Implementation toolkit for Section 117 Aftercare

Establishing a S117 Partnership Board

Suggested core membership:

• ICB Director of Mental Health (Joint Chair)
• Local Authority Director of Adult Social Care (DASS) (Joint Chair)
• Principal Social Worker and/or Principal Occupational Therapist
• Mental Health NHS Trust Directors / Clinical Representative
• Housing and homelessness Representative
• VCSE mental health Representative
• Commissioning Representative
• People with Lived Experience representatives
• Legal advisors

Core outputs to be included in objectives and work plans

• A joint S117 Policy that is reviewed annually
• Standard Operating Procedures (SOPs) across partners
• A partnership S117 register (or alternative agreed mechanisms such as linked datasets, reconciled records, regular data audits, and routine information-sharing processes)
• Joint Assessment and review templates
• Workforce training and development
• End-to-end pathway maps
• Performance framework and dashboard, to include audits and independent reviews
• Regular reports to respective Council and NHS Committees for assurance purposes.

Five-Dimensional Baseline Tool

Use a five-dimensional baseline tool to inform a joint improvement plan:

1. Legal compliance
2. Governance and infrastructure
3. Practice and workforce capability
4. Aftercare pathways and processes
5. Data quality and digital infrastructure

Develop a Joint Section 117 Policy

A comprehensive Joint S117 aftercare policy should include: 

• a clear statement on the duties placed upon the NHS and local authorities and eligibility criteria
• clear statement of roles and responsibilities
• funding rules and charging arrangements
• statement on accommodation funding
• a clear articulation on the interface between S117, continuing healthcare and the Care Act 2024
• a clear articulation of local arrangements for assessment and support planning standards, including expectations for co-production at an individual level (through shared decision-making with the person and, where appropriate, their carers) and at a system level (through formalised engagement, consultation and participation with people with lived experience in the design, review and improvement of S117 arrangements).
• a clear articulation of the local arrangements for reviews
• a clear articulation of the process to end a S117 aftercare plan including a joint decision protocol
• a clear statement on the dispute resolution arrangements.

Ensure legal review

• the draft Policy should be subject to a review by the Local Authority, ICB and NHS Trust legal counsel.

Ratification and review

• the joint policy should be formally ratified by the ICB Board and Local Authority in line with their respective governance arrangements, with reviews at least annually.
• S117 statute and case law
• learning from inquests, Prevention of Future Deaths reports and Ombudsman findings, including how this learning is translated into improvements in Section 117 practice, risk assessment and aftercare planning.
• the two statutory tests for aftercare
• CHC vs S117 vs Care Act
• Ordinary residence and accommodation rules
• completing lawful assessments
• person-centred and co-produced planning
• risk and relapse planning with focus on explicit consideration of risk, relapse and safeguarding, including the appropriate use and limits of positive risk-taking in the context of mental illness. This should address how autonomy and recovery-focused practice are balanced with relapse prevention, safeguarding duties and legal accountability within Section 117 aftercare planning, and how potential unintended harms are identified, mitigated and reviewed.
• cultural competency and inclusive practice
• carer involvement
• ending S117 appropriately
• how to maintain the S117 register.

Develop a national-aligned training package

The package should be co-produced with people with lived experience of S117 aftercare and kept under review, with updates made as required.

Training modules must include:

• Section 117 statute and case law
• learning from inquests, Prevention of Future Deaths reports and Ombudsman findings, including how this learning is translated into improvements in Section 117 practice, risk assessment and aftercare planning.
• the two statutory tests for aftercare
• CHC vs Section 117 vs Care Act
• ordinary residence and accommodation rules
• completing lawful assessments
• person-centred and co-produced planning
• risk and relapse planning with focus on explicit consideration of risk, relapse and safeguarding, including the appropriate use and limits of positive risk-taking in the context of mental illness. This should address how autonomy and recovery-focused practice are balanced with relapse prevention, safeguarding duties and legal accountability within Section 117 aftercare planning, and how potential unintended harms are identified, mitigated and reviewed.
  cultural competency and inclusive practice
• carer involvement
• ending Section 117 appropriately
• how to maintain the Section 117 register
   

Mandatory training requirements: Mandatory for:

• social workers
• care coordinators
• inpatient teams
• housing officers
• MH Trust staff
• commissioning staff
• panel members
• crisis and home treatment teams.

Competency framework: Staff must demonstrate competence in:

• legal literacy
• risk formulation
• collaborative planning
• trauma-informed practice
• strengths-based assessment
• recording to statutory standards.

