Reviewed by legal and social-care professionals
Last reviewed
TL;DR
Section 117 aftercare is free NHS and council care for anyone discharged from detention under Sections 3, 37, 45A, 47 or 48 of the Mental Health Act. It is not means-tested. NHS Continuing Healthcare (CHC) is a separate, fully-funded NHS scheme for “primary health needs.” When both apply, S117 covers mental-health-related needs; CHC may cover unrelated significant health needs. Searches are up 22% year-on-year — and councils still wrongly try to means-test S117 cases.
What is Section 117 aftercare?
Answer first: Section 117 aftercare is a statutory duty under section 117 of the Mental Health Act 1983 requiring the NHS and the local council jointly to arrange and pay for aftercare services for people discharged from detention under specific sections of the Act. It is free at the point of use and is not means-tested.
The duty is jointly held by the local Integrated Care Board (ICB) and the local authority. They must work together to assess what aftercare the person needs and arrange it. The two-part legal test is that the services must (a) arise from or relate to the mental disorder that triggered the detention, and (b) reduce the risk of deterioration or readmission. Mind's legal rights guide sets out the framework in family-friendly terms.
In 2024/25, NHS Digital recorded 52,731 new MHA detentions, with detention rates running at 90.1 per 100,000 for males and 80.0 per 100,000 for females. Most of those detentions trigger Section 117 entitlements on discharge — but families often only discover this after being wrongly billed for care.
Who is eligible — by MHA section
Answer first: Section 117 entitlement is triggered by detention under specific sections of the Mental Health Act 1983: Sections 3, 37, 45A, 47, 48, and Community Treatment Orders under Section 17A. Detention under Section 2 (assessment), Section 4 (emergency), Sections 5(2) or 5(4) (holding powers), or Sections 135/136 (police powers) does not trigger S117 — even if the person is later transferred to Section 3.
Section 2 alone does not trigger Section 117 — even when it leads to admission. The most common path to a Section 117 entitlement is detention under Section 2 followed by a transfer to Section 3 once assessment is complete. The Section 117 duty starts on discharge from the Section 3 detention, not the Section 2.
What does Section 117 cover?
Answer first:Section 117 covers any service the joint duty holders agree is needed to meet the person's aftercare needs. This typically includes community mental health support, specialist housing or supported accommodation, care home placements, day services, occupational therapy, employment support, and clinical follow-up. Services must arise from the mental disorder and reduce the risk of deterioration.
The Local Government and Social Care Ombudsman, jointly with the Parliamentary and Health Service Ombudsman, published updated Section 117 guidance in September 2022. It identifies the five most common errors councils and ICBs make:
- Failing to arrange Section 117 reviews — leaving families uncertain whether the duty still applies.
- No aftercare plan for CTO patients — leading to readmission under Section 3 because the CTO conditions weren't supported.
- Poor inter-agency communication between councils and ICBs about who funds what.
- Inadequate community follow-up after discharge — most acutely a problem in the first 3 months post-discharge.
- Wrongly charging for care home fees that should be free under Section 117 — the most directly financial of the five.
The financial point is the one that matters most to families. Care home fees can exceed £80,000 a year. If Section 117 applies, the council and ICB must cover those fees in full — and where charges have wrongly been levied, the LGO has repeatedly ordered refunds back to the start of the Section 117 entitlement.
“Local authorities and ICBs continue to make significant errors in their handling of Section 117 aftercare. Where these errors result in service users being charged for services that should have been free, we will continue to recommend full refunds dating back to the start of the entitlement.”
— LGO/PHSO joint Section 117 guidance, September 2022
How long does Section 117 last?
Answer first: Section 117 has no fixed end date. It continues until the ICB and the local authority jointly conclude that the person no longer needs the services. Both bodies must agree, in writing, with reasons. Section 117 does not end automatically because of time, the person being discharged from a community team, or being briefly readmitted under Section 2.
The statutory test is whether ending the services would risk the person's mental health deteriorating to a point where readmission becomes more likely. If the answer is yes — even partially — Section 117 must continue. In practice, many people remain on Section 117 for years, and some for life.
Section 117 does not end automatically just because:
- You were discharged from a community mental health team.
- A long time has passed since you left hospital.
- You went back to hospital voluntarily.
- You were detained under Section 2 (assessment) at some later point.
- You moved to a different council area (the original Section 117 council remains responsible under section 39 of the Care Act 2014).
If a council tells you Section 117 has ended for any of these reasons, ask for the joint decision in writing — including the date of the joint review, the names of the ICB and council representatives, and the clinical reasoning. If they cannot produce one, Section 117 has not lawfully ended.
Section 117 vs CHC — which one pays?
