Section 24 of the Act introduces a new statutory role to the 1983 Act– the nominated person – to replace the nearest relative. The 1983 Act provides for the role of the nearest relative. It sets out a hierarchical list of ‘relatives’ and includes a number of rules for identifying the nearest relative from this list. The Independent Review highlighted that service users and stakeholders consistently found the current model of family and carer involvement outdated and insufficient. This was found to be particularly true of the current nearest relative provisions.
	The general intention of this reform is that, in place of the nearest relative, a patient would be able to personally select someone as their nominated person to represent them and exercise the relevant statutory functions (which are extended by the Act). This supports the policy objective of improving support for detained patients and is linked to the wider policy intention to ensure that the views, experiences and expertise of patients are taken into account more fully and more seriously in their care and treatment, by allowing an individual to express their wishes through someone they know and trust. In doing so, these measures support the principle of choice and autonomy.
	Pursuant to the reforms, a nominated person can be selected by the patient at any time when they have capacity / competence to do so. Typically, it is envisaged that nominations would be made:
In advance of the detention – this could be done via a document that has been signed by the person, the nominated person and ‘validated’ by a health or social care professional. This would include for instance when a patient has been admitted to hospital informally.
At the time of the Mental Health Act assessment – the approved mental health professional (AMHP) would be required to check if a valid nomination has been made, and if not (assuming that the person has the relevant capacity/competence), they could explain what the nomination process involves and see if the person wanted to make a nomination.
Following detention – a patient would be able to nominate someone to be their nominated person at any time when they have capacity / competence to do so (by following the same process that applies to a nomination in advance of the detention).
	If someone lacks the relevant capacity / competence to make a nomination at the point of detention or at any other time, and has not previously nominated anyone, a nominated person can be appointed by an AMHP. This nominated person can be in place until the person has the relevant capacity / competence to make their own nomination and does so.
	The nearest relative currently has a number of important rights and functions under the 1983 Act, including:
The right to require an assessment to be made with a view to admitting the patient to hospital (section 13(4)).
The right to apply for compulsory admission or guardianship (sections 2,3,4 and 7).
The right to be consulted or informed before an AMHP makes an application for detention under section 3 or guardianship (section 11(3)-(4)).
The right to object to section 3 admission or guardianship (section 11(4)).
The right to order discharge of the patient (sections 23 and 25).
The right to information given to the detained patient or patient subject to supervised community treatment (section 132(4)).
The right to apply to the Tribunal (sections 66 and 68(1).
	The existing nearest relative powers listed in the paragraph above under this section are transferred to the nominated person role. In addition, the nominated person is given the following new powers and rights:
A right to be consulted about statutory care and treatment plans.
A right to be consulted about transfers between hospitals, and renewals and extensions to the patient's detention or community treatment order (CTO); and
The power to object to the use of a CTO.
	Currently, if the nearest relative exercises one of their powers (e.g., the ability to block admission), but the AMHP believes the grounds for this are unreasonable, the only means of overruling them is to remove or displace them as the nearest relative. This can prevent the nearest relative from continuing in their statutory role in supporting the patient while they are detained, even though they may be best equipped to protect and promote the patient's interests.
	As the nominated person will have been identified by the patient as someone they wish to be involved in representing them when detained under the 1983 Act, the provisions introduced by the Mental Health Act 2025 seeks to provide that the nominated person’s use of a power can sometimes be temporarily overruled, but that this does not require the nominated person being removed or displaced altogether, to ensure that where appropriate they continue to have a role in the patient's care and treatment while they are detained.
	A nominated person’s use of any of the following powers could be temporarily overruled:
The right to object to section 3 admission or guardianship;
The new right to object to the use of a CTO; and
The right to order discharge of the patient from detention, CTO, or guardianship.
	The process in which the use of a nominated person power can be overruled is via section 25 of the 1983 Act (i.e. the barring order). Currently, under section 23, the nearest relative can order a patient’s discharge from detention or from a CTO (where this follows detention under section 3). The nearest relative must give 72 hours’ notice in writing to the hospital.
	The nearest relative’s order may be barred if, within the 72 hours, the patient’s responsible clinician provides a written ‘barring’ report that they consider that the patient, if so discharged, ‘would be likely to act in a manner dangerous to other persons or to himself’ (under section 25).
	The barring report prevents the nearest relative from ordering discharge at any time in the six months following the date of the report. This time period has been amended by the Act to three months in order to align with the updated detention periods set out in these reforms. This is set out under section 29.
	Under section 66 of the 1983 Act, if the patient is detained under section 3 or on a CTO following section 3, then the nearest relative may, within 28 days of the barring report being issued, apply to the Tribunal for the patient’s discharge instead.
