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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

I have to pay my ex-spouse monthly spousal maintenance pursuant to a Court Order and I can no longer afford to pay. Can I stop paying?

Maintenance Orders embodied in a Court Order are variable. If you have lost a very large part of your income, then the Courts ought to take that into consideration when looking at a Court Application to reduce or end spousal maintenance payments. The outcome of any Court Application will, however, depend on a number of factors.

Technically, you should not just stop paying or reduce the maintenance payments, as your ex-spouse could then make an Application to Court for enforcement and payment of the arrears. You could ask the Court to forego you having to pay those arrears if you had evidence to prove that you could not make the payments, however, the Court will need to take a fair approach and you should not assume this request will be agreed.

You should first try to negotiate a reduction or termination of the maintenance with your ex-spouse, either directly or through a Solicitor. If this is possible, you should obtain a Court Order reflecting that agreement. Where a sensible compromise cannot be reached, a Court Application may be necessary.

How are the Courts applying the new guidance?

Overall it is our experience that the Courts are quickly adapting in the context of the Coronavirus epidemic and making pragmatic decisions. The Judges seem live to the difficulties currently been faced by practitioners dealing with litigation and they are applying the new guidance.

The Courts are also mindful of pressures on NHS frontline staff and are taking steps not to put additional pressures on them at this time, including in our experience vacating an imminent Trial.

What will my case look like going forward and what are the courts doing?

During the Covid 19 crisis lawyers and the courts have had to adapt with hearings being heard remotely and with more electronic communication. It is clear that going forward, some of these changes will become more permanent.

The Lord Chancellor, Robert Buckland QC MP, has spoken last week regarding changes to the justice system following the COVID-19 pandemic and we know that there is a significant backlog of work that needs to be processed.

Firstly, 10 sites have been identified for ‘Nightingale courts’ which will allow for better social distancing. The authorities have suggested that it is a possibility that courts will need to stay open for a longer time or at weekends, to increase the number of cases that can be heard safely on any given day. This will enable more cases to be heard in a day and therefore a swifter outcome for your case. The standard of video technology will also continue to improve, with plans for new technology being rolled out across all courts form July onwards. The enhanced use of technology may result in matters being heard more efficiently, decreasing the time spent during each hearing.

HMCTS is working to expand access to audio and video technology to support more and new types of hearings. There has been an increase in the use of new and varying equipment over the lock-down period. With the appropriate systems in place, many more hearings could take place on platforms such as the Cloud Video Platform (CVP). Throughout July, the CVP will be more readily available to Country courts. There will be further hardware rolled out to improve the quality of video hearings, and there will be more efficient methods used to organise video lists.

The increased use and training of CVP means that witnesses and advocates may not need to attend court and could attend the hearing remotely. This will give you increased flexibility, enabling you to attend from your office or home. The CVP is efficient and simple to use, with no complex functions; making it user-friendly. This should make litigation more time and cost effective (albeit that there will be the cultural challenge of having less contact with your legal team or the court experience).

What routes of challenge are available to an insurer's rejection of my business interruption claim?

Many policies will only provide business interruption cover if it arises from property damage. The FCA has acknowledged that insurers are entitled to reject claims in relation to such policies, notwithstanding the success of the FCA’s test case in the Supreme Court, and which was generally favourable to policyholders [Insert a link here to our update on the test case]. In other cases the policy wording will be less clear and businesses may legitimately feel that their insurer is wrongly withholding payment.

One route of challenge to an insurer’s decision is via one of the well-publicised class actions. Another route of challenge is by a complaint to the Financial Ombudsman Service (FOS). This service is open to consumers and small and medium-sized businesses, ‘micro-enterprises’, charities and trusts. The service will be an attractive option for many businesses, as it is free and relatively quick (although it remains to be seen how the service keeps up with an increase in demand as a result of the pandemic). You will need to have complained to your insurer before bringing a complaint with the FOS.

Further details can be found here.

Will councillors still be able to vote if they can’t meet in person?

Local government legislation formerly stipulated that councillors must be physically present to vote and this requirement has already led to the widespread cancellation of Council meetings.  There is a limit to what can be achieved under the chair’s emergency powers and delegation to officers.

The Government has now legislated to allow for remote voting until 7 May 2021. The secondary legislation required was issued in draft on 2 April and has been in force since Saturday 4 April.

The legislation allows for committee meetings to go ahead where members and any members of the public attending remotely can all times “hear (and where possible see) and be heard (and where possible be seen) by the other members in attendance”.

It remains to be seen how many local authorities take up the opportunity to hold a virtual committee meeting. Concern has been expressed that the demographic of local councillors may mean that members have difficulty with the technological mechanisms for holding such meetings. However, the message from the Secretary of State is clear that wherever possible, the planning system should keep moving in these current times.