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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.

Related FAQs

What will happen with inquests during the coronavirus outbreak?

The Chief Coroner adopts the approach taken by the Lord Chief Justice in that no physical hearing should take place unless it is urgent and essential business, and it is safe for all involved. If a hearing is to take place, social distancing must be maintained. All hearings that can take place remotely should do so, if it is not possible for social distancing requirements to be met. The expectation is that some hearings will go ahead, most notably Rule 23 hearings. Coroners are reminded that they must however conduct any remote hearings from a court. Decisions as to the most appropriate approach will be left to the senior coroner in that jurisdiction.

As we have already seen, some inquests will be adjourned, most notably those with multiple witnesses and/or a jury.

The guidance stresses the need, when dealing with medical professionals, for coroners to recognise their primary clinical commitments, particularly in these high-pressured times. This could mean avoiding or deferring requests for lengthy reports/ statements and accommodating clinical commitments if clinicians are called as witnesses.

The guidance encourages proactive reviews of outstanding responses to Prevention of Future Death reports and extending timescales for Trusts to respond.

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What happens if someone is asked to restrict their duties but, despite acknowledging the risks to their health involved, they say that they want to continue to work on the front line?

As their employer, you have an overriding duty to provide a safe system of work. The Trust would not be able to run a defence to say that an employee “waived their rights” and chose to continue to work. Provided the decision around restricting duties has been carefully thought out, a full risk assessment undertaken and the employee has been truly consulted about the impact on them, then the decision taken will be a reasonable management instruction. Failing to follow that reasonable management instruction could amount to a disciplinary offence.

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Which agreements will qualify for exemption?

There are four criteria which must be satisfied if an agreement is to be considered exempt:

  • It must improve production or distribution, or promoting technical or economic progress – the guidance suggests that cooperation ensuring essential goods and services can be made available to the public, or an important sub-set of the public such as key workers, will satisfy this criterion.
  • It must allow consumers a fair share of the resulting benefit – the guidance suggests this will be the case where the action prevents or reduces shortages.
  • It must not impose on the undertakings concerned restrictions which are not indispensable to the attainment of the above benefits – the guidance suggests this will be the case where the cooperation is the only reasonable option due to the urgency of the crisis and where the cooperation is temporary in nature.
  • It must not afford the undertakings concerned the possibility of eliminating competition – therefore the parties must endeavour to retain competition in respect of the products (in particular price competition).

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Who do you have to inform and consult?

The duty is to inform and consult appropriate representatives of the “affected employees”.

Note that the term “affected employees” means those who may be “affected by the proposed dismissals or who may be affected by measures taken in connection with those dismissals”. The term extends beyond those immediately at risk of dismissal to include those affected by measures associated with the redundancies.

“Appropriate representatives” can be:

  • The Trade Union (if recognised)
  • (For any roles not covered by collective recognition) any existing standing body of elected or appointed employee representatives (if already in place)
  • Employee representatives, who are elected specifically for redundancy consultation

Last updated on 7th May, 2020

How do I access the scheme?

Those who are eligible will be contacted directly by HMRC based on tax returns they have received. If you are eligible you will be asked to fill out an online application. HMRC will pay applicants directly.

Last updated on 31st March, 2020