Answer first: When both schemes could apply, Section 117 takes precedence for needs arising from the mental disorder. CHC should not be used to fund S117-eligible needs. However, a person on Section 117 can still receive CHC for significant health needs unrelated to the mental health condition that triggered detention. NHS England's 2020 “Who Pays?” guidance confirms the funding streams are distinct.
The interaction rule.Section 117 services and CHC services are funded separately and run alongside each other. A person on Section 117 for schizophrenia who later develops Parkinson's should receive Section 117 for mental-health-related support and a separate CHC assessment for Parkinson's-related needs. The two should not be conflated. Where the council has been using Section 117 to cover physical-health needs, families can request a CHC assessment to shift those costs to the NHS — and recover any contributions wrongly made.
Humber and North Yorkshire ICB publishes one of the clearest joint policies on the interaction. Their model is now used as a reference by other ICBs.
When the S117 vs CHC decision matters most
Three real-world scenarios make the financial stakes concrete. In each, the difference between a Section 117 finding and a means-tested social-care arrangement is tens of thousands of pounds a year.
1. Dementia under a Section 3
An elderly parent is detained under Section 3 for behavioural and psychological symptoms of dementia. They are discharged to a care home. The council attempts to means-test the placement. Under Section 117, the council and ICB must fund the placement free of charge for the duration of the entitlement — which, given the dementia is progressive, is likely to be lifelong.
2. Learning disability with co-morbidity
A young adult with autism and epilepsy is detained under Section 3 following a behavioural crisis. Section 117 covers their mental-health-related support package post-discharge. CHC may separately cover the epilepsy if it crosses the primary health need threshold — particularly if seizures are frequent, complex, or unpredictable.
3. Long-term schizophrenia with later-life physical decline
A person has been on Section 117 since the 1990s for schizophrenia. They later develop Parkinson's disease in their 60s. Section 117 continues for the mental-health-related needs. A fresh CHC assessment is appropriate for the physical-health needs, which are not arising from the mental disorder. Both schemes can run concurrently with no conflict.
The dementia scenario is by far the most financially significant — and the most commonly mishandled. The Alzheimer's Society's Mental Health Act factsheet confirms that Section 117 protection extends to dementia patients detained under Section 3, but families often only discover the entitlement after years of paying privately.
How to challenge a wrong Section 117 decision
Answer first:Where a council has wrongly means-tested a Section 117 case or wrongly ended a Section 117 entitlement, the route is: (1) request a Section 117 review in writing; (2) cite the LGO/PHSO 2022 joint guidance; (3) use the council's formal complaints procedure; (4) escalate to the Local Government and Social Care Ombudsman. Where charges have been wrongly applied, request a full refund dating back to the start of the entitlement.
Request a Section 117 review in writing
Email the council's adult social care team and copy the local ICB. State that you are requesting a joint Section 117 review under the duty established by the LGO/PHSO 2022 guidance. Ask for the joint decision in writing with reasons.
Reference the LGO/PHSO 2022 joint guidance
Cite the specific error pattern at issue (e.g. "failure to arrange S117 reviews" or "wrongly charging for care home fees"). Naming the LGO error type signals familiarity with the framework and makes the council more likely to respond constructively.
Use the council's formal complaints procedure
If the joint review fails to resolve the issue, raise a Stage 1 complaint via the council's formal procedure. Stage 1 typically resolves in 20 working days. If unresolved, escalate to Stage 2.
Escalate to the LGO
Once the council's complaints procedure is exhausted (or 12 weeks have passed without resolution), submit to the Local Government and Social Care Ombudsman. The LGO upheld 67% of detailed investigations in 2020-21 — its highest ever rate. Where charges have been wrongly applied, request a full refund.
Where the case involves disputed mental capacity — for example, a Section 117 patient subject to Deprivation of Liberty Safeguards (DoLS) in a care home — the Mental Capacity Act 2005 framework runs alongside the MHA framework. We're building a Best Interests Decision Challenge Letter generator (£29) for Q3 2026 — email hello@careadvocate.co.uk if you need this manually in the meantime.
When the council won't budge
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Section 117 and benefits, council tax, pension
Answer first: Section 117 itself does not affect benefits. Personal Independence Payment (PIP), Universal Credit, ESA, and the State Pension are all assessed independently of Section 117 status. Council tax may be reduced via the Severe Mental Impairment exemption — separately from Section 117. Care home top-up fees are not lawful for Section 117 placements unless the resident has freely chosen a more expensive home.
PIP: Section 117 status does not affect PIP eligibility, but mental-health-related care needs may strengthen a PIP claim. PIP is not means-tested.
