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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

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 sort of issues are likely to have arisen?

The Coronavirus pandemic will have impacted businesses in many different ways, but some of the most likely impacts that could have a legal implication are as follows:

  • Services were not performed in accordance with contract during the period of disruption. This could be a reduction in volume of services performed, a suspension of services, or performance in a way that does not comply with contractual KPIs
  • Late delivery or non-delivery of goods because of factory closures, or disruption in the supply chain
  • Changes being agreed between parties to contracts to deal with the consequences of the Covid-19 outbreak
What has been the response from the Competition and Markets Authority (CMA)?

The CMA is the government body that is responsible for protecting consumers from unfair trading practices. It has announced programme of work to investigate reports of businesses failing to respect cancellation rights during the Coronavirus pandemic.

Based on the complaints received by them from consumers, the CMA has identified three sectors of particular concern:

  • Weddings and private events
  • Holiday accommodation
  • Nurseries and childcare providers

The CMA has expressed concern about the number of complaints that it has received about businesses seeking to retain deposits for cancelled events, undue restrictions being placed on use of vouchers provided for cancelled bookings, and payments being demanded to hold open nursery places.

The CMA has said it will prioritise investigation of these sectors, and then move on to other sectors.

How do I make a Will while I am self-isolating?

Your lawyers can take your instructions by telephone, Skype, Zoom or a similar tool. However, the formal requirement to make a valid Will requires two witnesses to be present with you when you sign the Will and they must then add their signatures. The witnesses or their spouse cannot be beneficiaries or they will forfeit their inheritance.

The main challenge is how to have your witnesses with you at a time when we are being advised to socially distance. One option would be for the witnesses to stand outside your window or at a safe distance from you where they have a clear line of sight. The witnesses can watch you sign and then you could post your Will through your letterbox or leave it on a surface for them to pick up so that they can then sign their names too. If the witnesses live together then they do not need to keep two meters apart from each other.

The Wills Act 1837 requires that your witnesses must be physically present when you sign your Will and therefore it is not possible to do this by Skype, Zoom or similar video conferencing means. You may however want to video record the process by which you and your witnesses signed your Will so that you have a record of what was done, particularly if you are worried that someone might challenge the validity of your Will in due course.  You can of course re-execute your Will once social distancing has been relaxed if you are particularly concerned.

Be aware that the virus can remain on documents for more than 24 hours so it would be sensible for everyone to wear disposable gloves and in any event to wash hands thoroughly after handling the Will.

Emergency legislation may be passed regarding the requirement to make a valid Will but you must follow the current rules unless or until new legislation is passed.

What do I do if I can't travel to the UK to activate my visa?

If your 30-day visa to travel to the UK (vignette) has expired or is about to, you can request a replacement free of charge until the end of 2020 by contacting the Coronavirus Immigration Help Centre. This can be granted with new and extended validity dates to allow travel once you are able to.