Independent Mental DATE: Capacity Advocacy 25/02/2020 DNACPR - - PowerPoint PPT Presentation
Independent Mental DATE: Capacity Advocacy 25/02/2020 DNACPR INFORMATION - for Health Care For Health Care professionals Professionals Content DATE: Types of decision where an IMCA may be involved 25/02/2020 What constitutes
DNACPR INFORMATION
Care Professionals
DATE: 25/02/2020
DNACPR INFORMATION
Care Professionals
DATE: 25/02/2020
DNACPR INFORMATION
Care Professionals
DATE: 25/02/2020
DNACPR INFORMATION
Care Professionals
DATE: 25/02/2020
When a person is assessed as lacking mental capacity, and there is no one else appropriate to consult with, there is a legal duty to instruct an IMCA for the following decisions; 1) Serious Medical Treatment 2) Change of Accommodation And IMCA may be instructed for the following decisions; 1) Adult safeguarding 2) Care Review
DNACPR INFORMATION
Care Professionals
DATE: 25/02/2020
DNACPR INFORMATION
Care Professionals
DATE: 25/02/2020
DNACPR INFORMATION
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DATE: 25/02/2020
Serious medical treatment is defined as treatment which involves;
could be offered in circumstances where:
burdens to the patient and the risks involved
‘Serious consequences’ are those which could have a serious impact on the patient, either from the effects of the treatment itself or its wider implications. This may include treatments which:
treatment or having major surgery such as heart surgery), or
cancer).
DNACPR INFORMATION
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client
DNACPR INFORMATION
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disturbance in the functioning of the person’s mind or brain?
sufficient that the person lacks the capacity to make that particular decision?
The functional test
The person is unable to make a decision if they cannot:
decision to be made
part of the decision process
Document the capacity assessment The 2 stage test
DNACPR INFORMATION
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Document the Best Interest Decision
decision?
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maker when considering an SMT / DNACPR
the person’s capacity to be involved in this decision (Mental
Capacity Act Codes of Practice S.4.40 / S4.42): “If a doctor or healthcare professional proposes treatment or an examination, they must assess the person’s capacity to consent…..ultimately it is up to the professional responsible for the person’s treatment to make sure that capacity has been assessed.”
DNACPR INFORMATION
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DATE: 25/02/2020
10.42 MCA code of practice .– Where SMT is being considered for a person who lacks capacity to consent and there is no-one appropriate to consult NHS bodies must instruct an IMCA
(S.37MCA)
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serious medical treatment decision. If there is no one else appropriate to consult with regarding the best interest decision, the decision maker has a legal duty to instruct an IMCA.
to deem them not appropriate to consult with.
may not be acting in the person’s best interest.
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decision with ?
another paid professional. An appropriate person could be a friend or family member of the client. (S.10 – Code of Practice 2005)
consulted
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treatment’ as described in the Mental Capacity Act code of practice.
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Urgent decisions will have to be made and immediate action taken in someone’s best interests in these
appropriate to delay treatment or to consult the person or known attorney’s, IMCAs (S 3.6 MCA Code
Guidance from the British Medical Association, the Resuscitation Council (UK) and the Royal College of Nursing …. “If a CPR decision is needed when an IMCA is not available, the decision should be made, the reasons for it should be documented in the health record and an IMCA should be consulted at the first available
DNACPR INFORMATION
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making process.
where necessary.
issues and offer information on the person’s behalf
could include persons past views or wishes, spiritual or cultural beliefs and what course
so finely balanced that a decision cannot be reached, or if there is dispute.
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right to see relevant health care and social care records.”
as part of the process of working out whether a proposed decision is in the person’s best interests.” (Mental Capacity Act of Codes of Practice – Chapter 10)
DNACPR INFORMATION
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DNACPR INFORMATION
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The court held that the clinician has a duty to consult the patient in relation to DNACPR (the person had capacity) "unless he or she thinks that the patient will be distressed by being consulted and that that distress might cause the patient physical or psychological harm". It must be emphasised that the court is insisting only that doctors consult before making this decision. Explicitly, the court leaves the decision whether the DNACPR decision should be made to the doctor.
DNACPR INFORMATION
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“where a patient lacks the requisite capacity, section 4(7) MCA encompasses the procedural obligations to consult. The obligation can only be waived in situations where it is truly impracticable
discussion”
DNACPR INFORMATION
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“emphasises the importance of involving people (or their representatives if they are unable to make decisions for themselves) in the decision-making process; this often involves a person making a shared decision with their healthcare professionals, but where CPR has no realistic chance of success it may involve informing people of the decision and explaining the basis for it;” (Cardiopulmonary Resuscitation (3rd edition - 1st revision)
DNACPR INFORMATION
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decision is being considered for a resident in a Care Home” Please see handout sheet which details:
DNACPR INFORMATION
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The IMCA service is provided by Total Advocacy in North Yorkshire
Website: www.cloverleaf-advocacy.co.uk
DNACPR INFORMATION
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