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Home › FAQs › What is the guidance in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the Covid-19 pandemic?

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.

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The employee I need to consider suspending is a doctor – do I have to follow MHPS

Yes probably in our opinion, even if you are not considering taking any formal action against them. Ultimately if a doctor is suspended this could be considered as causing them reputational damage and it therefore is correct that they are afforded the protections (in particular in relation to keeping exclusion/suspension under review) of MHPS. Under Part V of MHPS there is provision for excluding practitioners if they are a danger to patients and they refuse to recognise it or if they refuse to co-operate. It doesn’t refer to a particular risk for the practitioner themselves, but it would appear logical that it would apply.

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What are some other factors?

No one factor will determine status and the outcomes will differ depending on the nature of the work being carried out and the business of the end user client.

When you have carried out an assessment based on the relevant factors you can either get in touch with us to discuss further, check your answers against HMRC’s CEST tool or do both before making a final determination.

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What can I do as an employer if employees are known to be breaking the local lockdown rules?

This will depend on the particular facts and the employee’s circumstances but an employee should co-operate with the employer so far as is necessary to enable compliance with any statutory duty or requirement relating to health and safety.

In addition, conduct outside of work can result in an employee’s dismissal if the conduct pertains to the employment relationship. If an employee breaches their lockdown rules and it affects their ability to work, such as it being no longer safe for them to attend work, or the reputation of the employer, these may be grounds for disciplinary action and subsequent dismissal.

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Will site visits, hearings and inquiries still take place?

Due to the new guidance on social distancing and remote working, the Planning Inspectorate initially stated that site visits, hearings and inquiries would be cancelled. However, there is very much a push from the Secretary of State to keep the planning system moving notwithstanding the requirements to adapt to new ways of working. The Government now expects all hearings to be conducted virtually and where a virtual hearing is not possible, the expectation is that alternative arrangements will be put “speedily” in place and in accordance with social distancing requirements.

The Planning Inspectorate have been exploring ways of conducting hearings and inquiries remotely using technological means and conducted their first “digital” hearing on 11 May .

The Business and Planning Act 2020, which entered the statute books on 22 July 2020, includes provisions which allow more flexibility in relation to how appeals are determined including an ability for the Secretary of State to decide to adopt a procedure which is a combination of written representations, a hearing and/or an inquiry.

Site visits have re-commenced where it is safe to do so. The Inspectorate is looking at whether a site visit is necessary and has conducted a trial of “virtual site visits” where sites are assessed by means of photographs or video evidence.

The Planning Inspectorate have subsequently been scaling up conducting digital hearings, which also includes holding virtual local plan examination hearings.

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Can you require an employee to tell their employer whether they have been tested for coronavirus/the results of that test?

Yes, this is very likely to amount to a reasonable management instruction which is put in place for public health reasons. Employers should make it clear to their employees that this is something they are required to do and that if they fail to do so this may lead to disciplinary action.

Last updated on 23rd June, 2020