• Mental Health Act requirements for CCGs not being implemented properly, government report warns
  • Report comes after health secretary Matt Hancock was warned by a coroner MHA duties were being “ignored”

NHS commissioners are failing to carry out their duties under the Mental Health Act, a report by the Department of Health and Social Care has warned. 

The unpublished report, seen by HSJ, was commissioned partly in response to Sir Simon Wessely’s review of the act, which said clinical commissioning groups must carry out their duties more effectively and consistently.

The report, completed in November 2019, relates to Section 140 of the MHA, which is designed to ensure the safe and appropriate admission of people in need of urgent care in their local area.

An approved code of practice says joint policy should be agreed between CCGs, councils, police forces, and ambulance services.

Professionals should also understand the roles and responsibilities of all agencies and individuals involved and receive the necessary training to be able to carry out their functions under the policy.

However, the DHSC report found requirements under section 140 were “not being implemented properly in many areas of the country”.

It was only able to find two examples of joint section 140 agreements and found “a lack of awareness amongst professionals and organisations of the meaning and responsibilities of [section] 140”.

The report made several recommendations, including:

  • Integrated care systems and sustainability and transformation partnerships should ensure they have a section 140 agreement in place;
  • Each area should have regular discussions about how admission to hospital is operating and how to resolve any ongoing problems and issues, updated by accurate, shared data;
  • The commissioning of beds in urgent cases by ICSs or STPs working with partner agencies should be a priority, along with clarity about what is an “urgent” case;
  • Agreements should include the availability of approved mental health professionals, section 12 doctors and the response times of ambulances or other mental health response vehicles; and
  • The Care Quality Commission should monitor how section 140 of the act and code guidance is implemented.

In early 2019, a senior coroner for Leicestershire wrote to health and social care secretary Matt Hancock warning CCGs’ statutory section 140 requirements were being “ignored”. This case is cited within the DHSC’s report.

The coroner’s warning was in response to the death of David Stacey in 2017. He was assessed as needing admission under the MHA, but no application was made because the mental health team was not aware of any available beds. The inquest found there were in fact available beds.

A separate CQC report has previously highlighted “low awareness” about the code of practice last year, as well as outdated training for staff within providers, and concerns over governance and monitoring.

HSJ has approached DHSC for comment.