Request a second opinion appointed doctor (SOAD)

Page last updated: 9 November 2023
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Second opinion appointed doctors (SOADs) safeguard people who do not agree to their treatment under the Mental Health Act, or are too unwell to agree.

An approved clinician must request a SOAD if a patient does not agree to their treatment, or is too unwell to agree:

  • 3 months after they started treatment after being detained in hospital
  • 1 month after the start of their community treatment order (CTO)

After these points, an approved clinician must request a SOAD if the patient's treatment has changed significantly, or if the patient no longer agrees to the treatment, or is not well enough to agree.

An approved clinician must also request a SOAD if electro-convulsive therapy (ECT) or neurosurgery to treat mental health has been recommended and the patient is too unwell to make a choice.

The role of the SOAD is to decide whether:

  • the treatment recommended is clinically defensible
  • the views and rights of the patient have been considered

Request a second opinion

Providers with 100 locations or fewer

Providers with 100 locations or fewer must use the provider portal to request second opinions. It's the quickest and easiest way to send us forms.

Sign in to the provider portal

Providers with over 100 locations

If you are a provider with more than 100 locations, use this form to request a second opinion:

It may lead to delays or your application being returned if you complete the form inaccurately.

After you have submitted your second opinion

We will send a confirmation email to the secure email address you provided. It will also have a reference number in case you need to speak to us about the second opinion.

We will also send an email to other contacts in the form.

Once a SOAD has been arranged, they will speak with you to arrange how they will contact the patient. You will be responsible for arranging an interpreter, if required.

If you need to speak to us about your request, email, quoting the reference number. If you do not have the reference number, provide the patient’s initials and date of birth.

Cancel a request for a second opinion

If you need to cancel a request, email with ‘cancellation’ as the subject.

You will need to cancel the request if the patient has moved hospitals. It is the responsibility of the new hospital to request a SOAD, if required.

Provider Portal

About the Provider Portal

Apply to become a SOAD

We are running open recruitment for consultant psychiatrists with at least 5 years’ experience to join our panel of doctors who can undertake second opinions.

If you would like to learn more about the role or request an application pack, email

SOADs appointed by CQC only work in England. For information about how to apply to become a SOAD in Wales, contact Health Inspectorate Wales.