Consultation on Updates to the Code of Practice for the Mental Health (Care and Treatment) (Scotland) Act 2003

Chapter 14 – Cross‑Border Transfers

Scope and how to use this chapter

This Chapter provides guidance on the transfers of persons with mental disorder into and out of Scotland under sections 289 and 290 of the Mental Health (Care and Treatment) (Scotland) Act 2003 (“the 2003 Act”) and the associated regulations.

Read Section 2 first for provisions that apply to all transfers, then move to Section 4 for transfers out of Scotland or Section 5 for transfers into Scotland. Within those sections, follow the relevant pathway:

• Pathway A covers people detained in, or treated in, hospital (including those conditionally discharged and informal in‑patients where the destination is outwith the UK) with decisions made by the Scottish Ministers.
• Pathway B covers people on compulsory measures in the community (Compulsory Treatment Order/Compulsion Order without detention) who request a move to England and Wales with decisions made by the RMO and consent from the receiving administration.
• Pathway C covers reception into Scotland of persons subject to measures corresponding or similar to detention in hospital (including conditional discharge) from England, Wales, Northern Ireland, the Channel Islands, the Isle of Man, or EU Member States with decisions made by the Scottish Ministers.
• Pathway D covers reception into Scotland of persons subject to corresponding or similar community requirements from those same territories listed for Pathway C above, with decisions made by the managers of the receiving hospital.

Section 3 covers directions for named individuals from outside Scotland escorting individuals within Scotland to the hospital where they will receive care and treatment. It also confirms what legislation covers a situation where an individual absconds while travelling to the receiving hospital. More detail can be found in Appendix C.

Section 6 covers the general effects of transfers, including what they mean for cessation of measures, treatment of prison sentences and victims of mentally disordered offenders.

Provisions applying to all transfers

Persons who must not be transferred

A transfer must not be pursued where the person is subject to, or the equivalent of, any of the following:

• an assessment order under section 52D of the 1995 Act
• a treatment order under section 52M of the 1995 Act
• an interim compulsion order under section 53 of the 1995 Act
• a temporary compulsion order under section 54(1)(c) of the 1995 Act
• a remand for inquiry into the person’s mental condition under section 200(2) of the 1995 Act
• an interim compulsory treatment order under section 65 of the 2003 Act.

A transfer must also not be pursued where the person is subject to a Compulsory Treatment Order/Compulsion Order without detention where the individual is not complying with the order, has breached the order, or is detained pending review or variation because of non‑compliance.

Transfers for which there are no arrangements in legislation

Some movements are not provided for in secondary legislation and therefore proceed only on a local, case‑by‑case basis. These include:

• informal in‑patients leaving Scotland for a place within the UK or entering Scotland from anywhere
• persons detained in hospital entering Scotland from outside England, Wales, Northern Ireland, the Channel Islands, the Isle of Man or an EU Member State
• persons on compulsory community measures who have not requested a move out of Scotland or who request transfer to a territory other than England and Wales; and
• persons on community requirements seeking entry to Scotland from outside England, Wales, Northern Ireland, the Channel Islands, the Isle of Man or an EU Member State.

For all these situations, decisions should be person‑centred and rights‑based, with independent legal advice taken as appropriate and a clear written record taken of the decision and its rationale.

Human rights and principles

All decision‑makers must apply the principles of the 2003 Act and consider the patient’s human rights, including Article 8 of the European Convention on Human Rights. The likely impact of a move on family and private life should be evidenced, any interference must be necessary and proportionate, in accordance with the law and for a legitimate aim, and mitigation - such as support for family contact - should be documented. Legal advice should be sought where necessary.

Practical planning

Transfers should be planned early with the multidisciplinary team and the managers of both the sending and receiving hospitals.

Patients, named persons, primary carers, nearest relatives, guardians and welfare attorneys should be informed of proposed timings and supported to prepare.

Transport must be appropriate, swift and comfortable, with arrangements for medication in transit if required.

Security requirements should anticipate absconding risks while observing the least‑restriction principle.

The receiving clinical lead should be identified, time‑critical dates noted, staff prepared for arrival, and, where the patient is under 18, age‑appropriate services confirmed.

Preventing delay

Most delays arise from incorrect notifications or missed time limits. Use the notification requirements precisely (summarised in Appendix A) and make no travel arrangements until either the Scottish Ministers have issued notice of their decision to authorise (for Pathway A) or the receiving administration or hospital has consented (for Pathways B, C and D).

