Ms A was detained under the Mental Health Act (“the MHA”) in Wales. In October 2015, she moved to a secure hospital (“the Hospital”) in England. In March 2016, Ms A was discharged from detention. This meant she was free to leave the Hospital, but she agreed to remain there on a voluntary basis while aftercare and supported accommodation were arranged to support her safe discharge into the community. Ms A remained in the Hospital until February 2017. Throughout, the Health Board remained the responsible body under the legislation to ensure Ms A’s aftercare services were provided to her in a timely manner.
Ms A’s Solicitor (“the Solicitor”) complained about the Health Board’s poor care after Ms A’s discharge from detention. The Solicitor said that the Health Board failed and/or delayed in providing Ms A with aftercare, appropriate supported accommodation and a referral to the Community Mental Health Team in England (“the CMHT”). In addition, the Solicitor complained that the Health Board failed to provide Ms A with mental health support and a safe environment during the time she remained at the Hospital as a voluntary patient. The Solicitor also complained about the Health Board’s poor complaints handling.
My investigation found that the Health Board should have made the necessary aftercare arrangements with the relevant NHS Trust in England before Ms A was discharged from detention. This contributed to the subsequent difficulties and delays.
However, the Health Board did make several referrals to the CMHT to find a solution which would progress Ms A’s reintroduction into the community. The CMHT did not accept Ms A’s referral until May 2017, and her aftercare was not properly in place until November 2017. I found that despite the Health Board’s attempts to resolve the issue, the main obstacle to progressing Ms A’s discharge from the Hospital to local supported accommodation was that the CMHT would not accept the referral from the Health Board until Ms A was registered with a local GP, was discharged from the Hospital, and had a local residential address. Ms A remained an inpatient at the Hospital for almost a year after her discharge from detention, on a locked rehabilitation ward with other patients detained under the MHA.
The Health Board acknowledged Ms A’s experience was neither acceptable nor in line with its usual practice but said it could not resolve the issues with the CMHT. From February 2017, it continued to fund a full inpatient service from the Hospital, so Ms A could receive the appropriate care package to enable her to move to the flat she had found.
I upheld Ms A’s complaints. I identified a need for cross-border health care guidance. I have shared my report with the Welsh Government for it to review whether action needs to be taken at an all Wales level to reduce the risk of a similar situation arising. Ms A’s human rights were also engaged as a result of the failures identified in my report. I recommended that the Health Board should:
- Provide Ms A with a fulsome and sincere apology from the Chief Executive for the failures identified.
- Refer Ms A’s case to its Legal & Redress Team to consider and pay appropriate financial redress in recognition of the distress caused to Ms A by the failures identified in this report and the unnecessary delays which compromised her right to a family life.
- Refer my report to the Board and to the Health Board’s Equalities and Human Rights team to identify how an individual’s human rights can be further embedded into its practices and procedures in respect of mental health care.
- Audit a sample of patients discharged from compulsory detention to somewhere outside the Health Board’s area to ensure that others have not been similarly disadvantaged.
- Pay Ms A £500 in recognition of the poor handling of her complaint and the additional unnecessary frustration and disappointment she experienced as a result.