From April 2009, there will be new legal safeguards for people who:

• Lack capacity to consent to arrangements being made for their care/treatment in a hospital or registered care home, and
• For whom the least restrictive option for meeting their care/treatment needs might constitute deprivation of liberty in the terms of the European Convention on Human Rights Article 5.

a)         As part of the Deprivation of Liberty Safeguards (‘DoLS’) medically trained assessors are required to carry out a range of up to three assessments (Mental Health, Mental Capacity, and Eligibility).  To be eligible to carry out any of these assessments, a person must be a currently registered medical doctor who is EITHER currently approved under s.12 of the MHA  OR is of at least 3 years’ post-registration experience with expertise in mental health matters, and who has completed additional training (see below for details, and for other professionals who can carry out the Mental Capacity and Eligibility assessments).

b)         For those NOT approved under s.12 of the MHA, but who have expertise in mental health matters, perhaps through treating many residents of care homes, there is a requirement to complete two training modules provided by the Royal College of Psychiatrists.

c)         Doctors who ARE s.12 approved only need to complete the second training module.  Doctors who have completed this training as appropriate are eligible to carry out the Mental Health Assessment, which can only be completed by a medically qualified and appropriately trained person, and the Mental Capacity Assessment, which can also be carried out by a ‘Best Interests Assessor’ (a social worker, psychologist, OT or nurse who has completed specific DoLS training).

d)         Only s.12 approved doctors who have completed the second DoLS training module, or a Best Interests Assessor who is also an Approved Mental Health Professional, are entitled to complete the ‘eligibility assessment’ which is part of the DoLS process: this is an assessment to consider whether the Mental Health Act is a better route than DoLS for providing the care and treatment needed.

e)         A medically qualified doctor who has completed DoLS training as appropriate, whether s.12 Approved or not, or a Best Interests Assessor whether an AMHP or not, is eligible to carry out the ‘Mental Capacity Assessment’ which is also part of the process.

The two training modules for doctors are available free, as an e-learning package, to all registered NHS doctors.  To register, go to:

http://www.e-lfh.org.uk/Projects/DOLS/Register.aspx

Module 2, which is for s.12 Approved doctors and eligible others who have completed module 1, is also being provided in Oxford, face-to-face, by Dr. Julie Chalmers (Consultant Psychiatrist) and Rachel Griffiths (Mental Capacity Act and DoLS Lead)

I am happy to answer further questions or discuss this training with any doctors who would like to explore this further.

Please would GP's who complete the training ensure that I know about them, since we must compile a register of eligible assessors.

.  Deprivation of liberty in a person’s best interests is, and should remain, an extremely rare occurrence, but this training is an excellent opportunity to explore the crucial differences between lawful, proportionate restriction of liberty, which is authorised and regulated under MCA ss.5 and 6, and deprivation of liberty which can only be lawful if scrutinised and authorised, by a court or using the DoL

Rachel Griffiths
Mental Capacity Act & DOLS Lead
Oxfordshire County Council
Mount House, Witney, OX28 4AZ
tel: 01993 894304; email rachel.griffiths@oxfordshire.gov.uk