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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

Will I need to make an application to the court for a remote hearing?

Despite remote hearings being the default position at present, formal permission will still be required by the court and a template order was circulated with the guidance. This template sets out the relevant directions and recitals to include in your order. An application to the COP for a remote hearing will not be required.

The employee I need to consider suspending is a doctor – do I have to follow MHPS

Yes probably in our opinion, even if you are not considering taking any formal action against them. Ultimately if a doctor is suspended this could be considered as causing them reputational damage and it therefore is correct that they are afforded the protections (in particular in relation to keeping exclusion/suspension under review) of MHPS. Under Part V of MHPS there is provision for excluding practitioners if they are a danger to patients and they refuse to recognise it or if they refuse to co-operate. It doesn’t refer to a particular risk for the practitioner themselves, but it would appear logical that it would apply.

What is the new Permitted Development Right for the construction of new dwellinghouses?

A new Permitted Development Right has been introduced by The Town and Country Planning (Permitted Development and Miscellaneous Amendments) (England) (Coronovirus) Regulations 2020 providing for the construction of new dwellinghouses on detached blocks of flats.

The new Right comes into force on 1 August 2020 and from this date development consisting of works for the construction of up to two additional storeys of new dwellinghouses immediately above the existing topmost residential storey which is a purpose-built, detached block of flats is permitted development.  The Right additionally covers specified associated works, the construction of fire escapes and ancillary structures, bin stores for example.

The Right is subject to detailed criteria being met and to a prior approval process to the Local Planning Authority who can consider the acceptability of the proposed development in a range of respects.  A link to the Regulations is here.

The Regulations additionally include a number of further amendments including additional rights for the holding of markets and for additional temporary uses of land for a time limited period.  They additionally include amendments to existing permitted development rights for the change of use of buildings to dwellinghouses through a requirement that there be adequate natural light in all habitable rooms.

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Specialist healthcare lawyers from Ward Hadaway ran a free webinar looking at the practical and legal considerations if required to treat healthcare workers from a BAME background or other vulnerable groups differently in the fight against the Covid-19 pandemic.

How do I avoid disputes and approach extensions of time and claims for additional payment with my Employer or Supplier?

The Construction Leadership Council (with backing from the Government) has issued practical guidance and draft pro-forma documents to enable all parties involved in the construction supply chain to enter into collaborative and open dialogue about applications for extensions of time and additional payment and to minimise potential disputes. The guidance can we downloaded here

The draft letters and notices included in the guidance have been prepared on the basis of the standard JCT Design and Build 2016 and NEC 3/4 Engineering and Construction Contract (Option A) and parties will need to make sure that they are completed/adjusted to comply with their own specific contracts.

The Cabinet Office has also issued a general statement calling on parties to contracts adversely affected by C-19 to act responsibly and fairly and to support national efforts to protect jobs and the economy.