Baroness Merron (Lab)

I hope it helps to advise that the responsible commissioner will be key to all that. I emphasise the need to design around the patient and their needs. If there are further points that I need to look at on this, I would be very pleased to. I am grateful to the noble Lord for raising it. Amendments 10 and 17 are technical and minor government amendments that make it clear, for the avoidance of doubt, that the responsible commissioner may make arrangements for a care and treatment review report—or a care (education) and treatment review report for children and young people—to be provided to persons other than those listed in the clause. They could, for example, be those who have an interest in the recommendations because they are involved in the review process, such as an independent mental health advocate, a nominated person or a professional involved in the patient’s care and treatment. This would be subject to the patient’s consent. We believe that this is important to clarify, since the review process is likely to involve more people than those who are listed in the legislation, although this will vary according to the individual and their needs and circumstances. In addition, the Bill makes specific provision to clarify which persons and bodies are to receive the report in every case to ensure that they can comply with their duty to have regard to the review recommendations. I hope that these government amendments find favour with noble Lords. Amendments 11 and 18 were tabled by the noble Lord, Lord Scriven, who raised the point that around a third of people have no CETR or CTR. My response is perhaps to provide the assurance that that is exactly why we are putting them on a statutory basis. It seems that Amendments 11 and 18 are intended to reduce the maximum amount of time between CTRs for adults and CETRs for children and young people from 12 months to six months following a patient’s initial review meeting. These amendments would apply to children and adults. I listened closely, as I have listened closely to all comments from noble Lords, but we believe that these amendments are somewhat unnecessary. Current drafting provides that review meetings take place at least once in a 12-month period, in line with the maximum timeframe within NHS England’s policy and guidance. This is in addition to the requirement that arrangements must be made for everyone to have a review promptly upon admission, within 14 days for children and 28 days for adults. Commissioners should use their judgment to determine the frequency of subsequent reviews, in line with the specific needs of the patient. Patients, their families and advocates can also request a review meeting at any point. There will be statutory guidance to provide commissioners with further information on factors to consider when determining whether more frequent reviews should take place. I understand the noble Lord’s point, but I hope that helps. For example, it is current practice that children under 18 have a review meeting every three months, and this would be articulated in the guidance. We consider it preferable to set out this information in statutory guidance, which can provide detailed case studies. That would not be possible if we set it out in the same way as primary legislation, not least because guidance can be readily updated in line with emerging best practice, including on frequency and considering particular circumstances.