Renewal of section or extension of a community treatment order

If you are detained under one of the sections of the Mental Health Act or are subject to a supervised community treatment order (CTO), and your doctor has renewed your section or extended your community treatment order, your detention will be reviewed by what is called a hospital managers’ panel.

This section aims to guide you through the review of a section renewal or extension of a community treatment order process and may also be of interest to your relatives or friends. It should be read in conjunction with the relevant patients’ rights leaflet which will have been issued to you by your named nurse or care co-ordinator or Mental Health Act administrator. You can get another copy from either of them.

The Mental Health Act office will have written to you informing you that your doctor has decided to renew your existing section or extend your existing community treatment order.

What does this mean?

Your named nurse or care co-ordinator will read you your rights which entitle you to contest (object to) the planned renewal of your section or extension of your community treatment order.

You will be asked how you wish your hospital managers hearing to held, either by video or by face to face, the choice is yours to make.

Who are the hospital managers?

The hospital managers are people who are specially trained and appointed for the purposes of hearing appeals of patients who are detained under the Mental Health Act (1983), or who are subject to a community treatment order.

What do they do?

The hospital managers have the power to discharge most detained patients from their section under the Mental Health Act (1983) and all patients subject to supervised community treatment orders. They cannot discharge patients who are remanded to hospital for a report on their mental condition under section 35 or remanded to hospital for treatment under section 36 or those subject to interim hospital orders under section 38, and they cannot discharge any patients who are detained under a restriction order.

What do I do now?

The Mental Health Act office will write to you acknowledging the renewal of your section or extension of your community treatment order, and will start the process for a hospital managers’ hearing.

Can I have legal representation?

Yes, you are entitled to have legal representation at hearings and the trust has a list of approved solicitors who are qualified to represent you at this type of hearing. The list and contact details are available from your named nurse or care co-ordinator or via the Mental Health Act administrator.

What happens next?

• The Mental Health Act administrator will request reports from the clinicians involved in your care:
  • doctor
  • care co-ordinator
  • named nurse
• The reports will contain information about the circumstances of your admission, your health, care and treatment received and what the plans are for your future care and treatment.
• The trust will aim to hear your appeal within four weeks from the date of your application and will give you details in writing of the date, time and venue of the hearing.
• Once the date has been set and the reports received, copies of all the reports will be delivered to you for you to read in advance of the hearing.
• Your named nurse or care co-ordinator will be available to assist you with this process.
• On the day of the hospital managers’ hearing, the panel will be composed of three members.
• Other people present at the hearing may include:
  • your care co-ordinator or social worker
  • your doctor
  • your nearest relative or friend
  • your independent mental health advocate (if you have asked for their support)
  • your named nurse (if you are an inpatient)
  • your solicitor (if you have decided to use one)

On the day of the hearing

• You will be asked to attend the hearing with your care coordinator, named nurse, doctor and solicitor if you have one. You can also have a friend, relative or independent mental health advocate accompany you.
• The panel members will have met and read the reports before the start of the hearing.

The hearing

• You and the others appearing before the panel will be introduced to the panel members by video or face to face, by the Mental Health Act administrator.
• The chair of the panel will explain the order of the hearing and what is to happen.
• The chair of the panel will ask you if you wish to meet with them privately before the hearing commences.
• The panel has to satisfy itself about matters regarding your health and welfare and what is in your best interests. It does this by considering the information contained in the reports provided and by asking questions during the hearing.
• Your concerns and questions will be dealt with during the hearing.
• The other panel members will also ask questions.
• Throughout the hearing you will be given every opportunity to challenge things people might say or the written reports you will have read. If you have a solicitor or independent mental health advocate they will help you do this.
• Once everyone has finished speaking, you and the professionals who have attended the hearing will all be asked to leave so that the panel can have a discussion and reach a decision on your appeal. This may take a little while as the panel has to carefully consider all the information provided.

The decision

• Everyone will be invited back into the hearing to be informed of the decision
• The chair of the panel will ensure that the decision of the panel is explained to you, your solicitor or independent mental health advocate (if you have one) and your named nurse. This will also be followed up in writing to you.

We hope this guide has answered some of the frequently asked questions. However, if there are any issues which have not been covered in this section, in the first instance, please speak to your named nurse who will contact the Mental Health Act office on your behalf.

Page last reviewed: May 15, 2025
Next review due: May 15, 2026