Summary: We will not investigate Mr X’s complaint about the care provided to him by Norfolk County Council, Norfolk and Suffolk NHS Foundation Trust and NHS Norfolk and Waveney Integrated Care Board. This is because an investigation would be unable to achieve the outcomes he is seeking.

The complaint

1. The complainant, Mr X, is complaining about the care provided to him by Norfolk County Council (the Council), Norfolk and Suffolk NHS Foundation Trust (the Trust) and NHS Norfolk and Waveney Integrated Care Board (the ICB).
2. Mr X complains that the Council, Trust and ICB failed to respect his wish to be discharged from section 117 aftercare and mental health services more generally. Mr X says the care they provided was heavy-handed and paternalistic, rather than of therapeutic benefit to him.
3. Mr X says the actions of these organisations has destroyed his trust in local services and increased his anxiety. He says he is now worried his autonomy may be further eroded through forced treatment.

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The Ombudsmen’s role and powers

4. We investigate complaints about ‘maladministration’ and ‘service failure’. We use the word ‘fault’ to refer to these. If there has been fault, we consider whether it has caused injustice or hardship (Health Service Commissioners Act 1993, section 3(1) and Local Government Act 1974, sections 26(1) and 26A(1), as amended).
5. We provide a free service but must use public money carefully. We may decide not to start or continue with an investigation if we believe we cannot achieve the outcome someone wants.

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How I considered this complaint

6. I considered evidence provided by Mr X and discussed the complaint with him. I also considered information provided by the Trust. In addition, I took account of relevant law, policy and guidance.
7. Mr X had an opportunity to comment on my draft decision. I considered his comments before making a final decision.

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What I found

Relevant guidance and legislation

Section 117 aftercare

8. The Mental Health Act 1983 (the MHA) allows that 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’.
9. A detention under section 3 of the MHA is for the purpose of providing treatment. A person who has been detained under section 3 of the MHA is entitled to free aftercare services under section 117 of the same legislation. These services are intended to prevent a deterioration in the person’s mental health and reduce the risk of them requiring further admission to hospital.
10. The duty to provide or arrange section 117 aftercare rests with the local authority and ICB.
11. The Code of Practice that accompanies the MHA (the MHA Code) sets out that a person’s section 117 aftercare needs should be clearly recorded in their care plan and subject to regular review.
12. Before they can discharge a person from section 117, the local authority and ICB must be satisfied the person no longer needs the aftercare services to prevent a deterioration in their mental health. The MHA Code says a person should not be discharged from section 117 simply because they have been discharged from specialist mental health services.

Discharge policy

13. The Trust produces a document entitled ‘Discharge from Trust Service’ (the Discharge Policy). This sets out the process staff should follow when discharging someone from secondary mental health services.
14. The Discharge Policy says that the service user should be at the centre of any discharge decision. In addition, the multidisciplinary team should ensure any agencies that will be supporting the service user after their discharge are involved in the discharge planning process.

What happened and my analysis

15. Mr X was detained under section 3 of the MHA in 2024. This meant he was entitled to free aftercare services under section 117 of the MHA. The Council and ICB had a duty to provide or arrange these services. In addition, Mr X was under the care of one of the Trust’s Community Mental Health Teams (CMHT) and had an allocated care coordinator.
16. The Trust held a section 117 meeting with Mr X in late February. The meeting heard Mr X would need medication and ongoing monitoring of his mental health via his care coordinator.
17. In February 2025, Mr X told a section 117 review meeting that he no longer wished to receive care.
18. In March 2025, Mr X complained to the Trust. He said he wanted to be discharged from section 117.
19. In its response, the Trust acknowledged Mr X had chosen to decline any support from the CMHT. Nevertheless, it said the professionals supporting Mr X remained concerned about his mental health and did not consider him ready for discharge from the CMHT or his section 117 provision.
20. I have seen nothing that would prevent the Trust from discharging Mr X from the CMHT at his request, in keeping with the local discharge policy. However, it is not for the Ombudsmen to say whether a person should be discharged from care. This is a matter for the service user and the professionals involved.
21. The situation with Mr X’s section 117 aftercare is different. The MHA Code is clear that the professionals involved in a person’s care must be satisfied that person no longer needs section 117 aftercare services to prevent a deterioration in their mental health and consequent readmission to hospital. In Mr X’s case, the view of the professionals involved in his care remains that his clinical history indicates an ongoing need for section 117 aftercare. This is ultimately a matter of professional judgment for the Council, Trust and ICB officers involved.
22. In his complaint to the Ombudsmen, Mr X, says the only outcome he is seeking is his discharge from section 117 and secondary mental health services more widely. This is not an outcome we would be able to achieve through an investigation as we are unable to direct what care services a person should or should not receive. For this reason, we will not investigate Mr X’s complaint.

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Decision

23. We will not investigate Mr X’s complaint as an investigation would be unable to achieve the outcomes he is seeking.

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Investigator's decision on behalf of the Ombudsman