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Ensuring patients can access justice


The Mental Health Tribunal is using remote hearings and adapting quickly to new ways of working to ensure as many cases as possible can be heard.

Image of Judge Sarah Johnston

Sarah Johnston, Deputy Chamber President in Health, Education and Social Care

When restrictions on movement began in mid-March, the Mental Health Tribunal worked quickly to prioritise hearing urgent cases remotely. Initially this was done via telephone but it soon progressed to video hearings in nearly all cases. The tribunal has managed to list all cases, except those where the patient was subject to a community order from the start. Listing for these cases began in May. Deputy Chamber President in Health and Social Care, Sarah Johnston said:

“This was a big change for our stakeholders and judicial office holders and we are indebted to them for embracing this change. We have worked with judges, representatives and hospital trusts to deal with technological teething problems and we are making progress. All our judges are now trained in the video system and guidance has been issued. We are about to train all our specialist members. It is our view that video hearings will be much better in our jurisdiction than hearings on the telephone, as it will ensure that litigants can see the judge and/or panel deciding their case and ensure they feel heard.”

Hearings usually take place in hospital premises, but this became impossible when hospitals were closed to visitors following government advice and judicial office holders were required to work from home. If hearings were to continue, they had to be conducted remotely to ensure the safety of patients, staff, representatives and judicial office holders. Judge Johnston explains:

“We used remote hearings to ensure that patients had speedy access to justice. Nearly all of our cases involve the liberty of the subject and it was imperative for those people to ensure justice was still in place.”

Mental Health are using the Cloud Video Platform (CVP) by Kinly. This has also been used successfully in Special Educational Needs Tribunals (opens in a new tab), which is one of the other jurisdictions in the Chamber. The system is secure and is accessible to users because witnesses do not have to download or buy any software to use the platform. Judge Johnson continues:

“These hearings have taken many forms. All judicial office holders are at home. In some trusts consultant psychiatrists are at home and all those giving social circumstances evidence are as well. The patient and nurse are in the hospital. In others, the psychiatrist, patient and nurse are in one room.”

The flexibility of the CVP is important, as a witness or judicial office holder can join via their smart phone, laptop or computer and – if the video facility fails – they can dial into the hearing room without video. Once the jurisdiction starts hearing community cases this will allow patients in the community to attend their hearing. Judge Johnston said:

“We have found video hearings work well when witnesses are able to connect. We do have some issues with hospital trusts who are having either hardware or software teething problems but we are working though these. As with all change it has been difficult for some but what is encouraging is that most of those involved have embraced it. We are asking for feedback from judges and patients on how the experience of a video hearing is for them to guide us in helping to fix these problems and to gather information for the future. “

During this unprecedented time, judicial office holders are working collaboratively and taking responsibility for work that does not usually fall within their remit to ensure access to justice. Judge Johnston concludes:

“Currently Judges are clerking their own hearings and dealing with technological issues involved in ensuring the parties can join. Doctors, nurses, care coordinators, hospital administrators, tribunal administrators and representatives are dealing with technical issues that would usually be dealt with by others. It has been very encouraging how we have all worked together to ensure that justice remains in place. We hope to have clerks available for these hearings shortly and are working with HMCTS to secure this service.”

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