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What is the guidance in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the Covid-19 pandemic?

The Department of Health & Social Care has published guidance for hospitals, care homes and supervisory bodies on the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) during the coronavirus pandemic.

In many scenarios created or affected by the pandemic, decision makers in hospitals and care homes will need to decide:

  • if new arrangements constitute a ‘deprivation of liberty’ (most will not), and
  • if the new measures do amount to a deprivation of liberty, whether a new DoLS authorisation will be required (in most cases it will not be).

If a new authorisation is required, decision makers should follow their usual DoLS processes, including those for urgent authorisations.

A summary of the key points to be taken from the guidance is outlined below:

Use of the MCA and DoLS due to Covid-19

  • During the pandemic, the principles of the MCA and the safeguards provided by DoLS still apply.
  • It may be necessary to change the usual care and treatment arrangements, for example to provide treatment for people with Covid-19, to move them to a new hospital or care home to better utilise resources or to protect them from becoming infected.
  • All decision makers are responsible for implementing the emergency Government health advice  and any decision made under the MCA must be made in relation to a particular individual, it cannot be made in relation to groups of people.

Best interest decisions

  • In many cases, a best interests decision will be sufficient to provide the necessary care and treatment for a person who lacks the capacity to consent to the care and/or treatment arrangements during this emergency period.
  • If an individual has made a valid and applicable advance decision to refuse the treatment in question, then the relevant treatment, even for Covid-19, cannot be provided.

Delivering life-saving treatment

  • Where life-saving treatment is being provided in care homes or hospitals, including for the treatment of Covid-19, then the person will not be deprived of liberty as long as the treatment is the same as would normally be given to any person without a mental disorder.
  • The DoLS will therefore not apply to the vast majority of patients who need life-saving treatment who lack the mental capacity to consent to that treatment, including treatment to prevent the deterioration of a person with Covid-19.

The full guidance can be found here.

Related FAQs

What are the temporary adjustments to Right To Work checks?

To facilitate social distancing the Home Office has stated that as of 30 March 2020, the following are permitted:

  • The RTW check can now take place over video call.
  • Job applicants no longer have to send original documents but can send scanned copies or photos to the employer.
  • Where the job applicant cannot provide these documents, employers can use the Employer Checking Service and if they have the right to work, then the employer will receive a Positive Verification Notice which will provide the employer with a statutory excuse for 6 months.

These adjustments remain in place until the Home Office confirms otherwise.

 

I'm a doctor. What should I do if I think I may be infected with coronavirus?

The GMC recognises the challenges the doctors may face as the situation continues to develop. This includes concerns about the risks to the health of the doctors when treating patients with coronavirus. Doctors should follow the current public health advice including self-isolating if they know or suspect that they are infected or are at a higher risk of infection.

 

Finally, all necessary steps should be taken to ensure that doctors have access to protective equipment and minimise the risk of transmission when treating patients. It is imperative that a record is kept of all decisions made and how any safety or health concerns have been handled.

 

The GMC continues to work with NHS England and UK’s Chief Medical Officers to provide updates and advice to all doctors as the situation develops. Click here for more information.

How do I ensure my use of video conferencing calls complies with GDPR?

With the loss of face-to-face meetings in the current situation, video conferencing has taken centre stage. But how do you do that in a compliant way? Here are some of the main high-level data protection issues to consider when selecting and implementing a new third party provider’s video conferencing system.

  1. Make sure you do your due diligence on the security measures offered by the provider. Clearly you can’t visit them, so look at the information offered publicly by the provider and read good quality, reliable, third party sources and ask the provider questions directly. Also ask any other organisations you know that use the provider. Document all this.
  2. If personal information is being sent outside of the UK/European Economic Area, make sure that transfer complies with GDPR. If it’s a US provider, is it registered in the EU-US Privacy Shield list or does it offer a model clause contract (you’re likely to need the 2010 version)? Or is the service provided from a country whose data protection laws offer equivalent protection to those in Europe? Look at the support service as well as the hosting. Document this.
  3. Make sure you put a compliant processor agreement in place. The provider should offer one as part of the contract terms. Check it meets GDPR requirements.
  4. You’re likely to need to update your privacy notice, particularly if you’re going to record calls. Provide participants with a short message and link to the privacy notice in the meeting invite and on any registration page.
  5. Create or update other GDPR-mandated documentation – for example, depending on your use, you may need a legitimate interests assessment and to update your record of processing.
  6. Finally, configure and use the system in a secure and compliant way. Look at the settings/options carefully and think through the security and compliance implications of each. That could include deciding who in the meeting can share their screen; whether or not you use passwords for participants; whether or not to record, and if you’re going to record, where to store the recording. Document your decisions and the reasons for them.

The ICO has said it understands that resources, whether they are finances or people, might be diverted away from usual compliance work during the pandemic. However the last thing you need at the moment is to create a bigger problem than the one you are trying to solve. So do the best you can, ask for help from one of our specialists if you need it, and keep the whole thing under review.

On 16 April 2020, Ian Hulme, the ICO’s Director of Assurance, posted a blog for business owners, employers and managers about how to safely roll out the latest video conferencing technology.

On 21 April 2020, the NCSC published security guidance for organisations on choosing, configuring and deploying video conferencing services.

If a member of staff does not inform me that they ought to be self-isolating will I still be liable for a fine?

Potentially no.

If an employer is not put on notice that the circumstances of a worker or agency worker are such that they ought to be self-isolating, by either the worker or agency worker themselves or another member of staff, then there ought to be a reasonable excuse, and potentially, no fixed penalty notice will be issued.

What happens if someone is asked to restrict their duties but, despite acknowledging the risks to their health involved, they say that they want to continue to work on the front line?

As their employer, you have an overriding duty to provide a safe system of work. The Trust would not be able to run a defence to say that an employee “waived their rights” and chose to continue to work. Provided the decision around restricting duties has been carefully thought out, a full risk assessment undertaken and the employee has been truly consulted about the impact on them, then the decision taken will be a reasonable management instruction. Failing to follow that reasonable management instruction could amount to a disciplinary offence.