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National Mental Capacity Forum
Mental Capacity Act in action
Baroness Ilora Finlay
Working together to promote and uphold the principles of the Mental Capacity Act 2016
Mental Capacity Act in action Baroness Ilora Finlay Working together - - PowerPoint PPT Presentation
Mental Capacity Act in action Baroness Ilora Finlay Working together - - PowerPoint PPT Presentation
National Mental Capacity Forum Mental Capacity Act in action Baroness Ilora Finlay Working together to promote and uphold the principles of the Mental Capacity Act 2016 What is the purpose of the Forum? NMCF: first year 1) Voice of the Person
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NMCF: first year
1) “Voice of the Person” 2) Leading change Leadership Group Engagement with MCA Implementation Group 3) Action Day NMCF National Action Day: 15 March 2016 (RCAnaes) 29 Feb 2017 (RCP) 4) Thematic work plan Financial sector Office of public guardian ‐ LPAs Clear messages – GMC toolkit Care planning – NCPC Listening
“A movement, not a committee”
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Laws ‐ Mental Capacity Act
- More than regulatory
instruments
- Send social messages
- Can have unintended
consequences
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Unintended consequences?
- Carers feel excluded
- Confidentiality can be used as a barrier to
communication
- Assessments take priority over listening
- Deprivation of liberty safeguards
bureaucracy
- Advance Decisions to Refuse Treatment are
not understood
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Mental Capacity Act 2005 – 5 principles
- 1. A presumption of capacity
- I can make a decision
- 2. Individuals supported to make their own decisions
- Do all you can to help me make a decision
- 3. Unwise decisions
- Don't assume I lack capacity
- 4. Best interests
- Changing clinical scenarios
- Consulting those important to P
- 5. Less restrictive option
- Liberty and security
1 5 4 3 2 After Shropshire Council
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Decision specific capacity
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Disorder of the mind or brain?
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Interfere?
Disorder of the mind or brain?
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Understand the information
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Retain information
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Weigh up information
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Communicate their decision
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And conflicts ……
Time conflicts: acute care v capacity needs Least restrictive
- ption versus
safety of others ?Validity of LPA H&W Advance care plan ADRT / DNACPR Confidentiality v discussing best interests decision Financial fraud / grooming is very difficult to detect In acute
- ut of hours
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Liberty and security
- Human rights – in balance?
- Where is keeping people safe?
- Autonomy
- Do no harm / do good
- Justice – to individual and to others
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How is the Forum making a difference?
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Is elephant in the room money?
Elderly woman, dementia, fall, fractured femur. Husband frail, exhausted, Adamant she wants to go home Assessed as self funding Care home = £4k pcm Home care = £8k pcm Capacity assessment – ‘wishes and feeling’
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Is elephant in the room money?
Elderly woman, dementia, fall, fractured femur. . Husband frail, exhausted, adamant she wants to go home Assessed as self funding Care home = £4k pcm Home care = £8k pcm Capacity assessment – ‘wishes and feeling’
- 1. Financial duty of attorneys to her, or to both despite his capacity?
- 2. Does fiduciary duty trump health or vice versa?
- 3. What if different attorneys: F / H&W?
- 4. Do ‘wishes and feelings’ trump ‘weigh up and understand’?
- 5. Does safety of P override safety of husband?
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Overall – tensions and solutions
- 1. A presumption of capacity
- Fluctuating
- Assessing capacity
- understanding, retention, weighing up,
communication
- 2. Individuals supported to make their own decisions
- Time for the person v allocation of resources
- 3. Unwise decisions
- But what if front page of the papers
- 4. Best interests
- Changing clinical scenarios
- Consulting those important to P
- 5. Less restrictive option
- Danger to themselves and others
1 5 4 3 2
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Other big pieces of work for the Forum?
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