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Section 17 Seven-Day Rule — MRCPsych Paper B MCQ

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HardMental Health LawSection 17 Seven-Day RuleMRCPsych Paper B

In England, an unrestricted patient detained under section 3 of the Mental Health Act 1983 is on a five-day period of section 17 leave staying with family. On day four the responsible clinician proposes extending the leave by a further four consecutive days, so that the total unbroken period away from hospital will be nine days. Before authorising the extension, which consideration is specifically required of the responsible clinician?

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

Reveal the answer and explanation

Correct answer: D — Whether the patient should instead be discharged onto a community treatment order

Explanation lettering: D = shown as A · A = shown as B · B = shown as D

B is correct. Section 17(2A) requires that, where leave is granted for more than seven consecutive days — or where an extension makes the total unbroken period exceed seven days, as here (nine days) — the responsible clinician must first consider whether the patient should instead be dealt with under section 17A, i.e. discharged onto a community treatment order. A CTO need not follow: longer-term leave remains lawful if more suitable, but both options must be weighed and the reasoning recorded. A is wrong: renewal of section 3 follows its own statutory timetable and is unrelated to leave duration. C is wrong: guardianship is a separate provision and no prerequisite to leave. D is wrong: no nearest-relative consent is required. E is wrong: section 17 leave is granted by the responsible clinician, not authorised by hospital managers. The duty does not apply to restricted patients, hence the stem specifies an unrestricted section 3 patient.

Reference: Mental Health Act 1983, section 17(2A)–(2B) (Leave of absence from hospital), as amended by the Mental Health Act 2007; see also Mental Health Act 1983: Code of Practice (England, 2015), chapter 27. https://www.legislation.gov.uk/ukpga/1983/20/section/17