Example of key stages in an end-to-end S117 pathway

(Illustrative example – local systems should adapt to local context, need and risk)

• Admission
  • Standard admission and care planning processes commence for all individuals.
  • Where a person is detained under, or subsequently moves onto, a S117–qualifying detention, this should be clearly identified and recorded, and relevant partners notified.
• Early engagement
  • Early conversations with the person and, where appropriate, their carers or supporters, about likely aftercare needs, preferences and priorities.
  • Accessible information provided about S117 aftercare and the right to advocacy, including Independent Mental Health Advocacy (IMHA), in line with statutory duties.
• Assessment and planning
  • Once S117 eligibility is established, joint S117 aftercare assessment and planning should begin, integrated with wider care and discharge planning.
  • Multidisciplinary involvement should be proportionate to assessed need and risk, reflecting both NHS/ICB and local authority responsibilities.
• Ongoing inpatient oversight
  • Regular multidisciplinary review of progress, risks and emerging aftercare needs as part of routine inpatient care.
  • Advocacy involvement should be supported where the person wishes this and where it would facilitate meaningful participation.
• Pre-discharge planning
  • A joint pre-discharge discussion or meeting to agree S117 aftercare arrangements, roles, responsibilities and funding.
  • Advocacy or other support (including legal advice) should be facilitated where requested by the person, rather than mandated.
• Post-discharge review
  • An initial post-discharge review within an agreed and proportionate timescale (for example, around 4–6 weeks) to confirm that aftercare arrangements are meeting identified needs.
• Ongoing review
  • S117 aftercare should be reviewed at least annually, and more frequently where needs, risks or circumstances change.

Embedding clear milestones

(Indicative timescales – to be applied flexibly and proportionately)

Local systems may find it helpful to embed indicative milestones to support timely coordination and accountability. For example:

• Early in admission: Notification to the Local Authority and ICB once a S117–qualifying detention is identified
• Within an agreed early period: Allocation of a named care coordinator and social care lead
• During admission: Commencement of joint S117 aftercare assessment and information-gathering
• Pre-discharge: Draft S117 aftercare plan agreed in principle
• At discharge: Clear handover to community-based services with agreed review arrangements

Milestones should support, not delay, discharge planning and should be adapted where circumstances require.

Pre-discharge considerations checklist

(To support safe, lawful and coordinated discharge)

Before discharge, local systems should ensure that:

• accommodation arrangements are confirmed where accommodation forms part of S117 aftercare
• benefits and financial arrangements are addressed, with clear distinction between chargeable and non-chargeable provision
• medication arrangements, physical health needs and GP liaison are completed
• a copy of the discharge letter is provided to the person in an accessible format.

Crisis, relapse and contingency planning

• a clear crisis or relapse plan is agreed and shared in an accessible format
• the person’s acknowledgement is recorded where possible; where this is not obtained, the reason is documented and appropriately verified.

Carer involvement

• carer involvement is recorded where appropriate, or the reason for non-involvement is clearly documented.

Advocacy

• the right to advocacy is explained in an accessible way
• information provided or referral made is recorded
• the person’s acknowledgement is recorded where possible; where not obtained, the reason is documented and appropriately verified.

Standardised S117 Assessment Template (see appendix 1 for template)

The S117 aftercare assessment is a joint, strengths-based assessment completed by the Integrated Care Board and the Local Authority with the person (and their carer, representative or advocate where appropriate). Its purpose is to identify the aftercare required to meet needs arising from, or related to, the person’s mental disorder and to reduce the risk of deterioration or readmission.

The assessment covers the following key areas:

1. Personal details and legal eligibility

• Confirmation of the person’s identity and contact details
• Mental Health Act qualifying section and dates
• Diagnosis linked to the S117 duty
• Confirmation that the S117 duty applies

2. Strengths, networks and what matters most

• The person’s relevant strengths, skills and resilience
• Informal networks and natural supports (family, friends, community)
• What matters most to the person, including values, routines and aspirations
• The person’s own goals for clinical recovery, personal recovery and living well
• How identified strengths and informal supports are reflected in the aftercare plan and risk management approach

This section ensures the assessment starts from strengths and outcomes, not deficits.