Confirm that any named person has been properly nominated and has accepted the role under the changes made by the Mental Health (Scotland) Act 2015 (“the 2015 Act”) changes and retain copies of the forms where these must accompany an application.

For transfers requiring corresponding measures, obtain early written confirmation of the legal basis in the receiving jurisdiction.

Where Tribunal proceedings or other court actions are pending, engage with the cross‑border team early since transfers commonly pause pending outcomes.

If the detaining order is close to expiry, discuss feasibility with the cross‑border team before applying.

Urgent applications must evidence clinical urgency, not bed pressure, and fast‑track applications require the patient’s written consent, an independent Approved Medical Practitioner (AMP) certificate of capacity and the named person’s written consent before submission.

Escorts must not assume their powers extend beyond the limits set by directions and by the law of other jurisdictions; ensure names and authorisations are confirmed before directions are issued.

Directions, escorts and absconding

Directions are the mechanism for authorising named escorts and conferring powers while the patient is within Scotland.

If escorts are drawn from another jurisdiction, the directions must name them and confirm that they are authorised to escort patients under their home law. Transfers should not proceed with external escorts operating in Scotland unless directions have been issued. The existence and extent of any powers outside Scotland depend on the law of the other territory, so escorts should not assume Scottish‑equivalent powers once a border is crossed and they should obtain any necessary advice from the receiving authority in advance.

Where a patient absconds while being conveyed, the 2003 Act and the relevant absconding regulations apply in accordance with the pathway and stage of travel; these provisions enable authorised persons to resume custody using reasonable force where warranted and to return the individual to the appropriate place or escort custody.

Transfers out of Scotland

Pathway A – Detained patients (including those conditionally discharged) transferring anywhere outwith Scotland, and informal In‑Hospital Patients but only if transferring outwith the UK

Pathway A is governed by the Part II of the Mental Health (Cross border transfer: patients subject to detention requirement or otherwise in hospital) (Scotland) Regulations 2005 (“the 2005 Regulations”) and requires a warrant from the Scottish Ministers.

Within the UK, transfers of detained patients must proceed on measures in the destination that are corresponding or similar to those in force in Scotland. For destinations outwith the UK, there is a presumption in favour of corresponding measures; exceptionally, a non‑corresponding transfer may be authorised where this is in the patient’s best interests and represents the minimum restriction on the freedom of the patient that is necessary in the circumstances.

Where a patient’s detention in hospital has been suspended, any UK transfer must be to a hospital because the corresponding measure is the underlying detention, not the suspension. For destinations outwith the UK for such patients, the presumption remains that the person is transferred to a hospital so that the receiving clinician can assess and determine longer‑term arrangements. Where a direct move to a non‑hospital destination is proposed, the application must explain why detention remains justified in Scotland but is not required at the destination and why alternatives in Scotland, such as a community‑based order or revocation, were not appropriate.

Before applying to the Scottish Ministers for a warrant authorising a patient’s transfer, the RMO must consult the MHO and anyone else appropriate -this should include the Scottish Ministers where the patient is restricted (meaning patients subject to compulsion orders and restriction orders, hospital directions, and transfer for treatment directions) - and have regard to the views expressed. The receiving hospital should confirm acceptance in writing; for outwith‑UK cases the RMO should obtain information on likely measures, treatment, care and services as evidence of corresponding or similar measures, and for informal in‑patients whose destination would be outwith the UK the proposed treatment plan must be secured.

Logistics such as escorts and any notification or consent requirements in the receiving jurisdiction should be agreed.

The statutory notification must then be issued in writing to the patient, the named person (or, where there is no named person, the primary carer and nearest relative), any guardian, any welfare attorney, and the MHO, inviting representations to the RMO within seven days and inviting notified parties (other than the MHO) also to inform the Scottish Ministers of any wishes or preferences they have about the transfer proposal within the same period. The notice must not specify a transfer date and must be sent in a form the patient can understand. Suggested wording is provided in Appendix D. During this period, the MHO must interview the patient, explain their rights to them and inform them of the availability of independent advocacy services, take steps to enable the patient to use those advocacy services, and provide their opinion of the proposal and any other relevant matters to the RMO, recording where it was not practicable to complete duties within the time limit.

