Coronavirus (COVID-19)

Please continue to wear your face mask while you are in our hospitals and community services.

For health information and advice, read our pages on coronavirus. Learn about the government response to coronavirus on GOV.UK

Section 48 – Transfer to hospital of an unsentenced prisoner (with or without restrictions)

An information leaflet for unsentenced prisoners who have been transferred to hospital. It includes information about why you are in hospital, what a restriction direction is, how long you will be there and what happens if you have to go back to court.

Quality Approved Resource logo

This leaflet may not be reproduced in whole or in part, without the permission of Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

Section 48 English (255kB)

  • 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.........................................................................................................................

    Restiction direction in place? Yes/No

  • Why am I in hospital?

    You have been moved 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 48 of the Mental Health Act 1983 that allows an unsentenced prisoner to be transferred to hospital.

    The Secretary of State may also have given you a restriction direction under section 49 of the Mental Health Act.

  • What is a restriction direction?

    If you have been given a restriction direction, it means that you cannot be discharged from hospital unless the Secretary of State for Justice says that you can leave. In this case, your discharge may be subject to certain conditions that would be explained to you nearer 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.

  • How long will I be here?

    You will be kept in hospital until your transfer direction ends.

    If you have been transferred here after being remanded by a Magistrates’ Court:
    you will be kept in hospital until your period of remand ends, unless you are sent to the Crown Court for trial or you are remanded again by the Magistrates’ Court (in which case you will stay in hospital). The Magistrates’ Court can also order the transfer direction to end if your responsible clinician says that you no longer need medical treatment for a mental disorder in hospital. You would then return to prison, unless the court decides to release you on bail.

    If you have been transferred here as a civil prisoner or under immigration laws:

    you will be kept in hospital until the date when you would have been released from prison or removed from the detention centre, unless your responsible clinician says you no longer need treatment. If you have been given a restriction direction and your responsible clinician says that you no longer need treatment, you will be returned to prison or a detention centre.

    In other cases:

    you will be kept in hospital until your responsible clinician says you no longer need treatment or until your case has been decided by the court. If your responsible clinician says you no longer need treatment you will be returned to prison, unless the court decides to release you on bail.

  • Can I be kept in hospital after the transfer direction ends?

    It is possible that you will be kept in hospital under a different section of the Mental Health Act if you need more treatment after your transfer direction ends. If so, you will be given another leaflet to explain this.

  • What will happen if I have to go back to court?

    If you are on remand and have not yet stood trial, you may have to go back to court. The Court will look at your case and may make a hospital order under section 37 of the Mental Health Act saying you should stay in hospital, or may give you an alternative sentence. The Court can only make a hospital order if two doctors say that you have a mental disorder and that you need to be treated under the Mental Health Act.

  • Can I appeal?

    You cannot appeal against the Secretary of State for Justice’s decision to transfer you to a hospital, or against remand by a magistrates’ court.

    But there are people you can ask to let you leave hospital.

    If you have not been given a restriction direction, you can ask the Hospital Managers to let you leave hospital. You can do this at any time. The Hospital Managers are a special committee of people set up within the hospital to decide whether people should be kept in hospital. The Hospital Managers may want to talk to you before deciding whether to let you leave. If you want to do this, you can write to the Hospital Managers at your local Mental Health Act Office at either:

    Mental Health Act Office
    St Nicholas Hospital
    Jubilee Road
    Gosforth
    Newcastle upon Tyne

    Mental Health Act Office
    Carleton Clinic
    Cumwhinton Drive
    Carlisle
    Cumbria
    CA1 3SX

    Or you can ask a member of staff to help you contact the Hospital Managers.

    Whether or not you have been given a restriction direction, 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 the 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 have not been given a restriction direction, your nearest relative can also apply to the Tribunal once during the second six months after your transfer direction and once in every year after that. This leaflet explains further down who your nearest relative is.

    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, it may mean you are taken back to prison or a detention centre, unless the Tribunal has recommended you stay in hospital.

  • 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.

  • Letting your nearest relative know

    If you have not been given a restriction direction, a copy of this leaflet will be given to the person the Mental Health Act says is your nearest relative.

    There is a list of people in the Mental Health Act who are treated as your relatives. Normally, the person who comes highest in that list is your nearest relative. The hospital staff can give you a leaflet which explains this and what rights your nearest relative has in connection with your care and treatment.

    In your case, we have been told that your nearest relative is:

    ..................................................................................................................................................................

    If you do not want this person to receive a copy of the leaflet, please tell your nurse or another member of staff.

  • Changing your nearest relative

    If you do not think this person is suitable to be your nearest relative, you can apply to the County Court for someone else to be treated as your nearest relative instead. The hospital staff can give you a leaflet that explains this.

  • 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:
    • talk to the people directly involved in your care
    • ask a member of staff for a feedback form, or complete a form on the Trust website www.cntw.nhs.uk (click on the ‘Contact Us’ tab)
    • telephone the Complaints Department 0191 245 6672
    • email complaints@cntw.nhs.uk Please note that information sent to the Trust via email is sent at your own risk
    • 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 from staff.

    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
    2021 Copyright, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

    Ref, PIC/202/0221 February 2021 V10
    www.cntw.nhs.uk Tel: 0191 246 7288
    Review date 2024