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The Law Commission Report
4 April 2017
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for news, legal updates, real
opinions and training:
https://www.linkedin.com/company
/health-and-social-care
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• summer 2014 – July 2015 pre consultation
& drafting of consultation paper
• July – Nov 2015 public consultation on
provisional proposals
• May 2016 interim report
• final report and draft bill published
13.3.7
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• reforms to s.4 MCA
• limitations to s.5 defence
• revised s.4b
• the ‘liberty protection safeguards’
– any setting
– from age 16
– authorisation by responsible body – NHS for
hospitals/CHC, LA for other cases
– additional scrutiny by AMCP where P
objecting
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• active (rather than passive)
duty to consider P’s
ascertainable wishes,
feelings, beliefs and values
• duty to give more weight to
this
• s.4b – express authority to
deprive of liberty:
‐ whilst seeking authority
from court
‐ whilst awaiting
authorisation under LPS
‐ in an emergency
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• in each case, you must reasonably believe
that P lacks capacity to consent to the
steps being taken and necessary to
deliver life sustaining treatment or
prevent serious deterioration
• s.4c / 4d – redress for unlawful dol in
private care homes or hospitals
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When
• public body moving P to long
term accommodation (unless
for 28 days or less)
• restricting P’s contact with
others
• provision of serious medical
treatment
• administration of treatment
covertly
• administration of treatment
against P’s wishes
The defence only available with
written record
• steps taken to establish
whether P lacks capacity
• steps taken to support P to
make own decision
• why it is believed P lacks
capacity
• why act in P’s best interests
• duty to provide advocate has
been complied with
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• written record must be prepared before
the act unless you reasonably believe
delaying the act would harm P
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• arrangements to enable care and
treatment to 16+ giving rise to a dol
• can be any setting / multiple settings
• can include arrangements for transport
• can include arrangements to ensure
return of P to placement
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• does not include arrangements for
assessing/treating mental disorder
(exception for LD outside MHA).
Therefore compliant patients lacking
capacity in hospital for treatment of their
mental disorder would need to be
detained under MHA under the proposed
regime
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• if P in hospital, the hospital manager
• if CHC, the CCG
• otherwise, the LA (on basis of ordinary
residence)
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• capacity assessment (can include
fluctuating capacity)
• medical assessment (of unsound mind?)
• assessment re whether LPS necessary and
proportionate weighing up likelihood of
harm to P/others
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• minimum of 2 assessors who must be
independent of each other
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• mental health arrangements excluded
• LPS cannot conflict with decision of
LPA/CAD on accommodation
• cannot conflict with MHA decisions (e.g.
CTO/s.17 leave)
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• thereafter reviewed by independent
reviewer
• person not involved in day to day care &
treatment of P
• if independent reviewer satisfied
conditions for LPS met RB can authorise
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• however some cases must be referred to
an AMCP for determination
– where P objects
– where dol necessary and proportionate
re: risk to others only
– discretion to refer others
– AMCP provided by LA (similar to AMHPs)
– cannot be involved in day to day care and
treatment
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• required to determine afresh whether the
conditions are met
• if satisfied, must approve the
arrangements and notify the approval in
writing to the ‘responsible body’
• if not – notify in writing, providing reasons
and describing steps to obtain approval
• should review information and where
practical meet P
• fresh consultation discretionary
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Authorisation
• authorisation record which can
travel with P so long as the
specific arrangements are
authorised
• once authorisation in place,
protection of liability to acts
done in pursuance to
authorisation
Duration
• can be renewed, 12 months, 12
months, 3 years
• suspension for short term
mental health admission
• reviews
• advocacy throughout
• recommends right to tribunal
or CoP with improved
accessibility & incorporation of
medical expertise
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• when can we expect a government
response?
• potential for pre-legislative scrutiny
• in the meantime, carry on with the
system we have...
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Report and draft bill available:
http:/www.lawcom.gov.uk/project/mental-
capacity-and-deprivation-of-liberty/
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We are delighted to be hosting the 2017 conference in
Birmingham on 27 April, 9:30am – 3:30pm.
• £99 + VAT per person
• IET Birmingham, Austin Court, B1 2NP
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Please get in touch if you have any questions
or wish to discuss the topics we’ve covered
further…
[email protected] | 01392 45 8768