Summary: Ms X complained that she was wrongly detained under the Mental Health Act, that the doctor involved in the assessment did not speak to her, and that information in her notes was wrong. We will not investigate Ms X’s complaint as it is late, and we have seen no good reason to investigate it now.

The complaint

1. Ms X complains she was wrongly detained under the Mental Health Act (MHA), following an assessment in 2021. Ms X also complains about how Westminster City Council (the Council), Central and North West London NHS Foundation Trust (the Trust), and NHS North London Integrated Care Board (the ICB) carried out the assessment. She said the doctor involved in the assessment did not speak to her. Ms X further complains that information recorded in her notes during the assessment was incorrect, meaning the assessing doctors were not aware of her medical history.
2. Ms X explained the impact of these events has been long lasting. She said to have her freedom taken away and to be given medication against her wishes was traumatising.
3. As an outcome of her complaint, Ms X wants the people involved to apologise and take responsibility to prevent this happening to anyone else. Ms X also seeks financial remedy.

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The Ombudsmen’s role and powers

4. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
5. We cannot investigate late complaints unless we decide there are good reasons. Late complaints are when someone takes more than 12 months to complain to us about something an organisation has done. (Local Government Act 1974, sections 26B and 34D, as amended, and Health Service Commissioners Act 1993, section 9(4).)

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How I considered this complaint

6. I considered evidence provided by Ms X, the Council and the Trust, as well as relevant law, policy and guidance.
7. I considered the Ombudsman’s Assessment Code.
8. Ms X had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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Relevant legislation

9. Under the Mental Health Act 1983 (MHA), when someone has a mental disorder and is putting their safety or someone else’s at risk they can be detained in hospital against their wishes. This is sometimes known as ‘being sectioned’. Usually, three professionals need to agree that the person needs to be detained in hospital. These include an Approved Mental Health Professional (AMHP) and usually (but not always) two doctors who have been specially approved to carry out Mental Health Act assessments (Section 12 doctors).
10. The AMHP is responsible for deciding whether to go ahead with the application to detain the person and for telling the person. They are also responsible for providing information about the proposed detention to the person’s Nearest Relative. Any admission to hospital under the Mental Health Act should be in the best interests of the person and they should not be detained if there is a less restrictive alternative. Local authorities are responsible for the actions of AMHPs.
11. When Section 12 doctors make recommendations under sections 2 or 3 of the MHA, they are acting under powers which have been given to them under the MHA. Ultimately, the doctors are providing their medical recommendations on behalf of the NHS. Because of this, the Parliamentary and Health Service Ombudsman can consider complaints about this work.
12. In this complaint, one Section 12 doctor was working for the NHS Trust that detained Ms X under Section 2 at the time of the MHA assessment. The second Section 12 doctor did not work for the NHS Trust. The ICB had a legal responsibility to pay for this doctor for attending to complete the MHA assessment. The ICB is therefore the responsible commissioner. This explains why both the NHS Trust and ICB are organisations in this complaint.  

My assessment

13. In 2021, Ms X was assessed under the MHA. The outcome of the assessment was that Ms X was admitted to hospital under Section 2 of the MHA.
14. Ms X explained that in 2024, she received a letter regarding her diagnosis. Ms X disagreed with the diagnosis and complained to the Trust. In her complaint, she also raised concerns about how the MHA assessment was carried out, and said the decision to detain her was wrong.
15. Ms X was dissatisfied with the Trust’s response and complained to the Ombudsmen.
16. I recognise that Ms X said she was not aware of her diagnosis until 2024. However, she explained she was aware of her concerns about the MHA assessment at the time it took place. Ms X said she continually raised her concerns with the people involved. The available evidence indicates she formally complained about the assessment in 2024, after receiving the information about her diagnosis. Ms X explained that the assessment and hospital admission were distressing and had a long-lasting impact on her.
17. I recognise Ms X’s explanation that this was a distressing and difficult time for her. However, Ms X was aware of her concerns about the assessment at the time, and did not complain to the Ombudsmen until 2024. Because of the amount of time that has passed since the assessment took place, it is unlikely we would be able to establish how the doctors communicated with Ms X during the assessment if we investigated her complaint now. Based on the available information, I have not seen good reasons for us to investigate Ms X’s complaint about the MHA assessment and decision now.

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Decision

18. We will not investigate Ms X’s complaint about the MHA assessment, as it is late and I do not consider there are good reasons to investigate it now.

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Investigator's decision on behalf of the Ombudsman