Skip to main content Accesibility Help
×
×
Home

Understanding community care law in England and Wales

  • Danny Allen
Summary

Although psychiatrists in England and Wales are generally familiar with the Mental Health Act 1983 and the Mental Capacity Act 2005, there is a body of law that is available to assist patients in the community with which they are generally less familiar. There are two main reasons for this. The first is that it is a rather confused amalgam of different statutes and case law affecting each other in ways that are less than clear. The other is that the care programme approach (CPA) was meant to cut through all this and make care provision straightforward. In fact, the latter has never been the case and community care law has always sat uneasily alongside the CPA, but in October 2008 the CPA was withdrawn from some patients with mental health problems. This article explains what is meant by community care law and how psychiatrists can use it to help their patients.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Understanding community care law in England and Wales
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Understanding community care law in England and Wales
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Understanding community care law in England and Wales
      Available formats
      ×
Copyright
Corresponding author
Dr Danny Allen, Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust, Harlow House, Harlow Road, High Wycombe HP13 6AA, UK. Email: danny.allen@obmh.nhs.uk
Footnotes
Hide All

Declaration of Interest

None.

Footnotes
References
Hide All
Clements, L (2004) Community Care and the Law. Legal Action Group.
Department of Health (1990a) The Care Programme Approach for People with a Mental Illness Referred to the Specialist Psychiatric Services (Health Circular HC(90)23; Local Authority Social Services Letter LASSL(90)11). Department of Health.
Department of Health (1990b) Caring for People. Community Care in the Next Decade and Beyond. Policy Guidance. (TSO) The Stationery Office.
Department of Health (1993) Approvals and Directions for Arrangements from 1 April 1993 Made Under Schedule 8 to the National Health Service Act 1977 and Sections 21 and 29 of the National Assistance Act 1948 (Local Authority Circular LAC(93)10). Department of Health.
Department of Health (1996a) Building Bridges: Arrangements for Inter-Agency Working for the Care and Protection of Severely Mentally Ill People (HSG (95)56). Department of Health.
Department of Health (1996b) Guidance on Mental Health (Patients in the Community) Act 1995 (accompanying Local Authority Circular LAC(96)8 and Health Service Guidelines HSG(96)11). Department of Health.
Department of Health (2002) Fair Access to Care Services. Guidance on Eligibility Criteria for Adult Social Care (Local Authority Circular LAC(02)13). Department of Health.
Department of Health (2008a) Refocusing the Care Programme Approach: Policy and Positive Practice Guidance. Department of Health.
Department of Health (2008b) Transforming Social Care (Local Authority Circular LAC (DH)(2008)1). Department of Health.
Department of Health, Social Services Inspectorate (1999a) Still Building Bridges. The Report of a National Inspection of Arrangements for the Integration of the Care Programme Approach with Care Management: para 1.28. Department of Health and Social Services Inspectorate.
Department of Health, Welsh Office (1999b) Code of Practice to the Mental Health Act 1983. (TSO) The Stationery Office.
R (on the application of Barry) v. (1) Gloucestershire County Council and (2) Secretary of State for Health [1997] 1 CCLR 40.
R (on the application of Fox) v. Ealing District Health Authority [1993] 1 WLR 373.
R (on the application of HP and KP) v. London Borough of Islington [2004] EWHC 7 Admin.
R (on the application of K) v. Camden and Islington Health Authority [2001] EWCA Civ 240.
R (on the application of M) v. Avon County Council [1994] 2 FLR 1006.
R (on the application of Munjaz) v. Ashworth Hospital Authority (now Mersey Care National Health Service Trust) [2005] UKHL 58.
R (on the application of Stennett and others) v. Manchester City Council [2002] UKHL 34.
R (on the application of Tucker) v. Sutton London Borough Council [1998] 1 CCLR 251.
R (on the application of Wahid) v. Tower Hamlets London Borough Council [2002] WL 237056.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Understanding community care law in England and Wales

  • Danny Allen
Submit a response

eLetters

The problem of community treatment orders

Zekria Ibrahimi, psychiatric patient
22 January 2010

According to the author the care programme approach (CPA) is a bureaucratic device, not a legal necessity, and it has been in effect downgraded since October 2008. The alternative is Section 47 under the National Health Service and Community Care Act 1990.

What is less clear is how CPA or Section 47 would link up with another new instrument of the Mental Health Act 2007, community treatment orders (CTOs), which the author does not mention.

Someone on a CTO would presumably be diagnosed as extremely ill, and would be more in need of Section 47 provisions. It would be shocking if placement on a CTO, which restricts the freedom of a patient so much, did not guarantee more access to resources even though they may be scarce- such as direct payments, and housing.

Illumination through legal precedent, case law and statute is not enough. How community care and community treatment orders function (or do not function) cannot be understood without an evidence base and randomised controlled trials. For example, maybe care within the family for the mentally ill is not so good as care from mental health professionals.

CTOs are now law, but they have a poor evidencebase (1). Some psychiatrists believe that they are not a magic cure for the revolving door syndrome (2). The unexpectedly large numbers put onto community treatment orders (3) call for another APT article, on how CTOs link up with community care law revolving round Section 47.

REFERENCES:

(1)Community treatment orders BMJ editorial Krishma Jethwa, Nuwan Galappathie. BMJ 2008;337:a613 (27 September)

(2)Community treatment orders are not a good thing. Simon Lawton-Smith/John Dawson and Tom Burns. BJPsych (2008) 193, 96-100.

(3) Community treatment orders. Jorun Rugkasa, Tom Burns. Psychiatry.Volume 8:12 December 2009. 493-495.
... More

Conflict of interest: None Declared

Write a reply

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *