Appendix 4

Section 17 – Leave of Absence – Checklist

All staff to ensure that all applicable questions have been satisfactorily completed prior to the granting of Section 17 Leave

Has the patient been involved in the planning of the leave and do they understand the dates, times and conditions of that leave? (where mental capacity allows)

Have carers/relatives/friends that are to be involved in the care of the patient during the period of leave been involved in and agree to the dates, times and conditions of leave?

Have any professionals who are to be involved with the patient during the period of leave been fully involved in the discussion and agree to their level of involvement?

Has a risk management plan been formulated in relation to the leave?

Have issues of patients coming into contact with children or vulnerable adults been considered and a Keeping Children Safe Assessment been completed where appropriate?

Are the outcomes of this reflected in the care plan, leave arrangements and conditions of leave?

Has the Section 17 Leave of Absence Form been fully completed with clear and concise instructions?

Has the patient been given a copy of the leave form?

Have all people concerned (professionals and carers) been informed of impending leave?

Have all those who are to be involved in the period of leave been given a copy of leave form?

If the patient is granted leave to another care provider have copies of the current Mental Health Act forms and treatment authorisation certificates been sent with the patient?

If the patient is granted leave to another hospital outside of NTW has a copy of the patient’s current prescription been also been supplied to the destination hospital.

Does the patient and others involved in the care understand who and where to contact if necessary while on leave?

Is there Ministry of Justice authorisation permitting the leave and conditions for those patients who are restricted?

Has a Community Treatment Order been considered if the leave is to last for 7 or more consecutive days?

Northumberland, Tyne and Wear NHS Foundation Trust

Appendix 4 – Section 17 - Checklist for Leave – V05 – Issue 2 – June 16

Part of NTW(C)03 – Leave, Absence without Leave and Missing Persons