Prison Transfers

Two doctors – one of whom must be section 12 approved – with the authorisation of the UK Home Secretary, can decide to transfer you from prison to hospital if they believe that you need treatment for a serious mental disorder.

A decision to detain is often taken because it is deemed to be in the best interests of health and safety – both of the individual affected, fellow prison inmates and prison staff  – to administer any treatment in hospital.

Under section 47 of the Mental Health Act, an individual can be detained in hospital for up to six months – unless a doctor or mental health professional deems it necessary for a person to remain in hospital for further treatment, in which case a person can be detained for a further six months.

After the second six-month period lapses, a detainment order can be renewed at 12-month intervals.

Under section 49 of the Mental Health Act 1983, an individual with a determinate sentence can be held in hospital up until their release date from prison. Following release, a person can only be detained under section 41(5) if  they need to remain in hospital. 

A section 45 can last up to six months and can be renewed for an additional six months. After the second six months lapses, the section can be renewed annually.

For individuals with indeterminate sentences, a section 49 does not expire until discharge from hospital.

The following have the authority to discharge a person from hospital:

• A Doctor
• Hospital Managers 
• A Tribunal

For individuals held under a section 47, a doctor can discharge an individual at any time. For those detained under a section 49, a doctor can recommend to the UK Home Secretary that a person be discharged.

Hospital managers can discharge you following a review of your case. They will review reports prepared by doctors, social workers, nurses and anyone else involved in your care while in hospital. They will also speak to an individual directly to determine what their wishes are.

Additionally, hospital managers can adjourn for further information or make informal recommendations about your case.  

A Tribunal can discharge an individual. A Tribunal is an independent panel of three people – a lawyer, a psychiatrist and a layperson. Reports will be provided by a doctor and nurses concerning an individual’s case. 

After reviewing the reports, a Tribunal can:

• Discharge a person (immediately or delayed for a period of time)
• Adjourn for further information
• Make formal recommendations on whether a person should be discharged, remain in hospital or return to prison

During a Tribunal, an individual does have the right to challenge evidence provided by medical professionals.

If a section 47 expires, the detainee can no longer be held in hospital and will be discharged. However, if a patient’s sentence has not come to end, and they are not yet eligible for parole, they will be returned to prison.

Under section 47, only a doctor can give authorisation for an individual to leave the hospital for a brief time. This is done under section 17 of the Mental Health Act. Leaving a hospital is time restricted and can be subject to conditions, such as being escorted by a nurse. 

If an individual fails to adhere to time limits or restrictions, they can be brought back to hospital, by the police if necessary. It is up to the individual’s clinical team to make decisions about leave within the hospital grounds.

Under section 49, an individual is prohibited from leaving hospital grounds without permission of the UK Home Secretary – even for a short time.

Any leave granted is time restricted and can be subject to conditions, such as being accompanied by a nurse. If the time limits or restrictions are not kept, the person can be brought back to hospital, by the police if necessary.

It is up to the clinical team to make decisions about leave within the hospital grounds.

Medication can be administered for up to three months, without an individual’s consent, if they are detained under a section 47 or 49. After the three months, except in an emergency, if a person refuses to consent to medication, the opinion of a second doctor is required before medication can be forcefully administered.