Community Treatment Orders (CTOs) exist under Section 17A Mental Health Act 83. A CTO can be imposed at the point of discharge to a patient subject to section 3 or 37. A CTO suspends the section 3 or 37 authorisation for detention unless and until the patient is recalled to hospital.Patients subject to CTOs can be recalled to hospital by the Responsible Clinician.A recall notice is then served on the patient, who can be detained for up to 72 hours.By the end of this period the CTO must be revoked or the patient released.A recall decision may be made on the basis that in the RC’s opinion the patient requires medical treatment in hospital for their mental disorder and there is a risk to the patient or others if they are not recalled. The RC does not have to have examined the patient prior to issuing such a notice.The patient can also be recalled for failure to make themselves available as required by the compulsory statutory conditions. Breaching any of the other conditions is not sufficient reason for recall. The CTO recall notice must take the form of form CTO3. It should be given to the patient personally if possible. On the patient’s arrival at the hospital a form CTO4 must be completed, logging the time of their detention. This marks the beginning of the period of up to 72 hours during which their care must be planned. The form CTO5 is used if a decision to revoke the CTO is then taken. If a patient cannot be persuaded to attend hospital, the community team should liaise with the inpatient team and consider seeking support of the police to achieve the patient’s admission to hospital. A warrant can be applied for under section 135 to allow a police officer to enter premises in order to retake the patient and convey them to a place of safety. Patients who are subject to a CTO can be admitted to hospital on an informal basis under Section 131.
The Lambeth Workhouse was a workhouse in Lambeth, London. The original workhouse opened in 1726 in Princes Road (later, Black Prince Road). From 1871 to 1873 a new building was constructed in Renfrew Road, Lambeth. The building was eventually turned into a hospital. The workhouse’s former master’s house and chapel are now occupied by the Cinema Museum.
The 19th-century workhouse was built for 820 inmates, divided by sex into two groups. It cost £64,000 to build and replaced the workhouse in Princes Road.The central block – originally the Master’s House – has been retained and converted for use as a small private cinema. Known as the ‘Cinema Museum’ it houses a large collection of films assembled by Robert Grant. It has become an extensive archive of historical and social importance. Ronald Grant and Martin Humphries established the Cinema Museum in 1986 to safeguard its future. It is still going.
The Cinema Museum, formerly the master’s house and chapel of Lambeth Workhouse.
The water tower of the workhouse is Grade II listed. In 2011, it was converted into an unusual residence with a lift and observation gallery made from the large water tank on the eighth floor. The new interior was designed by Sue Timney and the development was featured on the television show Grand Designs. The location also acts as a photoshoot and filming location.
Charlie Chaplin was sent to the Lambeth Workhouse when he was seven years old, as a consequence of the financial difficulties of his family.
“Steps will be taken to grow and support the National Health Service’s workforce and a new visa will ensure qualified doctors, nurses and health professionals have fast-track entry to the United Kingdom. Hospital car parking charges will be removed for those in greatest need.
My Ministers will seek cross-party consensus on proposals for long term reform of social care. They will ensure that the social care system provides everyone with the dignity and security they deserve and that no one who needs care has to sell their home to pay for it. My ministers will continue work to reform the Mental Health Act.”
It was Christmas Eve in the workhouse
The beadle was pissed as a newt,
The cold froze the porridge right over
And affected brass monkeys to boot.
The paupers looked forward to Christmas
As a time of indulgence and fun,
They got cocoa instead of cold water
A cracker, double porridge and buns.
The dinner was really the favourite
The thing they looked forward to best,
Featuring bulk issue reconstitute chicken
Which weren’t poorly but just looked depressed.
They could sing if they did it quietly
They could eat until they nearly felt full
They could kneel and pray extra long praises
Give thanks and other such bull.
So excitement were rising each minute
As Christmas came nearer their way
But just seconds before it struck midnight
A terrible voice said “Nay!”
“What bastard has pissed in me clog!”
(Twas the beadle who shouted in rage)
“For this no-one eats Christmas dinner
And I’ll put you each back in your cage.”
For he was a sensitive person
Who liked a laugh with the lads
But he got the hump at pissing in footwear
He’d borrowed that day off his dad.
“You’ll have nowt but stale bread and water”
Said he “Till the culprit owns up”
But no-one said they had done it
So the beadle locked them all up.
They spent the whole day bewailing
That their dinner had gone to the dog
And they cursed in despair that awful day
Someone pissed in the beadle’s clog.
But here comes that part of the story
The moral and pointed bit
That makes you see God’s got a plan
So you laugh and don’t give a shit:
The chicken was packed in Argentina
A friendly South American place
And was teeming and creeping with typhoid
That came from the old River Plate.
And so in the other workhouses
The paupers were dropping like flies
But as to this one it was only
The usual high average died.
And the paupers danced and sang praises
That they’d only had water and bread
Which doubled as a wake for the beadle who’d
Ate chicken and now was well dead.
So the moral we see quite clearly:
This is: God loves the poor,
And if you’ve only got bread and water
Why! he loves you ten times more.
So leave it all to your masters
It’s all for the best in the end
Don’t shout and be stubborn and nasty,
If the boss says bend, YOU BEND!
And the paupers have got a new beadle
Who never gets piss in his clog
Cos the typhoid that did for the old one
Also slayed his incontinent dog.
A Mental Health Act managers’ review is normally held at a hospital.
The following people will usually be there:
- The managers
- Your responsible clinician
- A nurse from the ward or your community nurse
- A social worker
- A hospital administrator
Your nearest relative may be invited if you want them to be there. If you do not want your nearest relative there, they can share their views in the reports of the hospital team. You also have the option of asking an Advocate to attend in order to give you support. In certain circumstances you can seek the attendance of a legal representative.
The managers will have read through the reports. Make sure you have had an opportunity to read the reports prior to the meeting. Remember that you can ask for the meeting to be delayed/adjourned if you have not had time to fully read the reports. After this the chairperson will give you a chance to speak. At the end of the hearing the hospital managers will decide if you should stay under your section or be discharged from it. Being discharged from the Section does not mean you are discharged from hospital – if the doctor suggests you can remain in hospital informally (that means voluntarily) then you are able to decide this for yourself. All three of the managers have to agree for you to be discharged unanimously. Even if only one of the managers disagrees then the Section will remain in place.
The government has put in place a number of precautions to prevent medication shortages regardless of what happens during Brexit. However, make sure to voice your concerns to your local Pharmacist. They’re a fantastic resource and can give you more up to date information on any medication that might be an issue and in case of any delays in obtaining them will know exactly what to do. The government has also introduced a “serious shortage protocol” for the antidepressant Fluoxetine, which allows pharmacists to give patients an alternative strength or form of the drug because of temporary shortages of some doses.