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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 is the NICE guidance around clinical decision-making?
  • Be alert to the fact that guidance on treating Covid-19 may change with emerging knowledge/scientific data and this may require subsequent modifications to treatment.
  • Critical care staff should support healthcare professionals who do not routinely work in critical care but need to do so.
Should we issue petitions?

Our advice to you here is simple. It will depend on the circumstances surrounding your debt but for the most part, unless it is crystal clear that there has been a debt outstanding long before Covid-19 and there was an inability to pay prior to the Covid situation we would recommend that you hold off issuing any further petitions until after the 31st December. Unless the criteria set out above is met, a judge is likely to exercise their discretion leniently and could dismiss the petition. This could also lead to cost consequences which would adversely affect you.

We are happy to discuss individual cases to assist creditors at this difficult time, however, generally any cases proceeding to petition would be the exception as opposed to the rule. Even if presenting a winding up petition is not available for now, there may still be other forms of legal proceedings that you can use to collect money owed to you, like county court proceedings.

Can I ask for relief from KPIs or service credits under a contract with a public sector body if the Covid-19 outbreak means that I am having difficulty in performing it?

The Cabinet Office has published a useful Procurement Policy Note (“PPN”) on relief available to suppliers due to Covid-19 (available here). In brief, you should not be penalised by a public sector body, if, in the current circumstances, you are unable to comply (fully or partly) with your contractual obligations. Public sector bodies are expected to work with suppliers and, if appropriate, provide relief against current contractual terms. This is in order to maintain business and service continuity and avoid claims being accepted for other forms of contractual relief, such as the occurrence of a force majeure event.

The types of relief that may be available to suppliers to the public sector will depend on the existing contracts in place. Some contracts may have a payments by result mechanism, whereas others may be based on certain key performance indicators (KPIs) being met. Other contracts may not include any such mechanisms and therefore it will be a matter for discussion between suppliers and the public sector body.

The PPN provides that, rather than a supplier seeking to invoke a clause that would permit the supplier to suspend performance of its obligations (such as a force majeure clause), public sector bodies should first work with the supplier to amend or vary the contract. Any changes should be limited to the particular circumstances and considered on a case-by-case basis. Changes could include:

  • Amending the contract requirements
  • Varying timings of deliveries
  • Relaxing KPIs or service levels
  • Extending time for performance (e.g. revising a contract delivery plan), and/or
  • Preventing the public sector from exercising any rights or remedies against the supplier for non-performance (e.g. liquidated damages or termination rights).

These should only be temporary variations and the contract should return to the original terms once the impact of the Covid-19 outbreak on the contract has ended. Discussions with the public sector body about any changes that are agreed should be documented, in a variation signed by both parties.

A public sector may also need to take account of regulation 72 of the Public Contract Regulations 2015, to ensure that any changes to a contract (even of a temporary nature) do not trigger a requirement to conduct a new tender process. Whilst this may be unlikely to be the case with temporary variations, suppliers should still bear this in mind when discussing any changes to a contract with a public sector body.

If you are a supplier to a public sector body and you are currently struggling to meet your contractual obligations, we recommend that you take legal advice as to whether it might be possible to take advantage of the flexible approach that the PPN requires public sector bodies to adopt – it could be that you can avoid service credits or other financial deductions, or the need to serve formal notices such as “force majeure” or other relief notices.

 

 

What tips can you share for giving evidence during remote hearings?

During these unusual times, we are all having to adapt to what has become the ‘new normal’ and implement changes in how we carry out civil cases. If you are to give evidence in a remote hearing, whether this is by Microsoft Teams, Skype for Business or the Cloud Video Platform, we have pulled together a quick and useful guide below on what would be expected by the courts:

Before the hearing

  • Make sure that you have access to the video-conferencing software that will be needed for the hearing. We will tell our clients and their witnesses in advance which platform will be used. The courts have increasingly been using Skype for Business to conduct the hearings (but you may find other platforms being used)
  • Test that your camera and microphone are working and it is clear to see/hear you.
  • Dress appropriately, as if it was an in-person hearing, and use the same formalities.
  • Ensure that the background which is visible on your screen is appropriate and allows for your face to be clearly seen. A ‘blur background’ option may also be available on your settings which you may prefer.
  • Make sure that your mobile phone is on silent and you are in a location where there will be no/minimal distractions. You should be on your own in a room when giving evidence, however, as we have all experienced with working from home, sometimes interruptions such as children appearing cannot be avoided.
  • Join the call ahead of the allocated time, in order to allow for any small technical difficulties.

During the hearing

  • Have a copy of the hearing bundle to hand, so that you can follow the proceedings (this may be in hard copy or soft copy). You are not allowed any other notes or papers, whether hard copy or electronic, in front of you when giving evidence.
  • Unless addressing the Judge or you have been directly asked a question, keep your microphone muted.
  • When giving evidence, you must make sure both your camera and your microphone are switched on.
  • Remote hearings can be difficult and if you do not understand or you do not hear a question properly, then do ask for the question to be repeated/re-framed.
  • You should not move away from the screen without permission from the Judge. The Judge will allow time for breaks.
  • Address the judiciary and other advocates the same way as you would if you were in a physical courtroom.
  • It is permitted to drink water throughout the hearing, but mugs of tea and/or coffee are probably best avoided. It is also not permitted to eat food during the hearing.
  • Don’t panic if someone walks into the room or the dog starts barking because there is a knock at the door. Judges are only too aware about what might happen. Communication is key and if the interruption has interfered with your train of thought or the evidence you are giving then do say so.
  • Be aware that all evidence is recorded and that a transcript of all evidence can be obtained at a later date.
Who is expected to be principal accountable person in local authorities who are landlords of high rises?

This will be dependent upon the how the leasehold structure is set up for each relevant building, but it may be the local authority. We would be happy to provide further advice in relation to specific buildings if you contact us separately with the relevant details and documents.