being encouraged to take on the role. Once an AC takes over the care of a specific patient, they are known as the Responsible Clinician (RC) for that patient. Nearest Relatives A Nearest Relative is a relative of a mentally disordered person. There is a strict hierarchy of types of relationship that needs to be followed in order to determine a particular person's Nearest Relative: husband, wife, or civil partner; son or daughter; father or mother; brother or sister; grandparent; grandchild; uncle or aunt; nephew or niece; lastly, an unrelated person who resides with the mentally disordered person. Thus a person's Nearest Relative under the Act is not necessarily their "next of kin". A mentally disordered person is not usually able to choose their Nearest Relative but under some circumstances they can apply to a County Court to have a Nearest Relative replaced. In practice, such applications are more commonly made by Social Services Departments. The Nearest Relative has the power to discharge the mentally disordered person from some sections of the Act. Hospital Managers Hospital Managers represent the management of the NHS Trust or independent hospital and have the responsibility for a detained patient. On their behalf, the non-executive members of the board of the relevant National Health Service Trust and appointed lay 'Associate Managers' may hear appeals from patients against their detention, Community Treatment Order and upon those detentions being renewed and extended. Cases are heard in similar settings to those heard by the First-Tier Tribunal (Mental Health) outlined below. First-Tier Tribunal (Mental Health) Mental Health Review Tribunals (MHRTs) hear appeals against detention under the Act. Their members are appointed by the Lord Chancellor and include a doctor, a lawyer and a lay person (i.e. neither a doctor nor a lawyer). Detained persons have the right to be represented at MHRTs by a solicitor. Discharge from hospital as a result of an MHRT hearing is the exception to the rule, occurring in around 5% of cases, when the Tribunal judges that the conditions for detention are not met. Civil sections Part II of the Act applies to any mentally disordered person who is not subject to the Criminal Justice System. The vast majority of people detained in psychiatric hospitals in England and Wales are detained under one of the civil sections of the Act. If a clinician consents, patients may choose to be treated as voluntary inpatient. This