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CTO Condition Variation — MRCPsych Paper B MCQ

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HardMental Health LawCTO Condition VariationMRCPsych Paper B

In England, a patient is subject to a community treatment order (CTO). A discretionary condition requires attendance at a community clinic for supervised oral antipsychotic treatment. Following review, the responsible clinician changes the treatment plan to a fortnightly depot injection at the same clinic and wishes to amend the CTO condition accordingly. What is the required statutory process for varying this condition?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — The responsible clinician varies the condition under section 17B using Form CTO2 and furnishes it to the hospital managers

Explanation lettering: E = shown as C · C = shown as E

A is correct. A change from supervised oral medication to a depot injection may require amendment of the existing treatment-attendance condition. In England, the responsible clinician may vary CTO conditions under section 17B and records the variation on Form CTO2, furnishing it to the hospital managers. AMHP agreement is required in the process of making a CTO, but is not a statutory prerequisite to later variation of its conditions. A Tribunal hearing and creation of a new CTO are not required. The patient’s views should be sought and considered, but consent is not the statutory mechanism by which a CTO condition is varied. Separately, variation of a condition does not itself determine the Part 4A authority required for compulsory medication in the community.

Reference: Department of Health and Social Care, Community treatment order (CTO) forms for use under the Mental Health Act: Form CTO2, section 17B—variation of conditions of a community treatment order, 2020. https://www.gov.uk/government/publications/community-treatment-order-cto-forms-for-use-under-the-mental-health-act