State pension and Universal Credit: Both unaffected by Section 117 directly. Hospital admission rules apply during a Section 3 detention (some benefit reductions after 28 days of inpatient stay), but Section 117 itself does not reduce benefits post-discharge.
Council tax: The Severe Mental Impairment (SMI) council tax exemption may apply to people with dementia, learning disabilities, or severe mental illness. The exemption is separate from Section 117 — but Section 117 patients often qualify. A GP must confirm the SMI in writing.
Care home top-up fees: Top-up fees are not lawful for Section 117 placements unless the person has freely chosen a more expensive home than their assessed needs require. Where top-ups have been wrongly applied, the LGO has ordered refunds. If a council asks the family for a top-up on a Section 117 placement, ask in writing for the basis under section 117 — they cannot lawfully charge.
Frequently asked questions about Section 117
What does Section 117 aftercare mean?
Section 117 aftercare is free care and support that the NHS and the local council jointly provide to anyone who has been detained in hospital under specific sections of the Mental Health Act 1983 — most commonly Section 3, Section 37, Section 45A, Section 47 or Section 48. It is a statutory duty under section 117 of the MHA, not a discretionary scheme, and it is not means-tested. Services can include healthcare, social care, supported accommodation, and care home placements.
How long can Section 117 last?
Section 117 has no fixed end date. It continues until the local Integrated Care Board (ICB) and the local authority jointly decide that the person no longer needs the services to prevent deterioration of their mental health. The two bodies must reach this decision together, in writing, with reasons. Section 117 does not end automatically because time has passed, the person was discharged from a community team, or they were briefly readmitted under Section 2.
Is Section 117 aftercare for life?
It can be — but it is not automatic. The Mind charity confirms there is no time limit. In practice, many people stay on Section 117 for years or for the rest of their lives, particularly where the underlying mental health condition is chronic. Section 117 ends only when the joint review concludes the person no longer needs the services. The LGO/PHSO 2022 guidance flagged failure to carry out reviews as one of the most common council errors.
Who pays for Section 117 aftercare?
The NHS (through the local ICB) and the local council jointly pay for Section 117 aftercare. They split the costs between health and social care components, but neither body can charge the person receiving care. The Care Act 2014 charging regulations explicitly exclude services provided under Section 117. NHS England's 2020 'Who Pays?' guidance confirms the funding streams are separate from CHC.
Can I be on Section 117 and CHC at the same time?
Yes — though Section 117 takes precedence for needs arising from the mental disorder that triggered the detention. NHS Continuing Healthcare can still apply separately for significant health needs unrelated to the mental health condition. Examples: a person on Section 117 since the 1990s for schizophrenia who later develops Parkinson's may receive Section 117 for mental-health-related needs and CHC for the Parkinson's-related needs.
Is Section 117 aftercare means-tested?
No. Section 117 services are provided free of charge regardless of capital, income, savings, or property. This is one of the most commonly misunderstood points — councils sometimes wrongly try to charge Section 117 patients for care home fees or community support. The Local Government and Social Care Ombudsman has upheld multiple complaints where families were wrongly charged and ordered refunds dating back to the start of the Section 117 entitlement.
Can a council charge for a care home if my relative is on Section 117?
Generally no. If the care home placement meets a Section 117 need, the council and ICB must fund it free of charge. The only narrow exception is where the person freely chooses a more expensive home than the assessed needs require — in which case a third-party top-up can apply, but only voluntarily. The LGO has repeatedly ordered refunds where councils have wrongly applied means-tested charges to Section 117 placements.
Does Section 117 apply to dementia?
Yes — if the person was detained under Section 3 (or Section 37, 45A, 47, 48) for behavioural or psychiatric symptoms of dementia, they qualify for Section 117 aftercare on discharge. This is a major financial issue: dementia care home fees can exceed £80,000 a year. If Section 117 applies, the council and ICB must cover those fees, not the family. The Alzheimer's Society's Mental Health Act factsheet confirms this protection extends to dementia patients.
Related guides
NHS Continuing Healthcare Funding Guide
The complete guide to CHC — when it applies alongside or instead of Section 117.
Discharge to Assess: Family Guide
If your relative is being discharged from a Section 3 detention, this is the parallel pathway you need.
12-Week Property Disregard
Means-tested care home funding — and how Section 117 is the fast escape route from it.
Free CHC Eligibility Screener
A 5-minute check on whether CHC could apply alongside Section 117 for unrelated health needs.
This article provides general information only and does not constitute legal or medical advice. CareAdvocate is an evidence preparation service reviewed by legal professionals and social care professionals. Section 117 entitlements turn on individual clinical histories — if you believe your relative has been wrongly means-tested, the LGO and Mental Health Act 1983 are the operative authorities. Last reviewed: 6 May 2026.