Guardianship under the Mental Health Act - proposal to cease data collection & publication

Closed 17 Feb 2021

Opened 6 Jan 2021

Feedback updated 29 Mar 2021

We asked

We consulted on the future of the Guardianship under the Mental Health Act data collection and publication. Our proposal was that we would cease this publication due to very low numbers nationally and limited use of the publication.  We sought to establish who uses the data, how it is used and what would be the impact if the publication was discontinued.

You said

62 responses were received. 53 of these were from local authorities, and 9 were from other organisations, including national bodies such as the Approved Mental Heath Professionals (AMHP) Leads Network.

The support for the proposal was split as follows:

 

Support proposal to cease

Do not support proposal to cease

Local Authority

32

21

Other

2

7

All

34

28

 

Reasons given for supporting the proposal were:

  • Guardianship orders are not widely used in practice
  • The published data is not used.

However it was acknowledged by a couple of respondents that some monitoring and oversight would still be valuable. 

Reasons given for not supporting the proposal are summarised as:

  • It is important to know how Guardianship orders are being used, despite the small numbers, as it remains a statutory provision.
  • People under Guardianship are subjected to the restrictions under the Mental Health Act and this should not be taken lightly. It is vital that we keep a record of who is under these sections of the legislation.
  • The data provides national oversight. It is not being collected or published anywhere else.
  • It has an important use in questioning why some areas are not using Guardianships.
  • Accurate statistics should be provided regarding use of all aspects of the Mental Health Act.
  • This is not the right time to discontinue the data collection and publication, given the Government’s Mental Health Act white paper and ongoing consultation of its proposals. This includes the aim to reduce the number of people detained in hospital and to reduce the restrictions placed upon patients. As Guardianship is arguably the least restrictive of all the sections of the MHA, it is important to continue the data collection to know how much it is being used and who is using it.

Of the respondents who said they currently use the data, all aspects of the data collection are important, this includes:

  • Number of new and continuing cases
  • Duration
  • Legal basis
  • Relationship to Guardian
  • Organisation and geographical area

We did

Firstly we would like to sincerely thank everyone who responded. You have provided valuable and important information to us which we were not previously aware of.

We have weighed up the responses, and whilst the majority supported the proposal to cease, we acknowledge the counter-view that it remains important to continue the data collection and publication. This is in order to provide an accurate national position, which would not be otherwise available, and it was pointed out that it is especially important at this time when a review of the Mental Health Act is ongoing.

Therefore we will be going ahead with the next data collection from 01 April 2021 and we expect to publish the data in September 2021. This will collect data for the periods 01 April 2018–31 March 2019, 01 April 2019–31 March 2020, 01 April 2020–31 March 2021.

Following this consultation it has since become clear that there are further factors to consider in terms of the longer term future of the Guardianship data collection and publication, such as the NHS Digital data strategy currently in development and Mental Health Act reforms. We will be open and transparent about any future decisions that are made.

In previous years we have produced an in-depth report to set out the findings. This year we will present the data in Excel tables and reduce our written commentary on the findings. However, as with all our data collections, users are encouraged to approach us directly with any requests for additional analysis and we can work with you to understand your requirements and provide the data.

Overview

Guardianship under the Mental Health Act 1983 is a biennial collection that NHS Digital currently requires Councils with Adult Social Services Responsibilities (CASSRs) to complete.

The collection relates to those patients aged 16 or over subject to Guardianship under Section 7 or 37 of the Mental Health Act 1983.

It is a record level collection with minimal information collected and has a very low number of records. For this reason, a decision was taken that the collection would be changed from annual to biennial following the 2015-16 release. 

Since then, numbers of Guardianship orders have continued to decrease year on year with just over 100 new cases in England during 2017-18 ( the last time data was collected).  The majority of CASSRSs do not report any new Guardianship orders. 

In order to protect individuals identity, small numbers in our published data are suppressed according to our policy on statistical disclosure control.  Due to the small number of Guardianship orders, the published data is aggregated at regional and national level to avoid having to suppress all the data.

Data was due to be collected in 2020, covering 2018-19 and 2019-20; however as a result of the coronavirus (COVID-19) pandemic a decision was made to defer this collection.

Why we are consulting

As a result of the very low numbers nationally and potentially limited use of the publication, our proposal is to cease the Guardianship publication with immediate effect.  We would like to establish:

  • Who is using this data
  • How people are using the data
  • How users would be affected if the publication was discontinued

Areas

  • All Areas

Audiences

  • Social Care

Interests

  • Data Collections