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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 might the transition to a "new normal" impact on contracts?

The workplace will not revert to its pre-Covid-19 state overnight, with social distancing in the work place likely to remain in place for quite some time to come.

This could mean that businesses will need to think carefully about how their capacity will be impacted, and how this will affect their ability to perform contractual obligations.

For example, if a business has an outsourcing contract under which it has to perform a business process, or produce a particular output, will it be able to comply with contractual performance standards whilst social distancing is still in place? In the context of a manufacturing business, what will be the impact on production schedules and delivery dates? There might also be an impact on operating costs, for example if processes are changed and additional shifts are introduced – can these additional costs be sustained?

Businesses need to plan a safe system of work for their employees to ensure they comply with Health and Safety legislation, but they also need to consider how this will impact on their ability to perform pre-existing contractual obligations. Ultimately, contractual arrangements with customers might need to remain on a revised footing for a number of months.

Getting to a point where agreement is reached on allocation of additional costs and/or changes to key elements of a contract such as scope of work, performance standards and delivery date will require co-operation between contracting parties. Again, it is important that any variations that are agreed are recorded properly and follow the required contractual procedures.

What is the new process for assessing status under IR35?

The end user client will be responsible for assessing if the contractor is employed or self-employed for tax purposes. It is required to take reasonable care in carrying out the assessments.

When an assessment is carried out the outcome must be confirmed to the contractor with accompanying reasons in a Status Determination Statement (SDS). This SDS must be provided to the contractor before making payment to them. It must also be provided to the agency if there is one in the chain (more on this later).

The end user client must have a dispute resolution procedure to enable to the contractor or agency to appeal the assessment outcome.

What is the government's "Kickstart Scheme"?

This scheme is specifically aimed at creating jobs for 18-24 year olds who are on Universal Credit and considered most at risk of unemployment because of the economic downturn. The Government has announced that it will pay young people’s wages (equivalent to 100% the National Minimum Wage plus the associated National Insurance contributions and employer minimum automatic enrolment contributions) for up to 6 months, and that this will amount to a grant worth approximately £6,500 per young person.

The jobs that are created must provide a minimum of 25 hours per week and be paid at a minimum of the National Minimum Wage The Chancellor announced that will be no cap on the number of jobs that will be funded under the Kickstart scheme.

Can I enact a rent suspension clause in my commercial lease?

Most rent suspension clauses in commercial property leases are unlikely to come to the assistance of the tenant. These clauses normally apply only where the premises has suffered substantial physical damage and are, as a consequence, incapable of being occupied, used or accessed. The coronavirus pandemic does not involve any physical damage to a property, loss from the crisis will be purely financial. Such losses then will not be covered by the landlord’s buildings insurance policy in a way that will allow a tenant to claim rent suspension.

I’m getting married but have had to postpone the wedding. Should I delay putting a prenuptial agreement in place until a later date?

No. The greater the gap between the completion of a Prenuptial Agreement and the Wedding the more likely it will be upheld by the Court. If such an Agreement is made shortly before the wedding takes place one of the parties to it could claim that they felt under pressure to sign and the Court may decline to follow it.