3. Health needs arising from or related to the Mental Disorder (ICB-led)

A holistic assessment of health needs that may fall within S117, including:

• medication and clinical treatment
• ongoing mental health support and care coordination
• psychological therapies
• monitoring mental state and relapse prevention
• physical health needs arising from or related to mental disorder, its treatment or functional impact.
• functional impact of mental disorder
• crisis, safety and risk management planning
• risk enablement and positive risk-taking including identification of potential harms of risk taking and agreed mitigation methods.
• specialist mental health pathways where relevant.

4. Social Care Needs Arising from the Mental Disorder (Local Authority-led)

A holistic assessment of social care needs that may fall within S117, including:

• daily living and home environment
• relationships, family life and social networks
• community participation and meaningful activity
• emotional, psychological and social wellbeing
• personal safety and safeguarding where linked to mental disorder
• physical health where mental disorder impacts ability to engage
• managing practical tasks affected by mental state
• crisis prevention, stability and recovery.

This ensures S117 is applied lawfully and broadly, not limited to clinical services alone.

5. Relapse indicators and crisis contingency planning

• Early warning signs of relapse identified with the person
• Agreed actions to take if concerns arise
• Clear responsibilities and routes to access support
• The person’s preferences during crisis, including advance statements (also referred to as advance choice documents), where these have been developed.

This section supports risk enablement, early intervention and prevention.

6. Funding and S117 Eligibility Decisions (Joint)

• Confirmation of which services meet the S117 aftercare definition
• Any services excluded from S117 and the legal reason why
• Agreed funding responsibilities between the ICB and Local Authority
• Date the joint funding decision was reached

This section provides transparency and reduces disputes.

7. Co-production, involvement and accessible communication

• How the person has been involved in decisions about their own assessment, care and support planning, including how their views, preferences and outcomes have shaped the plan, and any areas of disagreement and how these have been addressed.
• Family, carer and advocate involvement, including the role played, any views expressed, and the person’s consent or reasons for non-involvement where applicable.
• Communication and accessibility needs, including any reasonable adjustments required to support participation and understanding. Adjustments should be explicitly identified and recorded as such to demonstrate compliance with proactive Equality Act duties.
• Cultural, equality and human rights considerations, including how protected characteristics, identity, beliefs or experiences of discrimination have been considered in planning and decision-making.

In addition to individual-level involvement, local systems should also demonstrate system-level co-production, including how learning from people with lived experience has informed the design, delivery and review of S117 policies, pathways and services.

Together, this supports compliance with shared decision-making, co-production, equality and human rights duties, and promotes transparent, person-centred and lawful practice.

8. Consent and mental capacity

• Assessment of the person’s capacity to consent
• Whether the person agrees to the plan
• Any best interests decisions (where required)
• Consent to share the plan with relevant professionals

9. Review arrangements

• Initial review arrangements (within three months)
• Ongoing review frequency (at least annually)
• Named lead responsible for arranging reviews

This reflects the ongoing nature of the S117 duty.

10. Signatures and agreement

• Confirmation of joint agreement by:
  • The person
  • Health professionals
  • Social care professionals
  • Carer/representative/advocate (where involved)

Full assessment template

The full S117 Assessment and Support Plan template, including detailed prompts, tables and recording fields for each of the areas above, is provided in Appendix 1. Local systems can use the template to evidence lawful decision-making, co-production and compliance with S117 duties.

Minimum data set for the register

• Person details
• Legal section qualifying entitlement
• Responsible LA and ICB
• Date duty triggered
• Aftercare plan details
• Accommodation funded
• Care coordinator
• Review dates (automatic alerts)
• Decision about ending S117

Digital system requirements

• Read/write access for LA, ICB and NHS Trust
• Interoperability with shared care records
• Scheduled audit functions
• Automated workflow
• Clear user permissions

Data quality cycle

Monthly reports to:

• S117 Programme Board
• ICS MH Partnership Board
• Safeguarding partnership (where relevant)

Clear Funding Framework

• Zero charging for lawful S117 services
• Transparent decision-making
• Documented rationales that link to the statutory test
• Funding disputes resolved through joint protocol

S117 panel redesign

• Panel focuses on persons strengths, needs and outcomes to be met to prevent relapse/readmission.

Core membership

• Senior ICB and LA commissioners
• Local Authority Mental Health Lead and PSW/POT
• Clinical adviser (e.g. consultant psychiatrist)Housing representative
• Lived experience advisor (where appropriate)

Accommodation funding decisions

Use a three-step test:

1. Does the accommodation meet a need arising from the mental disorder?
2. Is it required to prevent deterioration or readmission?
3. Is it a specialist setting (this includes supported living) with therapeutic features?

