The Act retains many of the proposals from the draft Bill. These proposals were informed by the four key principles developed by the Independent Review and in partnership with people with lived experience of detention:
Choice and autonomy – involving patients in decision making, and considering their past and present wishes and feelings.
Least restriction – minimising restrictions on liberty so far as consistent with patient wellbeing and safety, and public safety.
Therapeutic benefit – ensuring patients receive effective and appropriate treatment.
The person as an individual – treating patients with dignity and respect, and considering their beliefs, values, past experiences and wider needs.
	The draft Bill included reforms to:
Better ensure that detention and compulsory treatment under the 1983 Act is only undertaken when necessary, with revisions to the criteria which must be met in order for a person to be detained, treated, or otherwise made subject to the 1983 Act and provide faster, more frequent reviews and appeals of both detentions and treatment;
Strengthen the voice of patients – with measures that aim to increase the role of the patient in decision making regarding their care and treatment, with the introduction of measures such as the clinical checklist, which are intended to encourage clinicians to support patients to engage in decision making and to give consideration to their wishes and preferences;
Improve and expand the roles and powers of people who represent and advocate for detained patients – including by allowing patients to choose the person who represents them;
Limit the detention of patients with a learning disability and autistic people under Part 2 of the 1983 Act to 28 days for the purpose of assessment of mental disorder. Patients may only be detained for treatment under section 3 if they have a co-occurring mental health condition that requires hospital treatment and meets the detention criteria under the 1983 Act. The Act retains hospital as a sentencing option under the 1983 Act, and also retains the facility to transfer patients with these conditions from prison to hospital;
Introduce duties on commissioners to monitor and improve their understanding of the risk of crisis amongst people with a learning disability and autistic people in the community who they are responsible for commissioning services for; and to ensure an adequate supply of community services to prevent inappropriate detentions in hospital;
Revise the criteria for the use of Community Treatment Orders (CTOs) in line with changes to the detention criteria, and enhance the professional oversight required for any CTO;
Remove police stations and prisons as defined places of safety under the 1983 Act to ensure people experiencing a mental health crisis or with severe mental health needs are supported in an appropriate setting;
Introduce a new 28-day time-limit for transfers from prisons and other places of detention to hospital for persons in the criminal justice system or immigration detention with severe mental health needs to speed up access to specialist inpatient care and treatment;
Introduce a new form of supervised community discharge for criminal justice patients who are no longer benefitting from being in hospital but who require conditions amounting to a deprivation of liberty to manage the risks they pose.
	In addition to the proposals from the draft Bill, the Act takes forward recommendations from the Joint Committee’s report. The planned reforms were also reviewed, to be assured that the reformed Act, has the necessary powers to enable clinicians to keep patients and the public safe. These reforms do not change the core function and powers of the 1983 Act, which is to detain and treat people when they are so unwell they become a risk to themselves or others. However, they do strive to ensure that when the very serious decision is taken to detain someone – there is a modern framework for the use of these powers, to ensure patients are treated with dignity and respect and that they receive care and treatment which supports recovery.
	The key changes since the draft Bill are:
Detention Criteria – ‘how soon’ The Act takes forward the Joint Committee’s recommendation that the proposed requirement for clinicians to consider ‘how soon’ a harm might occur should be removed from the detention criteria revisions proposed in the draft Bill.
Nominated Person: The Joint Committee supported the Nominated Person provisions but recommended that the Government work with Approved Mental Health Professionals (AMHP) to revise the proposals to address practical concerns. The Act removes the requirement for the AMHP to see the Nominated Person in person.
Advance Choice Documents: The Act takes forward reforms on Advance Choice Documents. However, rather than create a right for a patient to request an Advance Choice Document, as the Joint Committee recommended, the Act takes a different approach. The Act introduces duties on NHS bodies and Local Health Boards (Wales) to make arrangements so that people at risk of detention are informed of their ability to make an Advance Choice Document, and (if they accept) supported to make one.
Principles: In line with the Joint Committee’s recommendation, the Act amends section 118 of the 1983 Act, which makes requirements for the Code of Practice, the statutory guidance which sits alongside the Act, to include the language of the four principles from the Independent Review. This will apply to both the Code of Practice for England, and the Code of Practice for Wales.
Discharge: The Act contains measures for a new requirement for a patient’s responsible clinician (or the responsible authority for the patient) to consult with a second professional involved in the patient’s care when taking the decision to discharge them from certain provisions in the 1983 Act? powers under the Act.
	Further detail is set out in the Commentary on provisions.
Contents of the Act