The application to the Scottish Ministers is made on form TX1A and must include the prescribed particulars, including:

• the list of persons notified
• reasons for the application
• proposed arrangements for treatment and care at destination
• the MHO’s position and
• any representations received.

Applications may be standard, urgent or fast‑track (summary in Appendix B). Standard applications attract a standstill of seven calendar days for destinations within the UK and twenty‑eight calendar days for destinations outwith the UK; the Scottish Ministers may specify an earlier day for outwith‑UK transfers, provided the day is at least seven days after the warrant is issued, appropriate care and treatment would be available, and it is in the patient’s best interests.

Urgent applications require a clinical justification and the agreement of the Mental Welfare Commission, and the standstill reduces to three working days for a destination within the UK and seven calendar days for a destination outwith the UK.

Fast‑track applications are only available for transfers to England, Wales, Northern Ireland, the Channel Islands or the Isle of Man. They allow removal within the standstill period where the patient consents in writing, an approved medical practitioner (not the RMO) certifies capacity, the named person consents in writing, and after the Mental Welfare Commission is notified; if consent is withdrawn, or an appeal, or a reference by the Commission is made, the standstill period applies.

When the Scottish Ministers intend to authorise a transfer, they issue a notice of intention to the patient, the parties notified by the RMO, the RMO, the MHO, the Mental Welfare Commission and the proposed receiving authority. Where external consent is required, it is then sought from the receiving jurisdiction and, for restricted patients, from the justice authorities; for outwith‑UK destinations, embassies may be contacted to clarify any authorisation requirements.

The patient or entitled parties may appeal to the Mental Health Tribunal for Scotland, and the Mental Welfare Commission may make a reference; the point at which the standstill ends depends on the timing and outcome of any appeal or reference (see Appendix B).

Once authorisation is confirmed, the warrant is issued and will specify the destination and when removal can occur; for fast‑track cases, removal can occur immediately unless consent is withdrawn or there is an appeal or reference.

Directions must be issued if escorts from another jurisdiction will operate in Scotland and such directions must name those escorts.

Removal must occur between the end of the standstill and the end of the seventh day thereafter.

Within seven days of the patient’s removal, the managers of the sending hospital must notify the MHO, the Scottish Ministers and the Mental Welfare Commission of the date of removal and the name and address of their destination hospital (or residence for conditionally discharged patients).

On removal, detaining measures in Scotland cease to have effect when the person becomes subject to the measures corresponding or similar to detention in hospital authorised under the 2003 Act or the 1995 Act in the destination country or territory; persons on conditional discharge are treated as under the corresponding enactment there; and for hospital and transfer‑for‑treatment directions the sentence is treated in accordance with the receiving‑territory provisions.

If a warrant expires without removal, a fresh application for a new warrant is required.

Pathway B – Patients subject to Community‑Based Compulsory Measures transferring to England and Wales on request

Pathway B is governed by Part II of the Mental Health (England and Wales Cross-border transfer: patients subject to requirements other than detention) (Scotland) Regulations 2008 (“the 2008 Regulations”) and requires a warrant from the RMO.

This pathway applies only to persons subject to a Compulsory Treatment Order or a Compulsion Order without detention in hospital who either request transfer to England or Wales or, where incapable, whose named person makes that request. It continues to apply where measures under Compulsory Treatment Orders or Compulsion Orders are suspended. It does not apply to interim Compulsory Treatment Orders or Interim Compulsion Orders, nor where there is non‑compliance with measures or detention pending review because of non‑compliance. The move must be onto a corresponding order in England or Wales under section 80C of the Mental Health Act 1983.

The RMO must first notify the named person (unless they made the request), the Mental Welfare Commission, any guardian and welfare attorney, the primary carer, the managers of the specified hospital and the MHO.

Within three working days, the MHO should interview the patient and provide their view with reasons to the RMO, recording where duties could not be completed.

The RMO then decides whether to authorise removal having regard to the patient’s best interests, whether the responsible clinician and responsible hospital in England or Wales have been made aware of recorded matters, the risk to any person and the MHO’s views.

The RMO may authorise removal only if arrangements exist in England or Wales that will secure corresponding or similar measures, treatment, care or services, and must identify the responsible hospital and responsible clinician.

