Section 47(49) – Transfer to hospital with restrictions of a person serving a sentence of imprisonment

An information leaflet for people serving a sentence of imprisonment who have been transferred to hospital from prison. It explains why you are in hospital, what a restriction direction is, how long you could be there, and if you can be returned to prison.

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  • Patients name and ward

    1. Patient’s name

    ………………………………………………………………………………………………………………………………………………

    2. Name of the person in charge of your care (your “responsible clinician”)

    ……………………………………………………………………………………………………………………………………………..

    3. Name of hospital and ward

    ………………………………………………………………………………………………………………………………………………

    4.Date of your transfer direction………………………………………………………………………………………………………….

  • Why am I in hospital?

    You have been moved from prison to this hospital because the Secretary of State for Justice has been advised by two doctors that you have a mental disorder and that you need to be in hospital for medical treatment.

    The Secretary of State for Justice has issued a “transfer direction” under section 47 of the Mental Health Act 1983, which allows a sentenced prisoner to be transferred to hospital. You have also been made subject to a restriction direction.

  • What is a restriction direction?

    A restriction direction is made under section 49 of the Mental Health Act by the Secretary of State for Justice when he directs the transfer of a sentenced prisoner to hospital.

    It means that you cannot be discharged from hospital unless the Secretary of State for Justice or the Parole Board says that you can leave, and your discharge may be subject to certain conditions that would be explained to you at the time. While you are in hospital the person in charge of your care (your responsible clinician) must get the Secretary of State for Justice’s agreement before you can go on temporary leave or be sent to another hospital. They must also examine you and send a report about you to the Secretary of State at least once a year.

  • How long will I be here?

    Your responsible clinician will tell you when they think you are well enough to leave hospital. They will then ask the Secretary of State for Justice to agree. Until the Secretary of State has agreed, you cannot leave the hospital. If you try to leave the staff can stop you, and if you do leave, you can be brought back.

  • Can I be returned to prison?

    If your responsible clinician thinks that you no longer need treatment in hospital, you could either be returned to prison to serve the rest of your sentence or you could be released from hospital on the same terms on which you would be released from prison.

  • What happens if my sentence ends while I am in hospital?

    If your sentence ends while you are in hospital and you still need treatment, you can be kept in hospital. Your responsible clinician will tell you when you are ready to leave. If your responsible clinician decides you should stay in hospital, you will be given another leaflet telling you what will happen.

  • Can I appeal?

    Yes. You can ask a Tribunal to say that you should not be kept in hospital.

  • What is a Tribunal and what happens?

    The Tribunal is an independent panel which can decide whether you should be allowed to leave the hospital. It will hold a meeting with you and with staff from the hospital who know you. This meeting is called a “hearing”. You can ask someone else to come to the hearing to help you, if you want. Before the hearing, the members of the Tribunal will read reports from the hospital about you and your care. One of the members of the Tribunal will also come to talk to you.

  • When can I apply to the Tribunal?

    You can apply to a Tribunal once at any time during the first six months after you were given your transfer direction.

    You can then apply once during the next six months and then once in every year you are kept in hospital after that.

    If you want to apply to the Tribunal you can write to:
    The Tribunals Service
    PO BOX 8793
    5th Floor
    Leicester
    LE1 8BN
    Tel. 0300 123 2201

    You can ask a solicitor to write to the Tribunal for you and help you at the hearing. The hospital and the Law Society have a list of solicitors who specialise in this. You will not have to pay for help from a solicitor with this. It is free of charge under the Legal Aid scheme.

  • What happens if the Tribunal says I should not be kept in hospital?

    If the Tribunal says you should not be kept in hospital, the Secretary of State for Justice is unlikely to agree to your release before you have served your sentence. You are likely to be returned to prison to serve the rest of your sentence, unless the Tribunal has recommended you stay in hospital instead.

  • What treatment will I be given?

    Your responsible clinician and other hospital staff will talk to you about any treatment that you need for your mental disorder. In most cases you will have to accept their advice.

