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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

How should an employer handle personal information in relation to NHS Test and Trace?

Employers will be collecting and sharing health information. Health information is sensitive and higher data protection standards apply. Here are a few key pointers.

  • Update privacy notices to cover the new collection and sharing of employees’ information and provide these to the workforce. Be transparent and fair.
  • Identify the legal basis and condition for use of this information and put any required paperwork in place. The ICO guidance will help. For some conditions such as the employment condition, an Appropriate Policy Document (APD) will be required. The ICO has an APD template.
  • Only use the information for the purpose of managing the workforce during the pandemic.
  • Only collect or share information if it’s necessary – if it’s a targeted and proportionate way of achieving your purpose.
  • Make sure any health information collected and shared is accurate – there may be serious consequences if it’s not.
  • Work out how long the information must be kept for. Keep a record of that period and act on it at the appropriate time.
  • Security is very important – there may be malicious actors trying to trick employers and employees. Make sure employees know how to identify a genuine NHS Test and Trace contact. Keep the information secure. Use the ICO’s data sharing checklists** and keep a record of the disclosures made and why. Control external disclosures – only certain authorised members of staff should make them.
  • Make sure individuals can still exercise their data protection rights – that’s also very important. Keep data protection records up-to-date and ensure any exports of personal information outside the UK are compliant.
  • Before introducing employer-led testing like taking temperatures, thermal imaging or other potentially intrusive tests, work out if a data protection impact assessment (DPIA) is required. It will be if the intended processing is ‘high risk’. If it is, then carry out a full DPIA. It will help address the issues systematically and mitigate risks.
  • All this demonstrates ‘accountability’ – it shows affected individuals and the ICO that the employer is complying with data protection requirements.

If you need further help, please visit the ICO’s data protection and coronavirus information hub or ask our data protection team.

** Please note that this link is to the ICO’s existing checklists and data sharing code of practice. We will update the link to the ICO’s new checklists after they are published.

What is in the WH Toolkit?

We have developed a toolkit to assist with compliance. The Toolkit contains a specimen contract; detailed guidance; step by step guides and flowcharts; details of the factors to take into account for the status determination test; procedures for challenging the determination; and standard letters for the process.  Click here to fill in a form and register your interest in the Toolkit, which contains:

  1. Detailed guidance in the form of Key Facts
  2. Employment status checklist
  3. Employment status assessment flowchart
  4. Status questionnaire and guidance
  5. Letter confirming self-employed status (agency)
  6. Letter confirming employed status (agency)
  7. Letter confirming self-employed status (direct with PSC)
  8. Letter confirming employed status (direct with PSC)
  9. Status disagreement process guidance
  10. Status disagreement process flowchart
  11. Letter confirming outcome of status disagreement process
  12. Consultancy agreement
What are the temporary adjustments to Right To Work checks?

To facilitate social distancing the Home Office has stated that as of 30 March 2020, the following are permitted:

  • The RTW check can now take place over video call.
  • Job applicants no longer have to send original documents but can send scanned copies or photos to the employer.
  • Where the job applicant cannot provide these documents, employers can use the Employer Checking Service and if they have the right to work, then the employer will receive a Positive Verification Notice which will provide the employer with a statutory excuse for 6 months.

These adjustments remain in place until the Home Office confirms otherwise.

 

What happens if someone is asked to restrict their duties but, despite acknowledging the risks to their health involved, they say that they want to continue to work on the front line?

As their employer, you have an overriding duty to provide a safe system of work. The Trust would not be able to run a defence to say that an employee “waived their rights” and chose to continue to work. Provided the decision around restricting duties has been carefully thought out, a full risk assessment undertaken and the employee has been truly consulted about the impact on them, then the decision taken will be a reasonable management instruction. Failing to follow that reasonable management instruction could amount to a disciplinary offence.

How do I avoid disputes and approach extensions of time and claims for additional payment with my Employer or Supplier?

The Construction Leadership Council (with backing from the Government) has issued practical guidance and draft pro-forma documents to enable all parties involved in the construction supply chain to enter into collaborative and open dialogue about applications for extensions of time and additional payment and to minimise potential disputes. The guidance can we downloaded here

The draft letters and notices included in the guidance have been prepared on the basis of the standard JCT Design and Build 2016 and NEC 3/4 Engineering and Construction Contract (Option A) and parties will need to make sure that they are completed/adjusted to comply with their own specific contracts.

The Cabinet Office has also issued a general statement calling on parties to contracts adversely affected by C-19 to act responsibly and fairly and to support national efforts to protect jobs and the economy.