Consent must be obtained from the Department of Health in England or the Department of Health and Social Care in Wales.

If the RMO refuses authorisation, the patient or entitled parties may appeal to the Tribunal within fourteen days; the Tribunal applies the same tests and may direct the RMO to issue a warrant.

Any warrant must specify an effective date, as the date on or after which the removal can take place. The effective date must be at least three working days after signature of the warrant, beginning the day after the date of signature, and removal is authorised only within the fourteen‑day period beginning the day after that effective date.

Directions are required if escorts from England or Wales will operate within Scotland and such directions must name those escorts.

After removal, the hospital managers notify the MHO and the Mental Welfare Commission within seven days of the date of removal, and the Scottish requirements cease when the corresponding requirements in England or Wales take effect.

Transfers into Scotland

On reception into Scotland, the person is treated as if they are subject to the measures under the 2003 Act or the 1995 Act which most closely correspond to, or are most similar to, those to which the person was subject immediately before the transfer.

This includes (where applicable under the 2005 Regulations) cases where the person was, immediately prior to transfer, subject to a restriction/ conditional discharge arrangement in the relevant territory and is treated in Scotland as subject to the most closely corresponding measure which restricts their discharge.

Where the person is received in Scotland under the 2005 Regulations and, immediately before transfer, was liable to be detained by virtue of a measure corresponding or similar to a hospital direction or a transfer for treatment direction made while serving, or in connection with, a sentence of imprisonment imposed by a court in the relevant territory, the person’s sentence is treated as if it had been imposed by a court in Scotland.

Pathway C – Detained Patients and Conditionally Discharged Patients entering Scotland from England, Wales, Northern Ireland, the Channel Islands, the Isle of Man or an EU member State

Pathway C is governed by Part III of the 2005 Regulations and requires the consent of the Scottish Ministers before reception in Scotland.

Requests must be made under provisions in force in the relevant territory and include the necessary information; form TX1B should be used to ensure completeness. The Scottish Ministers consider requests as soon as practicable, seek clarifications where necessary and notify both sending and receiving hospital managers of their decision.

No patient who is subject to measures corresponding or similar to detention in hospital authorised by virtue of the 2003 Act or the 1995 Act, and who is in England, Wales, Northern Ireland, the Channel Islands, the Isle of Man or an EU member State, is to be received in Scotland without Ministers’ consent.

Where consent is given, the Scottish Ministers consider any directions issued by the other authority regarding conveying the patient to their destination, and may either issue directions themselves or arrange for the RMO or hospital managers to do so, or do both. Where escorts will be operating in Scotland, directions are required so that they have powers for the period lasting from the time of the patient’s entry to Scotland to arrival at their destination. On receiving notice from the sending hospital that the transfer is to proceed, the receiving hospital managers must promptly notify the relevant local authority so that a mental health officer is designated for the case and appoint an approved medical practitioner to be the RMO.

On reception in Scotland - meaning admission to the receiving hospital or, for conditionally discharged patients, arrival at the specified residence - the person is treated as if subject to the closest corresponding or most similar measure under the 2003 Act or the 1995 Act, to the measure to which they were subject immediately before transfer. This includes measures corresponding to a restriction order and conditional discharge from it. Time limits run as if the original measure’s effective date applied. Where the person was subject to measures corresponding to a hospital or transfer for treatment direction in connection with imprisonment, the sentence is treated as if imposed by a Scottish court, with the earliest date of liberation and sentence end calculated under Scots law and the Parole Board for Scotland involved as appropriate.

The MHO establishes whether there is a named person, notifies the RMO of their details if one is identified, prepares a Social Circumstances Report within twenty‑one days unless that would serve little or no practical purpose (in which case reasons are recorded and sent to the RMO and the Mental Welfare Commission), and informs the patient about available independent advocacy services and facilitates access to them.

The RMO must assess the patient within seven days of reception, ensuring there is no conflict of interest in relation to the medical examination, and consider whether any measure they have become treated as subject to is appropriate; where the patient has become treated as if they are subject to a compulsion order and a restriction order or subject to hospital or transfer for treatment directions, the RMO has specific reporting duties to the Scottish Ministers. Certain mandatory review requirements under the 2003 Act are disapplied where the assessment falls within those periods.