    After three months, there are special rules about any medicine or drugs you are being given for your mental disorder. If you do not want the medicine or drugs, or are too ill to say whether you want them, a doctor who is not from this hospital will visit you. This independent doctor will talk to you and to staff at the hospital who know you. The independent doctor will decide what medicine and drugs you can be given. Unless it is an emergency, these are the only medicine and drugs you can be given without your agreement.

    This independent doctor is called a SOAD (Second Opinion Appointed Doctor) and is appointed by an independent Commission which monitors how the Mental Health Act is used.
    There are different rules for some special treatments, like electro-convulsive therapy (ECT). If the staff think you need one of these special treatments, the rules will be explained to you and you will be given another leaflet.

  • Help from an independent mental health advocate

    You are entitled to help from an independent mental health advocate if you want it. These advocates are independent of people involved in your care. They can help you get information about your care and treatment, why you are being kept in hospital, what it means and what your rights are. They can come to see you and help you understand what you are told by people involved in your care and treatment. If you want, they can help you talk to these people or they can talk to them for you. They can also help you with the Tribunal.

    You can contact the independent mental health advocacy service yourself. Please ask a member of staff for the telephone number. There should be a telephone where you can talk to them in private. You can ask a member of staff where this is.

    If you do not want to contact the advocacy service yourself, you can ask a member of staff to contact the advocacy service for you.

  • Your letters

    All letters sent to you will be given to you. You can send letters to anyone except someone who has said they do not want to get letters from you. Letters to these people can be stopped by the hospital staff.

  • Code of Practice

    There is a Code of Practice that gives advice to the staff in the hospital about the Mental Health Act and treating people for mental disorder. The staff have to consider what the Code says when they take decisions about your care. You can ask to see a copy of the Code, if you want.

  • What if I have a comment, suggestion, compliment or complaint about the service?

    If you want to make a comment, suggestion, compliment or complaint you can:

     
    We are always looking at ways to improve services. Your feedback allows us to monitor the quality of our services and act upon issues that you bring to our attention. You can provide feedback in the following ways:

    • the quickest way for you to do this is to complete our short online survey at www.cntw.nhs.uk/poy
    • complete a Points of You survey, available on wards, reception areas or from staff
    • other options for sharing your feedback and experience www.cntw.nhs.uk/yourfeedback

     
    Patient Advice and Liaison Service (PALS)
    PALS provide confidential advice and support, helping you to sort out any concerns that you may have about any aspect of your or your loved ones care.

    We act independently when handling patient and family concerns, liaising with staff, managers and, where appropriate, relevant organisations, to negotiate prompt solutions. If necessary, we can also refer patients and families to specific local or national-based support agencies.

    North of Tyne
    Tel: 0800 032 0202
    Email: [email protected]
    Post: FREEPOST PALS

    South of Tyne
    Tel: 0800 328 4397
    Text: 07825 061 035
    Email: [email protected]
    Post: Patient Advice and Liaison Service, Garden Lodge, Hopewood Park, Ryhope, Sunderland, SR2 0NB

    9am – 4.30 pm, Monday to Friday
    An answerphone is available at all times for you to leave a message. A member of the PALS team will aim to return your call as soon as possible.

    If you do not feel that the hospital complaints procedure can help you, you can complain to an independent Commission. This is called the Care Quality Commission and it monitors how the Mental Health Act is used, to make sure it is used correctly and that patients are cared for properly while they are in hospital. The hospital staff can give you a leaflet explaining how to contact the Commission.

  • Further help and information

    If there is anything you do not understand about your care and treatment, a member of staff will try to help you. Please ask a member of staff to explain if there is anything in this leaflet you do not understand or if you have other questions that this leaflet has not answered.

    Please ask if you would like another copy of this leaflet for someone else.

  • Information about content, other formats, version control

    Further information about the content, reference sources or production of this leaflet can be obtained from the Patient Information Centre. If you would like to tell us what you think about this leaflet please get in touch.

    This information can be made available in a range of formats on request (eg Braille, audio, larger print, easy read, BSL or other languages). Please contact the Patient Information Centre Tel: 0191 246 7288

    Published by the Patient Information Centre
    2024 Copyright, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
    Ref, PIC/203/0124 January 2024 V10
    www.cntw.nhs.uk Tel: 0191 246 7288
    Review date 2027