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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

What do I do if I can't travel to the UK to activate my visa?

If your 30-day visa to travel to the UK (vignette) has expired or is about to, you can request a replacement free of charge until the end of 2020 by contacting the Coronavirus Immigration Help Centre. This can be granted with new and extended validity dates to allow travel once you are able to.

Can I reduce the risk of IR35 applying?

It is possible to review working arrangements for contractors before the new rules come into effect. This will require immediate action.

You could consider terminating current contracts and entering into new terms that reflect working arrangements for a self-employment arrangement.

Another possibility is encouraging contractors to abandon the PSC model and provide services under a compliant umbrella company.

In the event of a determination of employed status you should seek to enter new terms that at the very least reflect the new tax arrangements .

How does a Public Body amend its contracts to enable continued payment to contractors?

The latest Cabinet Office guidance published Monday 6 April 2020 titled ‘Procurement Policy Note PPN 02/20: Additional guidance. FAQs and model terms for construction’ provides model deeds of variation for JCT and NEC3 contracts to provide for such payments to be made. As the Cabinet Office guidance states, legal advice is likely to be required to make sure that the model variations work with your specific contracts. Please contact one of our construction specialists if you need advice and assistance.

For a copy of the guidance note click here: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/878338/PPN_02_20._Additional_guidance__FAQS_and_model_terms_for_construction.pdf

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.

How might the transition to a "new normal" impact on contracts?

The workplace will not revert to its pre-Covid-19 state overnight, with social distancing in the work place likely to remain in place for quite some time to come.

This could mean that businesses will need to think carefully about how their capacity will be impacted, and how this will affect their ability to perform contractual obligations.

For example, if a business has an outsourcing contract under which it has to perform a business process, or produce a particular output, will it be able to comply with contractual performance standards whilst social distancing is still in place? In the context of a manufacturing business, what will be the impact on production schedules and delivery dates? There might also be an impact on operating costs, for example if processes are changed and additional shifts are introduced – can these additional costs be sustained?

Businesses need to plan a safe system of work for their employees to ensure they comply with Health and Safety legislation, but they also need to consider how this will impact on their ability to perform pre-existing contractual obligations. Ultimately, contractual arrangements with customers might need to remain on a revised footing for a number of months.

Getting to a point where agreement is reached on allocation of additional costs and/or changes to key elements of a contract such as scope of work, performance standards and delivery date will require co-operation between contracting parties. Again, it is important that any variations that are agreed are recorded properly and follow the required contractual procedures.