Within fourteen days of reception, the hospital managers notify the required parties - including, where applicable, the Tribunal and the Scottish Ministers - of the particulars of the reception, the RMO’s details, whether relevant conditions are met, the necessity of measures, the date on which authorisation ceases or will cease, and the next review window.

Care plans must be prepared for those treated as subject to compulsory treatment orders and compulsion orders, in line with the 2003 Act, within twenty‑eight days of the assessment, and hospital managers are placed under duties to provide information to the patient. The information supplied must include details as to the patient’s rights, Tribunal processes, advocacy, Commission functions and access to legal assistance, with appropriate materials and communication support provided and recorded.

Pathway D – Patients subject to Community Requirements entering Scotland from England, Wales, Northern Ireland, the Channel Islands, the Isle of Man or an EU member State

Pathway D is governed by Part III of the 2008 Regulations and requires the consent of the managers of the receiving hospital identified to supervise the person.

The request must be made under provisions in force in the sending territory and include all necessary information. Managers consider requests as soon as reasonably practicable, may wish to seek clarification and must notify the requester of their decision.

A patient should not be received without managers’ consent.

Where consent is given, managers may issue directions for the patient’s conveyance, or arrange for the RMO to do so. Directions are required when escorts will operate within Scotland so that they have powers for the period lasting from the time of the patient’s entry to Scotland to arrival at their destination.

As soon as practicable after consent, managers must notify the relevant local authority - based on the residence or contact address in Scotland - so that a mental health officer can be designated by them as having responsibility for the patient’s case. The managers of the receiving hospital for purposes of supervision must also appoint an approved medical practitioner as the RMO.

On reception in Scotland, which for Pathway D means arrival at the specified residence, the person is treated as if subject to the corresponding Compulsory Treatment Order or Compulsion Order measures under Scots law. These measures may include treatment under Part 16 of the 2003 Act, attendance requirements for treatment or services, residence requirements, access for healthcare professionals, approvals for changes of address and duties to notify in advance of changes of address. Time limits run as if the new measure to which the patient becomes subject, post- transfer, first took effect on the date on which the original corresponding requirement first took effect in the sending territory. The MHO and RMO then complete their respective duties as adapted to community requirements. Following the RMO’s assessment the managers of the receiving hospital must notify the specified parties of details of the transfer, the length of the measure to which the patient is subject, and the period during which there will be a mandatory review, all within fourteen days of reception. Care plan preparation duties and duties to provide the patient with information mirror those imposed in Pathway C.

Where the RMO decides not to revoke a Compulsory Treatment Order treated as in force, the patient or named person may apply for revocation or variation without the ordinary three‑month bar once that decision has been taken, in accordance with the specific regulation.

General effects of transfers

Cessation of measures

Where a person whose detention in hospital is authorised by the 2003 Act or the relevant 1995 Act provisions is removed from Scotland under the 2005 Regulations, the measure which authorised the person’s detention in hospital in Scotland shall cease to have effect when the patient becomes subject to relevant measures in the country or territory to which the patient is removed.

Where a person who is subject to a relevant requirement (a compulsory community requirement other than detention in hospital) by virtue of the 2003 Act or the 1995 Act is removed from Scotland under the 2008 Regulations, the requirement to which the person is subject shall cease to have effect when the patient becomes subject to a corresponding requirement in England or Wales.

Treatment of prison sentence with respect to certain persons

Where a person is received in Scotland under the 2005 Regulations and, immediately before transfer, was liable to be detained by virtue of a measure corresponding or similar to a hospital direction or a transfer for treatment direction made while serving, or in connection with, a sentence of imprisonment imposed by a court in the relevant territory, the person is treated as if the sentence had been imposed by a court in Scotland.

For persons removed from Scotland, the effect on any sentence is governed by the law of the destination jurisdiction and should be confirmed in advance.

Victims of mentally disordered offenders

Under the existing victim notification arrangements, registered victims may receive information that a person has been transferred outwith Scotland, with notifications administered through the Scottish Prison Service Victim Notification Scheme arrangements and/or the Scottish Government CORO VNS administration arrangements (as applicable).

Operationally, clinical teams should ensure the relevant victim notification contacts are informed that a transfer has occurred, and should avoid providing transfer details directly to victims other than through the established victim notification scheme processes.