	All of the above relating to the barring order will apply for the nominated person.
	Section 24 of the Act introduces Schedule 2 and describes its contents. The Schedule deals with the appointment of a nominated person and transfers existing functions conferred on the nearest relative. The new functions conferred on a nominated person are provided for by sections 24 to 28.
	Schedule 2 inserts section 30A and section 30B into the 1983 Act.
	New section 30A introduces new Schedule A1 into the 1983 Act which confers the power to appoint a nominated person for a patient for the purposes of this Act and makes provision about the duration of the appointment.
	New section 30B ‘Power of court to terminate appointment of nominated person’ replaces section 29, which sets out the procedure for displacement of a nearest relative. It provides that the county court may make an order terminating the appointment of a nominated person. An order may be made on the application of the patient, an AMHP, or any person engaged in caring for the patient or interested in the patient’s welfare.
	An application for an order under this section may only be made on the grounds that-
The nominated person unreasonably objects to the making of an application for admission for treatment, or a guardianship application in respect of the patient;
The nominated person has, without due regard to the welfare of the patient or the interests of the public, exercised the power to discharge the patient under this Part of the 1983 Act or is likely to do so;
The nominated person unreasonably objects to the making of a CTO in respect of the patient;
The patient has done anything which is clearly inconsistent with the nominated person remaining the patient’s nominated person. This is intended to ensure that the person does not become locked-in with a nomination they wouldn’t want. For example, where the patient clearly does not like their nominated person but lacks capacity to revoke them, and the criteria for displacement are not met;
The nominated person lacks the capacity or competence to act as a nominated person; and
The nominated person is otherwise not a suitable person to act as a nominated person.
	Where an order under this section terminates the appointment of a nominated person for a patient, the person is disqualified from being re-appointed, for the period specified by the court in the order.
	Schedule A1 concerns the appointment of a nominated person by a patient. A person (the "patient") may appoint a person to act as their nominated person for the purposes of the 1983 Act.
	An individual is eligible to be appointed as a nominated person only if the person meets the age requirement of being 16 or over (or 18 or over if the patient is a child under the age of 16), and as long as the person is not disqualified by section 30B(6) (disqualification as a result of court order terminating previous appointment as a nominated person).
	The appointment of a nominated person under Part 1 of Schedule A1 is valid only if the person is eligible to be appointed as a nominated person and the appointment is made by an instrument in writing. This must be signed by the patient in the presence of a health or care professional or independent mental health advocate ("the witness"). The nominated person must sign a statement to confirm that they meet the age requirement and agree to act as the nominated person.
	The witness must sign a statement to confirm that the instrument was signed by the patient in the presence of the witness, and that the witness has no reason to think that:
The patient lacks capacity or competence to make the appointment;
The nominated person lacks capacity or competence to act as the nominated person;
Fraud or undue pressure has been used to induce the patient to make the appointment; and
the nominated person is unsuitable to act as a nominated person.
	The appointment of a nominated person under Schedule A1 Part 1 ceases to have effect if the nominated person dies, the patient appoints a different nominated person, the patient terminates the appointment, the nominated person resigns, or the county court terminates the appointment.
	The appointment of a nominated person may be terminated by the patient (giving the nominated person written notice). The notice must be signed by the witness and contain a statement that the notice was signed by the patient in the presence of the witness, stating that the witness has no reason to think that the patient lacks capacity or competence to terminate the appointment, or that fraud or undue pressure has been used to induce the patient to terminate the appointment.
	A nominated person may resign by giving signed written notice to the patient and either an AMHP, the relevant patient’s responsible clinician (if any), the relevant managers (i.e. hospital manager) or the relevant local social services authority (in respect of guardianship).
	Where an AMHP reasonably believes that a patient lacks capacity or is not competent to appoint a nominated person and has not appointed a person under Schedule A1 Part 1 to act as their nominated person, the AMHP may appoint a nominated person for the patient for the purposes of the 1983 Act.
	A person is eligible to be appointed as a nominated person under Schedule A1 Part 2 only if the person is an individual who meets the age requirement or is a local authority for the patient and is not disqualified as a result of a court order terminating previous appointment as a nominated person.
	Where an AMHP is deciding who to appoint as a nominated person for a patient who is aged 18 or over, if the patient has a ‘competent’ donee or deputy who is willing to act as the nominated person, the AMHP must appoint the donee or deputy. In any other case, the AMHP must, in deciding who to appoint, take into account the patient’s past and present wishes and feelings so far as reasonably ascertainable.
