Wiltshire County Council v RB & Ors
[2023] EWCOP 26
Northampton General Hospital NHS Trust v Jessica Mercer
7 October 2024
[2024] EWHC 2515 (KB)
High Court
A woman stayed in the hospital far longer than needed. The hospital wanted her to leave for a new care home, but she was scared. The judge decided the hospital had done everything right, and the woman had to leave. The judge also gave tips to hospitals on how to handle similar cases in the future so they don't have the same problems.
Key Facts
- •Jessica Mercer, medically fit for discharge since April 2023, remained in Northampton General Hospital for almost 18 months.
- •Ms. Mercer refused to leave due to anxiety about a new Supported Living placement.
- •The hospital sought a possession order.
- •Ms. Mercer has several disabilities, including Autistic Spectrum Disorder and Emotionally Unstable Personality Disorder.
- •A suitable placement was found by the local authority but Ms. Mercer and her mother expressed concerns about safety and preferred a different type of accommodation.
- •The hospital's evidence was provided in stages, leading to adjournments of the hearing.
Legal Principles
A patient with mental capacity has the right to refuse medical treatment.
Aintree Hospital NHS Trust v James [2014] AC 591 (SC); Pindo Mulla v Spain [2024] ECHR 753
A patient has no right to demand treatment a clinician deems inappropriate.
R(JJ) v Spectrum Community Health [2024] PTSR 1 (CA)
Judges are not clinicians and should not substitute their judgment for a clinician's.
Bolam v Friern Hospital [1957] 1 WLR 582; University College London Hospitals NHS v MB [2020] EWHC 882
Hospitals have legal powers to remove people who no longer need to stay.
s.119 Criminal Justice and Immigration Act 2008; s.74 Care Act 2014
A patient who is medically fit but unwilling to leave does not have the right to remain in hospital, but the hospital should engage with them and follow guidance.
s.74 Care Act 2014; NHS England Guidance (January 2024)
A hospital bed is likely not a 'dwelling' requiring a court order for eviction.
s.3 Protection from Eviction Act 1977; R(N) v Lewisham LBC [2014] 3 WLR 1548 (SC)
Hospitals can use private law to terminate a patient's license to occupy a room, making them a trespasser.
Barnet Primary Care Trust v H [2006] EWHC 787 (QB); Sussex Community NHS Foundation Trust v Price
A patient may raise public law defences to a hospital's possession claim.
Wandsworth v Winder [1985] AC 461 (HL)
Hospitals must comply with the Public Sector Equality Duty under s.149 Equality Act 2010.
s.149 Equality Act 2010
Mental Capacity Act 2005 assessments are crucial when a patient's refusal is affected by mental health issues.
Mental Capacity Act 2005
Outcomes
Summary possession order granted.
Ms. Mercer was medically fit for discharge, the hospital had followed appropriate procedures, and there were no valid public or private law defences. The proposed placement was deemed safe and appropriate.