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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 are the data protection implications of holding Covid-19 health data?

The ICO is providing new guidance to organisations regarding data protection and coronavirus, which can be accessed here: https://ico.org.uk/for-organisations/data-protection-and-coronavirus/

Information about the Covid-19 health status of individuals is special category data under the GDPR. This means it is high risk which has implications for how you use it, store it and keep it secure.

You will already hold health data about your employees as this is necessary to provide a safe, accessible place to work and to make reasonable adjustments to the workplace. You now need to make sure that the information you gather about your employees, visitors to your sites, customers and suppliers about Covid-19 is processed in accordance with data protection laws.

Is there anything I can do to try and settle my claim?

There are several options that can be used at this time to try and settle disputes. If it is not possible to settle a dispute via direct discussions between the parties then some form of Alternative Dispute Resolution (“ADR”) might be appropriate. Mediation is the most popular form of ADR. Most people’s perception of mediation is that it needs to be in person but that does not have to be the case.

Mediation can take place online or on the telephone. Most, if not all, ADR providers remain open for business and are quickly changing their business model to ensure that mediations can still take place. Mediation can be arranged at reasonably short notice and certainly so far as the online model is concerned, it mirrors the process that is adopted when parties appear in person. Online mediation allows for joint sessions with the mediator to take place and also for the parties to break out into their respective rooms for private discussions. If a dispute settles at mediation – and the vast majority do – then the agreement reached between the parties is binding and can be enforced.

A group of senior former judges and legal academics have now called for an acceleration in the use of ADR in light of the current circumstances. They have stated that courts should promote “and where appropriate require” the use of ADR. Mediation has particularly seen an increase in growth at this time.

ADR normally results in a quicker outcome than if the matter proceeds in the courts. Due to its conciliatory nature it is a very useful process where parties continue to be in a trading relationship. Contracting parties should also consider building ADR into dispute resolution clauses in their contracts so that in the event there is a dispute the focus is on resolving the dispute as soon as possible before it escalates into litigation.”

Can employees who are shielding be placed on Flexible Furlough?

Employees who are unable to work because they are shielding in line with public health guidance (or need to stay home with someone who is shielding) can be furloughed after 1 July 2020, as long as you have previously submitted a claim for them in relation to a furlough period of at least 3 consecutive weeks taking place any time between 1 March 2020 and 30 June.

One of my employees has contracted Covid-19, should I report it under RIDDOR?

You must only make a report under RIDDOR (The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013) when:

  • An unintended incident at work has led to someone’s possible or actual exposure to coronavirus. This must be reported as a dangerous occurrence
  • A worker has been diagnosed as having COVID 19 and there is reasonable evidence that it was caused by exposure at work. This must be reported as a case of disease
  • A worker dies as a result of occupational exposure to coronavirus.
What questions/factors should you look at to determine whether your procedure/policy in respect of MHFAs is or isn’t working?

It really depends on what your measure of success is! We would suggest regular wellbeing surveys – if the results of wellbeing surveys suggest that the culture is becoming more open, more psychologically safe, if people are asking for help or referring colleagues to MHFAs as a safe and effective pair of hands – these would be strong indicators of success.