	Where an AMHP is deciding who to appoint as a nominated person for a patient who is aged 16- or 17-year-old, if a local authority has parental responsibility for the relevant patient, the AMHP must appoint that local authority. If no local authority has parental responsibility for the relevant patient but they have a competent deputy who is willing to act as the nominated person, the AMHP must appoint the deputy. In any other case, the AMHP must, in deciding who to appoint, take into account the patient’s past and present wishes and feelings so far as reasonably ascertainable.
	Where an AMHP is deciding who to appoint as a nominated person for a patient who is aged under 16, if a local authority has parental responsibility for the relevant patient, the AMHP must appoint that local authority.
	Where this does not apply, they must appoint a special guardian within the meaning of the Children Act 1989, a person who is named in a child arrangements order as defined by section 8 of the Children Act 1989, or a person who has parental responsibility for the relevant patient.
	Where there is more than one person identified as a potential nominated person, the AMHP must take into account the relevant patient’s past and present wishes and feelings so far as reasonably ascertainable.
	The appointment of a nominated person by an AMHP is valid only if the person is eligible to be appointed as a nominated person, the person agrees to act as the nominated person, and the appointment is made in writing and signed by the professional.
	A nominated person must either be an individual or a local authority (including but not limited to the authority with parental responsibility of the patient). There are no other legal entities that can be the nominated person.
	Where an AMHP appoints a nominated person, the AMHP must notify the patient and the relevant (hospital) managers or social services authority in the case of guardianship, who then must take steps to inform the relevant patient of the appointment.
	The appointment of a nominated person by an AMHP ceases to have effect if in the case of an individual, they die, an AMHP appoints a different nominated person, an AMHP terminates the appointment, the relevant patient terminates the appointment, the nominated person resigns, the county court terminates the appointment under section 30B, the patient appoints a different nominated person under Schedule A1 Part 1, or the person for whom the nominated person was appointed ceases to be a relevant patient.
	Where an AMHP has appointed a nominated person for a patient, the AMHP may terminate the appointment by giving the nominated person and the patient written notice. Notice should also be provided to the relevant (hospital) managers or the relevant social services authority (in the case of guardianship). The appointment may only be terminated by an AMHP on the grounds that the person lacks capacity to exercise the functions of a nominated person, the person is otherwise not a suitable person to act as the nominated person, or the patient has regained capacity or competence to appoint a nominated person under Schedule A1 Part 1. A nominated person appointed by an AMHP may also resign by giving the patient and either the AMHP, the relevant patient’s responsible clinician, the relevant (hospital) managers or the relevant local social services authority, where appropriate, a signed written notice.
	Under previous legislation, certain unrestricted Part 3 patients have been conferred the safeguard of a nearest relative. However, the 1983 Act does not currently extend the safeguard of a nearest relative to restricted Part 3 patients, to Part 3 patients remanded to hospital under sections 35 or 36, or to Part 3 patients subject to an interim hospital order under section 38. Schedule 2 Part 3 confers the power to appoint a nominated person for these patients.
	Paragraph 27 addresses this and introduces section 36A (Remands to hospital: Nominated Person) into the 1983 Act. Under this paragraph, new section 30A, new section 30B and Schedule A1 are made applicable to patients that have been remanded to hospital under section 35 for assessment and section 36 for treatment. Under paragraph 28, new section 30A, new section 30B and schedule A1 are also made applicable to patients subject to an interim hospital order under section 38.
	Paragraph 29 gives a nominated person for an unrestricted Part 3 patient the following powers:
The right to be consulted about transfers between hospitals, renewals and extensions to the patient's detention and patient’s care and treatment plan, unless consultation is not reasonably practicable or would involve unreasonable delay; and
The power to object to the use of a CTO.
	The powers conferred to a nominated person for restricted Part 3 patients have been limited in the interest of public safety and criminal justice. Paragraph 30 limits a nominated person for a restricted patient’s powers to the following (whilst nominated persons for interim patients only have powers [a] and [b]):
The right to receive information from the hospital about the patient’s care and detention, unless the patient objects to this;
The right to be consulted about the patient’s statutory care and treatment plan; and
The right to be consulted about transfers between hospitals unless consultation is not reasonably practicable, would involve unreasonable delay, or is inappropriate. In circumstances where the Secretary of State for Justice is exercising their duty under sections 41 and 42 of the 1983 Act to protect the public from harm, and consultation with a nominated person would not alter the outcome, consultation would be inappropriate. Therefore, a nominated person’s right to be consulted about transfers will be disapplied. A nominated person should nevertheless be informed about the transfer as soon as is practical.
Nominated persons Section 24: Nominated person