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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

Will I have to go to court?

The vast majority of disputes settle without ever reaching a final hearing with something in the region of 2-5% of all cases actually ending up in court at a final trial.  So whilst it is very unlikely you would need to attend a court hearing, it is always a possibility.

What type of bundle will be required by the COP for a remote hearing?

Physical bundles may not be regarded as safe for public health and there are obvious difficulties in providing them with the current restrictions in place. Electronic bundles should be provided in PDF format, preferably paginated, indexed and bookmarked. The bundles should only contain documents and authorities that are essential to the issues required to be decided at the remote hearing and should be filed with the court by email.

Would it be appropriate to suspend someone who refuses to restrict their duties?

Suspension should always be a last resort and not a knee jerk reaction. We would not advise suspension unless a the above steps around the risk assessment have been undertaken. Depending on your local policies, suspension could then be an option on the basis that their health and safety and the health and safety of others are put at risk by their actions.

OPPORTUNITY: Funding towards legal advice for North East SMEs

We have teamed up with Scaleup North East to help companies impacted by the coronavirus outbreak plan how to get back to business.

Our specialist lawyers will provide a free “diagnostic” call with eligible businesses across the NE, exploring challenges they are facing in the aftermath of the lockdown, and identify specific steps to survive, and then thrive, in these challenging times and beyond.

Through the collaboration with Scaleup North East, eligible North East-based SMEs are then able to apply for up to 40% funding towards up to £4,000 of legal advice.

These might include:

  • Employment issues, such as dealing with a phased return to work
  • Measures to support cash-flow, such as amendment to terms of trading and debt collection procedures
  • Renegotiations and amendments to contracts, and other advice about contracts with suppliers and customers to deal with consequences of Covid-19
  • Managing property costs – review of leases, advice on break clauses and formalisation of any revised arrangements recently put in place with landlords/tenants
  • Health and safety implications of return to work and social distancing

Find out more on our website or contact partner Damien Charlton.  If you are not eligible because of location but are interested in the free “diagnostic”, please contact us.

What is the NICE guidance around Service organisation?
  • Trusts should allow for telephone advice rather than face-to-face review from critical care when clinically appropriate.
  • Hospitals should discuss the sharing of resources and the transfer of patients between units, including units in other hospitals, to ensure the best use of critical care within the NHS.

Please note, the above is intended to provide a summary of the key recommendations which emerge from this guidance. Access to the full guidance can be found here.