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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 happens if a patient is admitted to critical care during the pandemic?
  • On admission to critical care, the risks, benefits and likely outcomes of the different treatment options should be discussed with patients, families and carers so they can make informed decisions about their treatment wherever possible.
  • A member of the critical care team should be involved in these discussions whenever the patient or team needs advice about critical care to make decisions about treatment.
Will remote court hearings be permitted?

Court hearings have been conducted remotely, with the judgment in Kerry v SSCLG being given via telephone. The Senior President of Tribunals issued emergency Practice Directions which will apply to Property and Lands Chambers’ respectively. This has made provision for remote hearings. Inspections of properties have been suspended with immediate effect, with photographs, videos or external visits permitted where appropriate. Where inspections are essential, the case should be stayed.

Who do the Procurement Policy Notes (PPN) apply to?

All three of the PPNs are effective immediately and apply to the following Contracting Authorities:

  • Central Government Departments
  • Executive agencies
  • Non-departmental public bodies
  • Local authorities
  • NHS bodies
  • The wider public sector

In regards to PPN03/20, those in scope organisations that do not currently use procurement cards are advised to immediately put in place arrangements using the relevant Crown Commercial Service Agreement (Lot 2 of RM3828 Payment Solutions).

Will holiday entitlement continue to accrue for a period of furlough?

The guidance has confirmed that all remaining employment rights and terms continue while an employee is furloughed. Holiday will continue to accrue during furlough however you may reach agreement with employees on reducing entitlement provided that it does not fall below the statutory minimum of 5.6 weeks per year.

What should payroll look out for if the Government's Coronavirus Job Retention Scheme is used?
  • It is important to have a clear paper trail for any agreed reduction in salary, and hence any reduction in the amount of contributions. However, the contribution rates (as opposed to the amounts) should be the same as normal, and hence all processes and software should function as per normal and, amongst other things, remain compliant with auto-enrolment employer duties.
  • However, if the period of affected contributions does not overlap precisely with the period of reduced salary, for example because of different cut-off dates, there may well be instances of non-compliance with auto-enrolment employer duties at the beginning as well as at the end of the period covered by the Coronavirus Job Retention Scheme.
  • Accordingly, where an employer takes advantage of the Coronavirus Job Retention Scheme, good communication with the persons responsible for pensions administration and detailed record-keeping are essential to prevent non-compliances in the short-term and confusion in the long term.