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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

My planning permission is due to expire, can I extend the period for implementation?

The Government announced on 22 June 2020 that it would be making provisions to enable planning permissions that have lapsed since 23 March 2020, and those that are due to lapse before the end of 2020, to be automatically extended.
The Government’s detailed proposals are set out in section 17 of the Business and Planning Act 2020, which entered the statute books on 22 July 2020. If a relevant planning permission is subject to a condition which requires the development to be begun no later than between 19 August 2020 (when section 17 of the Business and Planning Act 2020 will come into effect) and 31 December 2020, the condition is automatically deemed to instead provide that the development must be begun no later than 1 May 2021.

The Act also makes provision for any conditions requiring development to be begun between 23 March 2020 and 19 August 20202 to be extended to 1 May 2021, although this is not automatic. Where the provisions have such retrospective effect, an application is required to the local planning authority. The local planning authority are only able to grant approval, however, if they are satisfied that any EIA and habitats assessments continue to be valid. Deemed approval provisions will apply if the local planning authority do not determine any application within 28 days. The local planning authority are not able to approve such applications after 31 December 2020 so applications should be made in good time in advance of this date. There is the possibility of an appeal against the local planning authority’s decision but notice of the appeal must be submitted before 31 December 2020.

The Act includes similar provisions in relation to both detailed and outline planning permissions.

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 do I do if I have been endorsed for a Global Talent, Start-up or Innovator visa but my endorsement is due to expire?

Endorsing bodies are still processing applications for these visa types and endorsements are still being issued. You usually have to apply for your visa within 3 months of receipt of your endorsement. In most cases you will still be able to submit your application online within this timeframe however it will not be completed as visa application centres across the world are closed. If you cannot apply because you haven’t been able to travel and your endorsement has expired, you may still be eligible for a visa. You should make your application as planned and UKVI will consider all applications on a case by case basis.

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.

What if the status determination is disputed?

You should have in place a dispute resolution procedure that sets out the appeal process or contractors or the agency as appropriate. You must respond to an appeal within 45 days.

If the status determination is disputed you should consider the contractor or agency’s reasons objections. You must consider if the original determination is to be maintained and give reasons for this. Or a new determination with reasons can be provided if appropriate.

Records of disputed determinations and the outcome of any appeal should be kept.