they could be retaken had they
absconded while still in the Isle of
Man or the relevant Channel
Island.
being conveyed from the Isle of Man or
any of the Channel Islands, in
accordance with a transfer under
section 85, but yet to arrive at the
hospital to which they are to be
admitted.
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UNITS Contact Details – Luton & Central Bedfordshire
Townsend Court (Older people inpatients)
Mayer Way
Houghton Regis
Bedfordshire
LU5 5BF
Tel: 01582 707581
Onyx Ward (Adult Acute MH Admissions)
Luton and Central Bedfordshire Mental
Health site
Off Calnwood Road, Luton, Bedfordshire
LU4 0LX
Tel: 01582 657500 / 657544
Robin Pinto Unit (Adult Low Secure)
Luton and Central Bedfordshire Mental
Health site
Off Calnwood Road, Luton, Bedfordshire
LU4 0LX
Tel: 01582 657500 / 657530
Coral Ward (Adult Acute MH Admissions)
Luton and Central Bedfordshire Mental
Health site
Off Calnwood Road, Luton, Bedfordshire
LU4 0LX
Tel: 01582 709181
Whichellos Wharf
The Elms
Stoke Road
Linslade
LU7 2TD
Tel: 01525 751170
Jade Ward (MHAU)
Luton and Central Bedfordshire Mental
Health site
Off Calnwood Road, Luton, Bedfordshire
LU4 0LX
Tel: 01582 700343
Crystal Ward (Functional Assessment OP)
Luton and Central Bedfordshire Mental
Health site
Calnwood Road, Luton, Bedfordshire
LU4 0FB
Tel: 01582 709187
Section 136 Suite (Place of Safety)
Luton and Central Bedfordshire Mental
Health site
Off Calnwood Road, Luton, Bedfordshire
LU4 0LX
Tel: 01582 700343
London Road (Rehab)
105 London Road
Luton
LU1 3RG
Tel: 01582 708900
Crisis Resolution & Home Treatment Team
Calnwood Court
Calnwood Road
Luton
LU4 0FB
Tel: 01582 556971
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UNITS Contact Details – Bedford
Weller Wing (Keats Ward)
Kempston Road
Bedford
MK42 9DJ
Tel: 01234 299985
Weller Wing (Chaucer Ward)
Kempston Road
Bedford
MK402 9DJ
Tel: 01234 299966
Fountains Court (older people ward)
Bedford Health Village
3 Kimbolton Road
Bedford
MK40 2NT
Tel: 012134 310792
Bedford Mental Health Assessment Unit
Weller Wing
Kempston Road
Bedford
MK42 9DJ
Tel: 01234 299963
Bedford & Mid Beds Crisis Resolution &
Home Treatment Team
Weller Wing
Kempston Road
Bedford
MK42 9DJ
Tel: 01234315691
Bedford Section 136 Suite (Place of Safety)
Weller Wing
Kempston Road
Bedford
MK42 9DJ
Tel: 01234315691
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