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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

Who is responsible for planning in the event of an excess of deaths?

In the unfortunate event that there will be a significant number of deaths, planning will fall to the local resilience forum; which includes all relevant local organisations and statutory bodies, who will have prior experience in working in excessive death scenarios.

It is for the coroners to ensure that they are familiar with the local resilience forum plans and discussions required. This will include issues regarding storage capacity and post-mortem examination capacity.

Last updated on 31st March, 2020

Can I collect health data in relation to Covid-19?

Yes. With respect to employees you have an obligation to protect their health so you can gather information to do that. You might gather information from your employees on who has the virus, who has had it and recovered and also who has tested negative. You might also want to know if individuals have been in contact with someone who has it or if they are in a vulnerable group. It is reasonable to want to know where individuals have travelled. In the future it may also be reasonable to know if they are planning to travel to a virus hot spot, as the impact of the virus around the world is likely to continue for some time even after the outbreak has been contained in the UK.

It is reasonable to gather some information about visitors to your site, be they customers or suppliers, as this information will also help protect your staff. However, you should keep what you gather to a minimum. For visitors, it’s unlikely that you need to know anything more than they have Covid-19, are displaying symptoms or have recently been in contact with someone who has the virus.

Last updated on 28th March, 2020

What if employees display coronavirus symptoms?

It remains the case that anyone who has symptoms, however mild, or is in a household where someone has symptoms, should not leave their house to go to work. Those people should self-isolate, as should those in their households.

Last updated on 12th May, 2020

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.

Last updated on 26th March, 2020

How do I make a Will while I am self-isolating?

Your lawyers can take your instructions by telephone, Skype, Zoom or a similar tool. However, the formal requirement to make a valid Will requires two witnesses to be present with you when you sign the Will and they must then add their signatures. The witnesses or their spouse cannot be beneficiaries or they will forfeit their inheritance.

The main challenge is how to have your witnesses with you at a time when we are being advised to socially distance. One option would be for the witnesses to stand outside your window or at a safe distance from you where they have a clear line of sight. The witnesses can watch you sign and then you could post your Will through your letterbox or leave it on a surface for them to pick up so that they can then sign their names too. If the witnesses live together then they do not need to keep two meters apart from each other.

The Wills Act 1837 requires that your witnesses must be physically present when you sign your Will and therefore it is not possible to do this by Skype, Zoom or similar video conferencing means. You may however want to video record the process by which you and your witnesses signed your Will so that you have a record of what was done, particularly if you are worried that someone might challenge the validity of your Will in due course.  You can of course re-execute your Will once social distancing has been relaxed if you are particularly concerned.

Be aware that the virus can remain on documents for more than 24 hours so it would be sensible for everyone to wear disposable gloves and in any event to wash hands thoroughly after handling the Will.

Emergency legislation may be passed regarding the requirement to make a valid Will but you must follow the current rules unless or until new legislation is passed.

Last updated on 1st April, 2020