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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

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It is where the need for a role at a specific site, or the number of people performing a role, has ceased or diminished or the site closes down.

Do you recommend a structured approach to MHFA supervision?

Yes – there should be a framework in place to ensure that MHFAs are fully supported themselves and so that individuals are supported beyond the support the MHFAs provide.

What are the changes to the law?

On 25th June 2020, the Corporate Insolvency and Governance Act, among other things, introduced new restrictions on suppliers of goods and services to terminate the contract in the event that the customer enters an insolvency process.  This has very important consequences for many businesses as it could expose them to greater financial risks.

Do I have to quarantine for 14 days when arriving in the UK?

From 8 June 2020, people entering the UK from overseas (excluding those entering from Ireland, the Channel Islands or the Isle of Man) must comply with a mandatory 14 day quarantine period. However, for those travelling to England, a number of country specific exemptions have been introduced.

A full list of the countries excluded from the quarantine provisions can be found on the gov.uk website which change on a regular basis, often on short notice.

Where a quarantine period does apply, a person will not be able to leave the place they are staying in for 14 days, except in some very limited circumstances.

These rules will apply to both British and foreign nationals, however there are some further exemptions to this rule where a person is coming to the UK to undertake a certain role (such as a healthcare professional coming to the UK to provide essential healthcare). A full list of the narrow exemptions can be found on the gov.uk website.

Before travelling, individuals will be asked to provide their contact details and information about their journey and the accommodation that they will be self-isolating in. To do this, individuals will need to fill in an online form on the gov.uk website. Individuals who refuse to fill in this form may be fined £100 and/or denied entry at the UK border should they not be a British citizen or UK resident.

The information provided in the form will ensure that the Government can check that an individual is self-isolating at the address given. Where an individual refuses to self-isolate they can be fined £1,000 if they are staying in England or Wales.

Once visa application centres re-open overseas and UK visa applications are processed, this 14 day period will need to be taken into consideration and may require employment start dates in the UK to be delayed.

How do I implement temporary contractual arrangements?

The Government expects the use of bespoke contractual documents to implement temporary arrangements relating to your PFI contracts.

With time and resource precious commodities, focus should be given to documenting:

  • The key changes to your PFI requirements
  • The temporary nature of the measures
  • The requirement for best efforts on behalf of the PFI Contractor
  • The importance of continued health and safety measures at all times