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Home › FAQs › What is the guidance in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the Covid-19 pandemic?

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

Are permitted development rights now in existence for the creation of emergency medical facilities?

Yes. The Town and Country Planning (General Permitted Development) (Coronavirus) (England) (Amendment) Order 2020 came into force on 9 April 2020 giving permitted development rights for emergency development. The permitted development right is available to local authorities and health service bodies (as defined) on land owned, leased, occupied or maintained by it for the purposes of:

  • Preventing an emergency
  • Reducing, controlling or mitigating the effects of an emergency
  • Taking other action in connection with an emergency

It could cover, for example, the temporary change of use of buildings into a Nightingale Hospital or the establishment of a testing centre.

The permitted development right is not permitted in certain instances and is subject to a number of conditions including the notification of the local planning authority and the cessation of the use before 31 December 2020.

Further detail of the permitted development right is available at the link below.

http://www.legislation.gov.uk/uksi/2020/412/made

Last updated on 14th April, 2020

I’m a doctor. Should I work outside my field of practice during the pandemic?

Whilst it is acknowledged that doctors may be working in unfamiliar circumstances or surroundings, or in clinical areas outside their usual practice. Doctors should consider the best course of action to take in these circumstances by utilising the following:

  • What is within their knowledge and skills
  • What support other members of the healthcare team could offer
  • What will be best for the individual patient given available options
  • The protection and needs of all patients they have a responsibility towards
  • Minimising the risk of transmission and protecting their health.

Last updated on 26th March, 2020

Can you place employees who TUPE transfer to you on Flexible Furlough?

A new employer may claim under the scheme in respect of the employees of a previous business transferred after 10 June 2020 as long as:

  • the TUPE or PAYE business succession rules apply to the change in ownership
  • the employees being claimed have previously had a claim submitted for them by their prior employer in relation to a furlough period of at least 3 consecutive weeks taking place any time between 1 March 2020 and 30 June

In these circumstances, the maximum number of employees that the new employer can claim for will be the total of both:

  • the maximum number of employees the new employer claimed for in any one claim ending on or before 30 June
  • the number of employees that are being transferred to the new employer which have had a claim submitted 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. This is subject the maximum cap the previous employer was subject to.

A new employer is also eligible to claim under scheme in respect of the employees associated with a transfer of a business after 10 June 2020 from the liquidator of a company in compulsory liquidation where:

  • TUPE would have applied were it not for the company being in compulsory liquidation
  • the employees being claimed for have been furloughed and a had a claim submitted for them by their prior employer in relation to a period of at least 3 consecutive weeks taking place any time between 1 March 2020 and 30 June

In these circumstances, the maximum number of employees that the new employer can claim for will be the total of both:

  • the maximum number of employees the new employer claimed for in any one claim ending on or before 30 June and
  • the number of employees that are being transferred to the new employer which have had a claim submitted for them by their prior employer in relation to a furlough period of at least 3 consecutive weeks taking place any time between 1 March 2020 and 30 June. This is subject to the maximum cap the previous employer was subject to.

Last updated on 16th June, 2020

Can I demand that my employees have the vaccine?

In most circumstances the answer will be no. It would be an infringement of their human rights. It could also be a criminal assault.

However where there is a high risk to employees of exposure to COVID-19, such as care homes and healthcare environments, you might be able to make it a requirement of their role to have the vaccine.

First, consider whether you need to have a blanket requirement covering all employees or whether only certain groups who work in the most high risk areas require the vaccine.

You will need to do a thorough risk assessment balancing the amount that the risk of exposure would be reduced against the interference with the employee’s human rights. Consideration will need to be given as to whether insisting on the vaccine is proportionate to the risk and whether other less invasive steps could be taken instead, such as maintaining social distancing, wearing a mask, washing hands.

Any requirement for employees to be vaccinated should be communicated clearly to employees and trade unions together with a clear explanation for why it is necessary.

Last updated on 6th January, 2021

Can employees reduce their pension contributions?
  • Remember that employees will also be making contributions on any reduced wage under the Coronavirus Job Retention Scheme. The amount contributed may be less, but the contribution rate will be the same, unless the following applies.
  • Employees may reduce their DC employee contributions if their scheme rules allow them to do so, but no further than the statutory minimum if the scheme qualifies as the employer’s auto-enrolment vehicle.
  • Employees might choose to opt-out or cease active membership of their scheme, which might cause a spike in administration at a time when administrators are likely to be understaffed. It is important that employers remember they must not do anything to encourage or induce employees from leaving an auto-enrolment vehicle as this may constitute an offence.
  • Employees who leave their scheme in this way will have to be re-enrolled in due course as and when required by law.
  • For DB schemes, specific considerations apply (see the last section, below).

Last updated on 14th April, 2020