Skip to content

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 are the new Procurement Policy Notes (PPN)?

The Government has produced and published three new Procurement Policy Notes as a direct result of the ever changing Covid-19 environment.

PPN 01/20: Responding to COVID-19

The purpose of PPN 01/20 is to ensure that contracting authorities are able to procure goods, services and works with extreme urgency, to allow them to respond to the pandemic efficiently.

This PPN provides guidance for the following circumstances:

  • Direct award due to extreme urgency (regulations 32(2)(c)) (click here to read our article regarding regulation 32)
  • Direct award due to an absence of competition or protection of exclusive rights
  • Call off from an existing framework agreement or dynamic purchasing system
  • Call for competition using a standard procedure with accelerated timescales
  • Extending or modifying a contract during its term

PPN 02/20: Supplier relief due to COVID-19

PPN 02/20 focuses predominantly on the supplier to assist in keeping supply chains open and ensuring that suppliers are kept financially sound during these unpredictable times.

This PPN provides guidance for the following circumstances:

  • Urgent reviews of contract portfolios and to update suppliers if they believe they are at risk
  • Put in place appropriate payment measure to support supplier cash flow
  • Where contract payments are based on ‘payment by results’ make payments based on previous invoices
  • Ask suppliers to act on a ‘open book’ basis and make cost data available to the contracting authority during this period
  • Ensure invoices submitted by suppliers are paid immediately on receipt

PPN 03/20: Use of Procurement Cards

The third guidance note PPN 03/20 relates to the use of procurement cards to increase efficiency and accelerate payment to suppliers.

This PPN provides the following advice and urges organisations to arrange with their procurement card provider to:

  • Increase a single transaction limit to £20,000 for key card holders
  • Raise monthly limits on spending with procurement cards to £100,000 for key card holders
  • Spend on procurement cards each month in excess of £100,000 should be permissible to meet business needs

Although the above advice has been provided, should these limits not be necessary, organisations should seek an appropriate transaction limit or monthly limit.

The PPN also advises that by 30 April 2020, in scope organisations should:

  • Ensure that a number of appropriate staff have the authority to use these cards
  • Open all relevant categories of spend to enable these cards to be used more widely
I am finding life at home very difficult and I want to separate from my spouse. Is this possible under the current pandemic?

The National Police Chiefs Council (NPCC) issued guidance mid-April confirming that you can move to a friend’s address for several days to “cool off” following an argument at home. You should strongly consider either yourself or your spouse moving elsewhere where children are involved as it prevents the children from witnessing conflict within the home, at what is already an emotionally charged time for them. Nevertheless, you should also consider and take legal advice on the financial implications of either of you or your partner moving out and how contact with the children is going to be promoted with both parents, if suitable. The Government Guidance has confirmed that children can be moved between households if they have separated parents.

It is still possible to issue Divorce proceedings and much of the process has now been taken online. The main divorce suit is dealt with separately to the separation of financial assets and children arrangements, which can often take much longer to review and discuss. While staff shortages may mean slower turn-around times there is no reason to suspect that a divorce will not otherwise go ahead as anticipated. Once coronavirus has passed, it is likely that divorce rates will spike and there will be an increased demand on the Court system, so your divorce process may take longer if you delay filing your divorce.

It is also still possible to issue Court Applications regarding any financial settlements or children arrangements, however, the Court system was already under significant pressure before coronavirus, so the pandemic will only add to that and we expect Court processes to significantly be slower in those areas.

Court Applications should in any event be used as a last resort and there are alternative dispute resolution processes available which you should consider, including Arbitration and Mediation. Family lawyers are continuing to advise and assist individuals, manage their separations and can provide information about the options available, using alternative methods of communication such as Teams, Skype or Zoom for clients. Understandably, speaking aloud may be difficult in circumstances where you are not able to get any private time away from your spouse due to you being in lockdown and so email correspondence may be the most appropriate method of communication.

We are conscious that asking a particular group of people, who have a protected characteristic under the Equality Act 2010, to restrict their duties, could expose the Trust to allegations of discrimination. What steps can we take to avoid someone/a group of people feel that they have been treated differently because of their protected characteristic?

A claim for indirect discrimination is the most likely risk here. The first point to make is that the decision to review duties is being made based on the growing amount of medical evidence that the BAME community is being disproportionately adversely affected by the COVID 19 pandemic compared to other ethnic groups. The key is to ensure that blanket policy decisions are not taken, nor should assumptions be made about the risk to each individual concerned. Decisions should only be made on an individual basis with an open dialogue with the individual concerned. You as their employer, need to ensure that the individual feels listened to and heard; that this is not just a tick box exercise.

Consider having a working group which has an overview of the policy decisions being made. That working group should contain representatives from across the staff groups including staff side, but importantly, representatives from different ethnic backgrounds to ensure the important voices are heard. Accountability should be built into that group. This group should also be a safe environment for staff to raise concerns about their health and safety and safe systems at work.

What suggestions do you have to raise the profile of the MHFA group in an organisation, particularly with agile working?

Details of your MHFAs should be posted somewhere that everyone can access easily – a specific area on an intranet or whatever alternative exists. Regular comms involving the MHFAs, webinar sessions, Q&A sessions and mental wellbeing drop in sessions are all ideas that may work well.

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.