Once in force, the Victims, Witnesses, and Justice Reform (Scotland) Act 2025 (“the 2025 Act”) will strengthen the information that may be provided to registered victims when a person is transferred outwith Scotland, including (subject to safeguards) information about the jurisdiction to which the person becomes subject as a result of the transfer.

In addition, the 2025 Act enables Scottish Ministers, when providing victim notification information, to provide ancillary information they consider appropriate; this provides scope for more meaningful contextual information to be shared (where lawful and appropriate) alongside core notifications.

These provisions operate alongside existing victim notification arrangements and include an express safeguard that jurisdictional information need not be provided where Ministers have cause to believe that doing so would not be in the interests of justice.

Once the 2025 Act provisions are in force, clinical teams should ensure that the relevant victim notification administrators are informed promptly when a transfer outwith Scotland occurs, provide the information required to support victim notifications (including, where appropriate, the jurisdiction of transfer), and flag any case-specific reasons why it may be inappropriate to disclose jurisdictional information; victim communications should continue to be made through established scheme processes.

Implementation is being phased through commencement regulations; this Code should therefore be read alongside up‑to‑date commencement information.

Appendix A – Notification Matrix (Who must be notified, by pathway)

Pathway	Stage	Must notify	Deadline	Notes
A – Out of Scotland (detained/ in‑hospital)	Pre‑application notice	Patient; Named person (or primary carer + nearest relative if no named person); Guardian; Welfare attorney; MHO	7 days to make representations	Use wording in Appendix D; sender is RMO; do not state transfer date
A – Out of Scotland (detained/ in‑hospital)	MHO duties	Patient (interview; inform as to rights; inform of independent advocacy services)	Within 7 days of notification of MHO	Record attempts if not practicable
A – Out of Scotland (detained/ in‑hospital)	Post‑removal – sending hospital managers’ duties	MHO; Scottish Ministers; Mental Welfare Commission	Within 7 days of removal	Include date and destination/ address (for conditional discharge)
B – Out of Scotland (community)	Request notified by RMO	Named person (unless requester); Mental Welfare Commission; Guardian; Welfare attorney; Primary carer; Managers of specified hospital; MHO	As soon as practicable	—
B – Out of Scotland (community)	MHO duties	Provide view to RMO	Within 3 working days	Record if not practicable
B – Out of Scotland (community)	RMO notification of decision	Patient; named person; Guardian; Welfare attorney; Primary carer; Mental Welfare Commission; Managers of specified hospital; MHO; Responsible hospital in England or Wales; Responsible clinician in England or Wales (if applicable)	As soon as practicable after making a decision	—
B – Out of Scotland (community)	Post‑removal – duties of managers of sending hospital	MHO; Mental Welfare Commission	Within 7 days of removal	Include date and destination address
C – Into Scotland (detained/ conditional discharge)	Consent granted – duties of managers of receiving hospital	Local authority	As soon as reasonably practicable	Managers must hold Ministers’ consent before admission
C – Into Scotland (detained/ condition discharge)	RMO notification(post reception)	Managers of the receiving hospital	As soon as practicable and within 14 days of reception	A report stating whether relevant conditions apply to the patient, the type of mental disorder the patient has, and the necessity of the measures applied.
C – Into Scotland (detained/conditional discharge)	Managers (post‑reception)	Patient; Named person; Guardian; Welfare attorney; Nearest relative/ primary carer (unless patient objects); Mental Welfare Commission; Mental Health Tribunal for Scotland (Compulsory Treatment Order/ Compulsion Order); Scottish Ministers (Compulsion Order and Restriction Order/ Hospital Direction/ Transfer for Treatment Direction); MHO	Within 14 days of reception	Include among other information RMO details, review windows, cessation/expiry dates
D – Into Scotland (community)	Consent – duty on managers of the receiving hospital	Person who made the request	As soon as reasonably practicable	Whether they consent to the reception in Scotland of the patient
D – Into Scotland (community)	Consent – duty on managers of the receiving hospital	Relevant local authority	As soon as reasonably practicable after giving notice to the person who made the request	Name and address of patient, the measure the patient will be treated as subject to under the 2003 Act or the 1995 Act, and the expected date of the patient’s arrival in Scotland.
D – Into Scotland (community)	Post reception - RMO	Managers of the receiving hospital	Within 14 days of reception	Report stating whether relevant conditions apply to the patient, the type of mental disorder the patient has and whether it is necessary for the patient to be subject to the measures the patient has been treated as being subject to following transfer
D – Into Scotland (community)	Managers (post‑reception)	Patient; Named person; Guardian; Welfare attorney; Nearest relative/ primary carer (unless patient objects); Mental Welfare Commission; Mental Health Tribunal for Scotland; MHO	Within 14 days of reception	Include sending/ receiving hospitals; date of transfer; RMO details; whether conditions and measures to apply to the patient, and review windows

