The transfer process is multi-disciplinary, requiring input from numerous health and justice agencies. Section 37 subsection (2) inserts section 47A into the 1983 Act which places the new duty on authorities and bodies involved in a potential transfer, to seek to ensure the transfer takes place within 28 days from the initial referral for a report to admission to hospital, unless there are exceptional circumstances. For an overview of how the process works, see the NHS England’s good practice guidance.1
	If a person serving a sentence of imprisonment exhibits a severe mental health need, the prison or youth detention healthcare team (which could be any of the bodies provided for in 47A(2)(c)) will request an initial medical report to assess if the transfer detention criteria under the 1983 Act are met. This request is the beginning of the process where various healthcare providers or commissioners (which could be any of the bodies provided for 47A(3)(c)) facilitate the necessary clinical steps needed – two reports from registered medical practitioners and identifying an appropriate bed for the individual.
	The Secretary of State for Justice and those responsible for running the place of detention in which the individual is being held are responsible for facilitating access to the individual, and organising the physical movement from place of detention to hospital. The Secretary of State for Justice is responsible for issuing the transfer warrant once they are satisfied the statutory criteria are met and having regard to the public interest and all the circumstances. It may be a transfer does not occur where it is found not to be necessary, the detention criteria are not met or the Secretary of State decides not to issue a warrant, but where there is potential for a transfer, these authorities are all bound by the duty in section 47A(4).
	New section 47A(1), (2) and (3) provide for a statutory notice procedure, so that the relevant referring bodies must notify the relevant notified authorities in new 47A(3) and 48B, inserted by section 37. For section 47 transfers, this will be the Secretary of State for Justice, the institution’s governor, director or manager (depending on where the person is detained), and any of the healthcare authorities who may have a role in relation to the prisoner’s transfer (i.e. facilitating the second medical report, or admitting and receiving the prisoner in a hospital) when an initial referral has been made. This will ensure all bodies are aware of the duty and their obligations to take relevant steps to facilitate any resulting transfer.
	Section 47A(4) provides that the 28-day limit does not apply where there are exceptional circumstances which make it inappropriate to do the transfer in this period. For example, this could be in cases where there is a riot in a place of detention meaning the patient cannot be safely moved, where hospital provision becomes unavailable owing to a fire, flood or other unexpected event, or in clinically exceptional or complex cases where a longer time period is required to properly understand an individual’s needs and identify appropriate treatment. Section 47A(5) provides that a shortage of hospital accommodation (i.e. beds) or a shortage of hospital staff are not (together or separately) to be counted as exceptional circumstances, unless these shortages have arisen as a result of other exceptional circumstances.
Patients concerned in criminal proceedings or under sentence Section 37: Transfers from Prison to hospital: time limits Persons serving sentences of imprisonment transferred under section 47