AN v St Andrew’s Healthcare & Anor

A provisional decision to conditionally discharge a restricted patient does not finally determine the patient’s mental state. Until a final direction is made, the tribunal may consider fresh evidence and must assess whether the patient is then suffering from mental disorder. A patient may be detained for a reasonable period while arrangements for conditional discharge are investigated. If the provisional finding is maintained and arrangements cannot be made within a reasonable period, discharge may be required. The tribunal retains power to revisit its provisional findings, even without a material change in circumstances, provided fairness is observed and the patient has notice of the issue.

The First-tier Tribunal found that AN did not have a mental disorder and made a provisional decision to direct his conditional discharge under the Mental Health Act 1983. It deferred a final decision while arrangements for accommodation and community supervision were investigated. On a later application, the First-tier Tribunal refused to reconvene immediately and stated that it would retain its full powers at any reconvened hearing.

AN appealed, arguing that his continued detention had become unlawful and that the tribunal could not revisit its finding that he had no mental disorder. The central issues were whether the detention was unlawful and whether the tribunal could reconsider its provisional finding before making a final decision.

1. Appeal dismissed. The First-tier Tribunal had not erred in law by refusing to reconvene immediately. The tribunal was entitled to allow further time to investigate complex arrangements for conditional discharge.
2. Under sections 72 and 73 of the Mental Health Act 1983, a restricted patient may be conditionally discharged subject to liability to recall, with further conditions imposed if appropriate. Section 73(7) permits the tribunal to defer a direction for conditional discharge until necessary arrangements have been made.
3. The effect of R (H) v Secretary of State for the Home Department [2003] QB 320 and [2004] 2 AC 253 is that a tribunal may make a provisional decision, monitor progress, and reconsider the position if circumstances or arrangements require it. A patient without mental disorder may be detained for a reasonable period while arrangements are made. If arrangements cannot be made within a reasonable time, discharge may be required.
4. The provisional finding that AN did not have a mental disorder was not an operative final finding. When the tribunal makes its final decision, section 72(1)(b)(i) requires it to decide whether the patient is then suffering from mental disorder. The word then refers to the time of the tribunal’s review. The tribunal must therefore assess the evidence available at the time of the final decision, and its conclusion may be the same as, or different from, the provisional conclusion.
5. There is no estoppel or equivalent principle preventing reconsideration in mental health proceedings. The reasoning in R (Von Brandenburg) v East London and the City Mental Health NHS Trust [2004] 2 AC 280 applies equally, or at least provides support, in the case of restricted patients. If a different finding is contemplated, fairness requires notice to the patient.

• Upper Tribunal (Administrative Appeals Chamber): the appeal against the First-tier Tribunal’s interlocutory decision dated 21 October 2025 was dismissed. The Upper Tribunal held that the First-tier Tribunal had jurisdiction to revisit its provisional mental-state finding at a reconvened hearing.
• First-tier Tribunal (Health, Education and Social Care Chamber): on 21 October 2025, Judge Lawrence refused the application to reconvene immediately and stated that the tribunal retained its full powers at any reconvened hearing.