Appendix B – Time Limits, Standstill & Appeals (by pathway)

Pathway A – Out of Scotland (patient detained/ otherwise in‑hospital):

• Standard: within UK – standstill 7 calendar days; outwith UK – standstill 28 calendar days (Ministers may specify a day ≥ 7 days).
• Urgent (clinical): standstill – for a UK destination is 3 working days; for a destination outwith the UK it is 7 calendar days (requires Mental Welfare Commission agreement).
• Fast‑track removal: to England & Wales /Northern Ireland / the Isle of Man / the Channel Islands – allowed within standstill if all consents/certificate in place; if consent withdrawn or appeal/reference made, revert to standstill.
• Appeals: patient/named person (and specified others) may appeal after notice of intention to authorise; the Mental Welfare Commission may also refer a proposed removal to the Mental Health Tribunal for Scotland. Standstill ends when the Scottish Ministers notify the RMO, which will be either after the 21‑day appeal period or as soon as practicable after the determination of the Mental Welfare Commission reference, unless fast‑track consents used.
• Removal window: 7 days beginning the day after standstill ends. If this window is missed, a fresh application is needed.

Pathway B – Out of Scotland (patient in the community):

• MHO view: supplied within 3 working days of RMO notification of proposed removal.
• If RMO refuses authorisation to remove: appeal available to the Mental Health Tribunal for Scotland within 14 days beginning with the day on which notice received.
• Warrant: effective date ≥ 3 working days beginning on the day after date of signature; removal permitted only within 14 days beginning the day after the effective date.

Pathway C – Into Scotland (patients detained in hospital / conditionally Discharged from hospital) and Pathway D – Into Scotland (patients subject to community measures corresponding or similar to Compulsory Treatment Order or Compulsion Order):

• Consent must precede reception (Scottish Ministers for C; receiving hospital managers for D).
• MHO designation/RMO appointment: as soon as practicable after notice/consent.
• RMO assessment: within 7 days of reception.
• MHO Social Circumstances Report: within 21 days of reception (or record reasons why not and notify RMO/Mental Welfare Commission).
• Managers’ notifications: within 14 days of reception.
• Care plan: within 28 days of assessment.

Appendix C – Directions, Escort Powers & Absconding (summary)

Directions

• Out of Scotland (Part II of 2005 Regulations, and Part II of 2008 Regulations): Directions must be issued if escorts from another jurisdiction will escort while in Scotland; list named escorts and confirm their authority under the law of their home country or territory. Without directions, they have no powers in Scotland.
• Into Scotland (Part III of 2005 Regulations, and Part III of 2008 Regulations): Where escorts enter Scotland, directions confer: (a) for external escorts – the same powers in respect of the patient as in their home territory (being England, Wales, Northern Ireland, the Channel Islands, the Isle of Man or a member State of the EU) while in Scotland, plus powers to pursue/resume custody and restrain using reasonable force if the patient absconds/attempts to abscond; (b) for Scottish escorts – the powers they would have if the patient were already subject to the measure under the 2003 Act or the 1995 Act to which they will be treated as if they are subject.
• Cross‑border limits: Authority beyond Scotland depends on the law of the other territory. Confirm in advance; do not assume powers continue across borders; seek legal advice as necessary.

Absconding

A patient who is subject to civil compulsory measures, such as a compulsory treatment order, an emergency detention certificate, a short term detention certificate or an interim compulsory treatment order, and who absconds while being removed from Scotland under the 2005 or 2008 Regulations (Pathways A and B) is liable to be taken into custody and dealt with in accordance with sections 301 to 303 of the 2003 Act, as applied (with modifications) by those sets of Regulations.

