Hospital managers must ensure staff know it is inappropriate to recommend lawyers to mental health patients who are appealing against detention under the Mental Health Act, the Care Quality Commission has urged.

This is one of a number of recommendations made in the first ever report into first-tier tribunals, formerly known as Mental Health Review Tribunals.

The report also recommends that hospital staff should explain to patients the purpose of the visit and the fact that the medical member of the tribunal will visit them to carry out a pre-hearing examination.

It says that hospital staff have a duty to tell patients - verbally and in writing - of their legal position and their right of appeal to the tribunal.

The report also states that hospitals must ensure that tribunal hearing rooms meet the required specification, particularly that they are large enough to accommodate all parties, but that they do not become overcrowded.

In 2009/10 there were more than 25,000 first-tier tribunals, an increase of almost 5,000 on the previous year, at least partly due to the introduction of community treatment orders, the report says.

CQC Mental Health Act commissioners interviewed more than 150 patients for the report, and found a very mixed picture.

They found that delays were significant in shaping patients’ negative views of the process, and they said that a lack of information about how long the process would take also caused distress for some patients.

CQC chairman Dame Jo Williams said people going through the tribunal process “placed a great deal of hope” in it.

“It is important for their wellbeing that they come out of the tribunal, whether successful or not, feeling that they have been treated fairly and given every opportunity to make their case,” she said.