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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

How does salary sacrifice affect the Government's Coronavirus Job Retention Scheme?
  • Employee pensions contributions are often paid by way of salary sacrifice arrangements.
  • Use of such arrangements may reduce the amount of wage an employer can claim under the Coronavirus Job Retention Scheme, as the reimbursement is calculated by reference to an employee’s actual pay as at 28 February 2020, hence post sacrifice pay.
  • Using the Coronavirus Job Retention Scheme does not in itself bring a salary sacrifice arrangement to an end, but where an employer wishes to maximise the amount of an employee’s pay that will be covered by the CJRS, the employer and employee(s) concerned may agree to terminate the salary sacrifice arrangement as part of furlough. HMRC has recently announced that the Covid-19 pandemic will be considered a “life event” (i.e. one of the permitted reasons to break a salary sacrifice arrangement mid-term), if the employment contract is updated accordingly.
Do you need to use HMRC's CEST tool?

CEST stands for Check Employment Status for Tax and, although this should do exactly what is says on the tin, there has been criticism of its accuracy and effectiveness. The CEST tool does not test whether there is ‘mutuality of obligation’ in the relationship which is a key factor in determining status.

You are not obliged to use CEST if you are happy with your own assessment process. If you do use CEST keep a record of the certificate given at the end of the assessment and keep this on the contractor’s file. HMRC will stand by the outcome of a CEST assessment provided the information has been honest and accurate. However, you must have entered information honestly to rely on it – you can’t just say what you want to get the right answer, as HMRC may test what you have said.  Also, many people are unhappy with the CEST tool and consider it leans too much towards employed status.

How should an employer handle personal information in relation to NHS Test and Trace?

Employers will be collecting and sharing health information. Health information is sensitive and higher data protection standards apply. Here are a few key pointers.

  • Update privacy notices to cover the new collection and sharing of employees’ information and provide these to the workforce. Be transparent and fair.
  • Identify the legal basis and condition for use of this information and put any required paperwork in place. The ICO guidance will help. For some conditions such as the employment condition, an Appropriate Policy Document (APD) will be required. The ICO has an APD template.
  • Only use the information for the purpose of managing the workforce during the pandemic.
  • Only collect or share information if it’s necessary – if it’s a targeted and proportionate way of achieving your purpose.
  • Make sure any health information collected and shared is accurate – there may be serious consequences if it’s not.
  • Work out how long the information must be kept for. Keep a record of that period and act on it at the appropriate time.
  • Security is very important – there may be malicious actors trying to trick employers and employees. Make sure employees know how to identify a genuine NHS Test and Trace contact. Keep the information secure. Use the ICO’s data sharing checklists** and keep a record of the disclosures made and why. Control external disclosures – only certain authorised members of staff should make them.
  • Make sure individuals can still exercise their data protection rights – that’s also very important. Keep data protection records up-to-date and ensure any exports of personal information outside the UK are compliant.
  • Before introducing employer-led testing like taking temperatures, thermal imaging or other potentially intrusive tests, work out if a data protection impact assessment (DPIA) is required. It will be if the intended processing is ‘high risk’. If it is, then carry out a full DPIA. It will help address the issues systematically and mitigate risks.
  • All this demonstrates ‘accountability’ – it shows affected individuals and the ICO that the employer is complying with data protection requirements.

If you need further help, please visit the ICO’s data protection and coronavirus information hub or ask our data protection team.

** Please note that this link is to the ICO’s existing checklists and data sharing code of practice. We will update the link to the ICO’s new checklists after they are published.

Should I stop paying my commercial rent?

Commercial leases generally prevent a tenant from withholding payments of rent. If a tenant stops paying rent there will be a breach of the tenant’s covenant to pay rent which, strictly speaking, will entitle the landlord to forfeit the lease and/or seek to recover the arrears in the courts. 

However, on 23 March 2020, the Ministry of Housing, Communities and Local Government announced that all commercial tenants in England, Wales and Northern Ireland missing rent payments are to benefit from a government ban on forfeiture of their lease. This change, which will prevent landlords from terminating leases and evicting commercial tenants, is included in the Coronavirus Bill. It will come into force very shortly (once the Coronavirus Bill receives Royal Assent, which is expected to be in a matter of days) and will last until 30 June 2020, with an option for the government to extend this deadline.

It is anticipated that many commercial tenants will take advantage of the reprieve and withhold their rent. Importantly note the rules will apply not only to principal rent but to “any sum a tenant is required to pay”, leaving the burden of supplying services and insuring the premises on landlords.

It is also important to note however that the protection offered by the government is from the threat of forfeiture should tenants withhold rental payments. The liability to pay the rent however remains an interest on unpaid rents will accrue. Furthermore, remedies other than forfeiture may be pursued by the landlord e.g. service of a statutory demand before insolvency or ordinary litigation proceedings for arrears etc.. Tenants then ideally should look to reschedule or suspend rental payment through discussions with their landlord.       

The advantage of this being you might be able to negotiate a sensible and manageable repayment program in respect of the suspended rent, free of the threat of litigation.

What are the contractual issues that businesses need to think about as they get back to business following lockdown?

It is clear that we are emerging from a completely unprecedented period of disruption for many businesses, and this may have had a huge impact on their contractual arrangements both with suppliers and customers.

As the lockdown eases, and we get back to business, it’s important that businesses take stock of what has happened, and ensure they review and address the legal and contractual consequences of what has been happening since the start of the global pandemic.