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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

Is there anything I can do to try and settle my claim?

There are several options that can be used at this time to try and settle disputes. If it is not possible to settle a dispute via direct discussions between the parties then some form of Alternative Dispute Resolution (“ADR”) might be appropriate. Mediation is the most popular form of ADR. Most people’s perception of mediation is that it needs to be in person but that does not have to be the case.

Mediation can take place online or on the telephone. Most, if not all, ADR providers remain open for business and are quickly changing their business model to ensure that mediations can still take place. Mediation can be arranged at reasonably short notice and certainly so far as the online model is concerned, it mirrors the process that is adopted when parties appear in person. Online mediation allows for joint sessions with the mediator to take place and also for the parties to break out into their respective rooms for private discussions. If a dispute settles at mediation – and the vast majority do – then the agreement reached between the parties is binding and can be enforced.

A group of senior former judges and legal academics have now called for an acceleration in the use of ADR in light of the current circumstances. They have stated that courts should promote “and where appropriate require” the use of ADR. Mediation has particularly seen an increase in growth at this time.

ADR normally results in a quicker outcome than if the matter proceeds in the courts. Due to its conciliatory nature it is a very useful process where parties continue to be in a trading relationship. Contracting parties should also consider building ADR into dispute resolution clauses in their contracts so that in the event there is a dispute the focus is on resolving the dispute as soon as possible before it escalates into litigation.”

Last updated on 31st March, 2020

How are civil hearings being conducted?

The majority of hearings are taking place by video or phone.

Court guidance has been issued on telephone and video hearings during the coronavirus outbreak:

https://www.gov.uk/guidance/hmcts-telephone-and-video-hearings-during-coronavirus-outbreak

Where a Judge orders “teleconferencing”, it will take place using BTMeetMe, or video conferencing using Skype for Business or Cloud Video Platform.

All hearings are subject to the relevant jurisdictional rules and practice directions and usual court etiquette, including wearing appropriate attire and not eating or drinking during a hearing.

Electronic bundles of documents and authorities (if required) need to be prepared, indexed and paginated and sent to the Court well in advance of any hearing.

Last updated on 15th May, 2020

Do all contractors have to be assessed?

Individual contractors who are not operating via an intermediary (eg sole traders) do not need to be assessed under IR35. However, you will always have the risk with those individuals that there is no intermediary – therefore if their tax status is wrong, HMRC are very likely to consider that responsibility for this would fall on the hiring company in any event.

Last updated on 4th February, 2021

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.

Last updated on 19th May, 2020

What sort of issues are likely to have arisen?

The Coronavirus pandemic will have impacted businesses in many different ways, but some of the most likely impacts that could have a legal implication are as follows:

  • Services were not performed in accordance with contract during the period of disruption. This could be a reduction in volume of services performed, a suspension of services, or performance in a way that does not comply with contractual KPIs
  • Late delivery or non-delivery of goods because of factory closures, or disruption in the supply chain
  • Changes being agreed between parties to contracts to deal with the consequences of the Covid-19 outbreak

Last updated on 7th May, 2020