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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 was included in the Government’s self-employment income support scheme?
  • A taxable grant worth 80% of the average monthly profit over the last three years (one or two years will be reviewed for those who do not have three years of tax returns)
  • The grant will be capped at £2,500 per month
  • The scheme was initially available for three months and has been extended as necessary
  • Individuals claiming a grant can continue to do business (unlike employees who must not work when furloughed)
How can workers get to work safely?

The Government’s guidance says walk, cycle or drive to work and avoid public transport if you can. Businesses will need to support workers in adopting alternative travel methods to reduce exposure to the virus. You could consider staggering start and finish times for shifts to reduce commuting during peak hours, or support cycling with secure storage facilities and a drying room.

What was the purpose of the Chancellor's economic update?

On Wednesday 8 July 2020 as part of a summer ‘mini-budget’, Rishi Sunak delivered the Government’s response to the threat to millions of jobs due to the existing furlough arrangements being wound down from August 2020 until it planned to close at the end of October 2020. In a wide-ranging speech to Parliament, the Chancellor announced a number of schemes to look to protect jobs beyond October 2020, in particular in certain sectors and for those aged 18-24. As the Government releases further information over the coming days and weeks, we will add to these FAQs.

What is happening about court and arbitration hearings?

The courts are seeking to adapt to our new circumstances and have urgently been looking to introduce new ways of working. The courts have been testing out different ways of holding court hearings. The advice is changing almost daily and some courts have been developing local practices. Going forward the court, the parties and their representatives will need to be more proactive about all forthcoming hearings.

Everyone involved in the case is to consider as far ahead as possible how future hearings should best be undertaken and work collaboratively. It will normally be possible for all short, interlocutory, or non-witness, applications to be heard remotely. Some witness cases will also be suitable for remote hearings. The parties just need to ensure that everyone involved can use the technology suggested.

The courts have been looking at and held remote hearings using, non-exhaustively, BT conference call, Skype for Business, court video link, BT MeetMe, Zoom and ordinary telephone call. Bundles for the hearing will be prepared and circulated electronically.

If the hearing cannot be held remotely because the parties do not have the requisite technology or the length of the hearing combined with the number of parties or overseas parties, representatives and/or witnesses make it undesirable to go ahead with a hearing in court at the current time, then it may be that the case will need to be adjourned. We are hearing of trials being adjourned and that they will not be re-listed before at least September.

HMCTS has advised that several priority courts will remain open during the coronavirus pandemic to make sure the justice system continues to operate effectively. It publishes a daily operational update from the courts and they aim to update it by 9am. The link is https://www.gov.uk/guidance/hmcts-daily-operational-summary-on-courts-and-tribunals-during-coronavirus-covid-19-outbreak.

Also, the courts have circulated a civil listing priority list with Priority 1 listing work which must be done and which includes injunctions, any applications in cases listed for trial in the next three months, any applications where there is a substantial hearing listed in the next month and all Multi Track hearings where parties agree that it is urgent.

In the Priority 2 list, which consists of hearings which could be done, are enforcement of trading contracts, trial involving the survival of a business or the insolvency of an individual, small and fast track trials where the parties say they are urgent, and appeal in these kinds of cases.

Similarly, in arbitration proceedings, the parties and arbitrators are being encouraged to utilise technology to make sure that hearings take place. We have heard of Zoom being used very successfully for multi-party proceedings.

Can I get contracts signed electronically if signatories are working remotely?

With the outbreak of coronavirus leading to a requirement for more employees to be working remotely, especially following Government advice that all non-essential travel including to and from work should be avoided, there has been an increased requirement for businesses to be more flexible in their approach to signing contracts.

The traditional approach has been for contracts to be printed and signed with a “wet ink” signature. However, this is not a strict legal requirement in the majority of circumstances and contracts can be formed without this degree of formality. English law recognises that contracts can be formed by electronic means – including the exchange of emails or the typing of a name into a document to signify agreement to it.

Whilst this approach offers a lot of flexibility, more sophisticated electronic signature tools are recommended for important documents, to enable the identity of the signatory to be validated and reduce the possibility of fraud.

If businesses are considering changing their contracting processes because of coronavirus, or because of a general shift towards paperless working, it is important to ensure that proper approval processes remain in place, and to consider whether a software tool should be used to complement them. Systems such as DocuSign are widely used.

There also remain some situations where legal advice is recommended before relying on an electronic signature:

  • Where the other party is abroad – as local laws that are different from English law might apply
  • If executing a deed – the law requires certain types of document to be executed as a deed (for example, transfers of land and powers of attorney), and the issues around electronic signature and witnessing are more complicated here