A person who is being transferred into Scotland from England, Wales, Northern Ireland, the Isle of Man, or any of the Channel Islands, who is subject to mental health measures corresponding or similar to those made in Scotland under the 1995 Act or the 2003 Act in those territories (Pathways C and D) is liable to be taken into custody and dealt with in accordance with sections 301 to 303 of the 2003 Act as applied (with modifications) by the Mental Health (Absconding Patients from Other Jurisdictions) (Scotland) Regulations 2008.

A patient who is subject to a compulsion order (with or without a restriction order), a hospital direction or a transfer for treatment direction under the 2005 or 2008 Regulations, and who absconds, is liable to be taken into custody in accordance with regulations made under section 310 of the 2003 Act (the Mental Health (Absconding by mentally disordered offenders) (Scotland) Regulations 2005).

Once the patient/person is taken into custody following absconding during a cross‑border transfer, what happens next depends on which regime applies:

• Removal from Scotland (Scottish civil/criminal provisions): the person retaking may return the patient to the hospital where they were detained, take them to the hospital where they were to be detained, or - if that is not appropriate or practicable - take them to another place considered appropriate by the patient’s responsible medical officer. These powers apply while the patient remains in Scotland.
• Transfer into Scotland from another jurisdiction: while the person is in Scotland, the person retaking may return the absconder to the custody of the escorts from whom they escaped or, if that is not practicable, take the patient to the receiving hospital or any other place considered appropriate by the responsible medical officer.

If the patient absconds outwith Scotland, after having crossed the border, the availability of pursuit/retaking/restraint powers depends on the law of the other jurisdiction and any powers conferred or recognised there. This should be confirmed in advance.

Absconding and territorial limits (individuals from EU member States, and from outwith the UK and EU)

Individuals from EU member States: sections 289 and 290 of the 2003 Act allow (where applicable) for reception into Scotland of persons subject to corresponding measures or similar requirements from an EU member State. Both the 2005 Regulations and the 2008 Regulations accordingly make provision for a patient who absconds in Scotland during such a cross-border transfer from an EU member State. However, the Mental Health (Absconding Patients from Other Jurisdictions) (Scotland) Regulations 2008, which concern absconding patients from outwith Scotland, who are subject to compulsory mental health measures, and who are found in Scotland, apply only to individuals subject to compulsory mental health measures in England and Wales, Northern Ireland, the Isle of Man and the Channel Islands. Those Regulations do not extend to individuals subject to such measures in EU member States, who have absconded and who are found in Scotland. In such a situation, therefore, the applicable absconding/retaking framework for EU receptions will depend on an assessment of the particular circumstances of the case.

Individuals from outwith both the UK and the EU (“third countries”): sections 289 and 290 of the 2003 Act provide for reception into Scotland only from the England and Wales, Northern Ireland, the Isle of Man, the Channel Islands and (where applicable) EU member States; they do not provide for reception into Scotland from other countries. Where a person arrives in Scotland from outwith both these UK territories and the EU, any compulsory measures must be considered under the ordinary Scottish civil or criminal mental health framework, and jurisdiction‑specific legal advice should be taken. Persons who abscond into, or out of, Scotland

General guidance on persons who abscond and arrive in Scotland from another territory, or who abscond and leave Scotland for another territory, where does not relate to a cross-border transfer, is beyond the scope of this chapter.

Appendix D – Suggested Wording for 7‑day Notification (Pathway A)

“I am writing to tell you that an application is to be made to the Scottish Ministers for a warrant to transfer [you/name] out of Scotland to [hospital]. Before deciding whether to apply, I am giving you the opportunity to tell me your views on the proposal. You have 7 days from receiving this notice to do so.

You may also inform the Scottish Ministers of any wishes or preferences you have in relation to the proposal within the same 7 days by emailing restrictedpatient@gov.scot or writing to the Cross‑border Transfer Administration Team, Scottish Government, Room 3ER, St. Andrews House, Regent Road, Edinburgh, EH1 3DG.”

Appendix E – Known Special Situations

• Outstanding criminal charges: may not prevent UK transfers but plan for court attendance; outwith UK may engage extradition/treaty complexities - contact cross‑border team early.
• Tribunal hearings or ongoing court challenges: proposed transfers will generally await outcomes - engage early with the cross‑border team.
• Prison sentences (HD/TTD): cross‑jurisdictional differences can affect routes back and earliest date of liberation - start discussions early; allow longer timeframes.
• Order expiry approaching: if < 3 weeks remain for detained transfers out, discuss feasibility before applying.