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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 am agreeing a financial settlement with my ex-spouse. Should we carry on negotiating despite COVID-19?

No. Before continuing any negotiations, you need to strongly consider whether now is the best time to settle. There is a myriad of uncertainty due to the pandemic, with unemployment rates increasing, volatility in the stock markets and difficulties regarding placing valuations on assets. This could all lead to the financial settlement being unfair to you and cause you financial difficulties in the future.

Any financial settlements reached following marital separation should be embodied in to a Court Order, to prevent future claims from your ex-spouse. As a general principle, although maintenance orders are always variable, financial orders in respect of capital (e.g. house, cash, investments, pensions) are final and it is very difficult to set aside a Court Order. The question will be whether or not the pandemic is judged as a Barder event, which broadly means something viewed as unforeseen. It would be challenging for you to argue that the effects of COVID-19 are unforeseen given the widespread expectation of an economic crisis. The Court previously found against a husband who wanted to revisit an Order that he said was unaffordable following the 2008 financial crisis, with one Judge commenting that a 90% drop in the Husband’s share price was a “natural process of price fluctuation”.

Even if you informally agree a settlement with your ex-spouse, and you do not have this reflected in a Court Order, your ex-spouse may still rely on this agreement within future Court proceedings and argue that you should be held to it.

It is, therefore, very dangerous to be reaching any financial settlements at this time with your ex-spouse without careful consideration and legal advice. Further, even if an agreement is reached, market volatility can mean longer implementation times, especially when a settlement relies on the sale of property.

Am I obliged to offer staff flexible furlough?

No, there is no obligation on employers to offer a flexible furlough arrangement to staff. Operationally, flexible furlough may not be appropriate for your business and equally, returning on a part-time basis may not be suitable for individuals already furloughed for various reasons. Concerns about returning to work part-time or at all should be considered on a case-by-case basis.

When should I apply to extend the period allowed to file accounts?

The application has to be made before the date on which the accounts should have been filed, so this process can’t be used if you are already late. If you don’t make the application before your filing deadline, then a fine will automatically be generated if your accounts are filed late. Whilst you could appeal against such a fine on the grounds that the delay was caused by coronavirus issues, this is likely to be a much more time consuming and uncertain process that applying in advance.

It does not appear that the process applies to Confirmation Statements or other returns.

What is the NICE guidance around clinical decision-making?
  • Be alert to the fact that guidance on treating Covid-19 may change with emerging knowledge/scientific data and this may require subsequent modifications to treatment.
  • Critical care staff should support healthcare professionals who do not routinely work in critical care but need to do so.
What measures can be taken without notification to the European Commission?

There have always been ways for public bodies to assist without being required to notify these for approval. These continue to be available during the financial crisis, and are likely to be increasingly useful for measures which need to be introduced quickly. The measures include:

Those where it is possible to conclude that there is no effect on trade between Member States – for example, measures which are likely to have only a limited local effect. The European Commission has concluded, for example, that measures to assist locally-focused cultural activity can be assumed to have no effect on inter-State trade. 

Those where it is possible to conclude that the State is acting in a way consistent with a commercial operator (the so-called Market Economy Operator Principle) – particular care will need to be taken in the context of current economic conditions to ensure that it can reasonably be asserted that a commercial operator would act in the same way as the public body.

Measures under the General Block Exemption Regulation – this legislation allows various types of aid, or aid schemes, to be employed.

Examples include aid for SMEs, aid for research and development, aid for local infrastructure and aid to ports and airports.

De Minimis Measures – Member States are permitted to grant small amounts of aid to undertakings over three fiscal years (the current year and the previous two years). This allows undertakings to receive up to €200,000 (or €500,000 where they are providing public services).