Section 117 places a joint duty on the relevant CCG (or LHB in Wales) and LSSA to provide (or arrange for the provision of), in co-operation with relevant voluntary agencies, after-care services for certain classes of detained patient.
It applies to patients who were detained under s3, s37, s37/41, s45A, s47, s47/49, s48/49. It begins when they cease to be detained and (whether or not immediately after so ceasing) leave hospital. The duty continues until the CCG and LSSA are satisfied that such services are no longer required. This decision cannot be made during the continuance of a CTO.
The relevant bodies are usually those for the area in which the patient was ordinarily resident immediately before being detained or (if the patient was not ordinarily resident anywhere in England or Wales) for the area in which the person concerned is resident or to which he is sent on discharge by the hospital in which he was detained.
No charge can be made for after-care provided under s117 (and if charges have been made then they can be claimed back).
- 1. For patients discharged between 1 April 2013 and 31 March 2016, the duty on a CCG imposed by s117 can be imposed on a different CCG in the situations set out in the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012. CCG B is responsible instead of CCG A in certain circumstances which are set out in Regulation 14. The rough gist is that if the patient is registered with a GP in area B then it is the CCG in area B which is responsible.
- 2. For patients discharged from 1 April 2016, the situation is different, following changes made by National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2016. See that page for details, and also see the notes on the "Who Pays?" guidance below.
- Department of Health and Welsh Government, 'Mental health aftercare in England and Wales: Arrangements for resolving disputes over ordinary residence involving local authorities in England and Wales' (March 2015)‡. These arrangements, made under s117(5), set out the process by which the Secretary of State for Heath and the Welsh Ministers will decide which of them will determine a dispute about where a person was ordinarily resident for the purposes of s117(3) if the dispute is between an LSSA in England and an LSSA in Wales.
- The following documents relate to amendments to the 'Who Pays' document, effective from 1/4/16 (once the amended 'Who Pays' document has been located it will be uploaded here): (a) LGA, ADASS and NHS England, 'Building the right support - Frequently Asked Questions (finance)' (gateway reference 04659, updated 9/4/16)† (full text is in Annex A); (b) ADASS, 'Updated NHS "Who Pays" S117 Guidance' (19/4/16)†; (c) Emmett Maginn, 'Who pays? Significant changes to determining which CCG is responsible for funding s117 MHA 1983 aftercare after 1 April 2016' (Browne Jacobson, 11/5/16)†. Amendments made in April 2016 to paragraphs 33 and 34 of the August 2013 ‘Who Pays?’ document (which should be read subject to the Regulations themselves) state that: if a patient who is resident in the area of CCG A is discharged to the area of CCG B, the responsibility to pay for s117 aftercare remains with CCG A; if the patient is subsequently readmitted or recalled to hospital for assessment or treatment of his mental disorder (except where the admission is into ‘specialised commissioned services’), or changes his GP practice (and associated CCG), CCG A still retains responsibility.