If YES = funded by S117.
If NO = rent funded via housing routes; support funded under S117.

Standards for culturally appropriate and inclusive aftercare

Culturally competent practice should recognise and respond to the full range of cultural, social and identity factors that may influence a person’s mental health, engagement with services and access to support. This includes, but is not limited to, ethnicity and race, as well as non-ethnic and subcultural identities, lived experience, and socioeconomic context. Standards should include:

• Choice of interpreter or communication support, including British Sign Language (BSL) and other non-spoken language needs
• Cultural formulation or equivalent structured approaches, applied flexibly to understand identity, context and meaning
• Trauma-informed practice, including recognition of systemic, historical and relational trauma
• Anti-racist, anti-stigma and anti-discrimination frameworks, addressing both individual and structural barriers
• Accessible information, provided in preferred formats and languages, and responsive to literacy, digital access and cognitive needs
• Advocacy support, including culturally appropriate advocacy where required

Cultural competence should also explicitly consider factors such as Deaf culture, neurodiversity, care-experienced communities, distinct national or regional identities, poverty, homelessness, digital exclusion and social class, to reduce the risk of unmet needs, disengagement or inequitable outcomes.

Equality Impact Assessment (EIA)

An Equality Impact Assessment should be completed for:

• the S117 policy or procedure
• Pathway redesign activity
• assessment and review templates
• training and workforce development packages.

EIAs should consider how protected characteristics and wider social and structural factors may affect access, experience and outcomes under S117 aftercare.

Lived experience (of S117 aftercare) co-production panel

Local systems should establish or utilise mechanisms for ongoing co-production with people who have lived experience of S117 aftercare. Panel functions may include:

• reviewing and co-facilitating training content
• quality-checking assessment and review templates
• shaping workforce guidance and practice expectations
• contributing to audits, reviews and service improvement activity.

Section 117 Key Performance Indicators (KPIs)

Access and timeliness

• Time from qualifying detention to first S117 aftercare assessment
• Time from admission to identification and recording of Section 117 eligibility (where applicable)
• Time from discharge to first post-discharge S117 review
• Percentage of people with a current annual S117 review
• Percentage of people with a current S117 aftercare plan

Quality

• Percentage of aftercare plans that clearly meet the statutory S117 test
• Percentage of plans demonstrably co-produced with the person
• Percentage of assessments and plans evidencing carer involvement, or a recorded rationale where this is not appropriate

Outcomes

• Reduction in unplanned mental health readmissions
• Reduction in crisis presentations
• Reduction in out-of-area placements

Equity

• Outcomes data stratified by mental health diagnosis, alongside ethnicity, age, disability, gender and indices of deprivation, with analysis of differential access, funding decisions and pathway intensity, to identify and address inequities in S117 service provision.

Audit framework

Quarterly audits should examine:

• legal compliance and defensible decision-making
• recording quality, including evidence of professional curiosity, the voice of the person, identified outcomes, and progress towards those outcomes
• risk, safety, relapse and contingency planning
• funding decisions, including the appropriateness and rationale for accommodation-related decisions.

Legal compliance and safeguards

Local systems should monitor:

• percentage of cases with a recorded legal basis for S117, named decision-maker and date of determination
• percentage of cases with advocacy offered and the person’s response recorded
• percentage of cases with documented reasonable adjustments
• percentage of cases where the S117 duty ended with a clear written rationale and joint review sign-off
• timeliness of inter-agency dispute resolution
• percentage of complaints and Ombudsman findings relating to S117 with completed and monitored action plans
• percentage of Prevention of Future Deaths (PFD) reports relating to Section 117 with governance review and tracked actions
• percentage of audit findings that result in system or practice change, with follow-up review at the next quarterly governance panel.

• Memorandum of Understanding: Joint Working Arrangements for Section 117 Mental Health Aftercare
• Partnership Section 117 Aftercare Workforce Competency Framework
• Partnership Section 117 Mental Health Aftercare Assessment and Support Plan Template
• Partnership Section 117 Review of Aftercare Plan Template
• Partnership Section 117 Light Touch Review of Aftercare Plan Template
• Section 117 Aftercare: Escalation and Dispute Resolution Protocol
• Section 117 Mental Health Act (MHA) Partnership Baseline Diagnostic Tool
• Section 117 Mental Health Act Aftercare: Annual Partnership Audit Tool
• Section 117 MHA – Accommodation Funding Decision Tool