IMCA and paid relevant person's representative roles in the Mental Capacity Act Deprivation of Liberty Safeguards

Appendix E: Department of Health briefing on DOLS (April 2010)

The Mental Capacity Act 2005: Deprivation of Liberty Safeguards – the early picture


  1. The Mental Capacity Act Deprivation of Liberty Safeguards (MCA DOLS) was introduced, as part of the Mental Health Act 2007, by the Department of Health in April 2009. The MCA DOLS are new statutory safeguards.
  2. The MCA DOLS were introduced to prevent deprivations of liberty without proper safeguards including independent consideration and authorisation. Deprivations of liberty in hospitals or care homes, other than under the Mental Health Act, should now follow the MCA DOLS process and all affected patients and residents should benefit from the new safeguards. The NHS and Social Care Information Centre published activity data for MCA DOLS, for the first time, in March 2010.

Number of people benefiting from DOLS safeguards

What do the numbers show?

  1. Firstly, some five and a half thousand people have benefited from the new MCA DOLS safeguards, in the first nine months. This means some five and a half thousand people have had their deprivation of liberty independently assessed and considered by best interests assessors. The Department is expecting the figure, by the end of the first year, to be about seven thousand.
  2. Secondly, the published data refers only to completed cases, so is a slight underestimate of the activity. However, activity levels are at about a third of the level estimated prior to the introduction of the new safeguards. Fewer people than thought are receiving care or treatment which involves them being deprived of their liberty, but there are probably a number of deprivations not recognised and not authorised.
  3. Thirdly, approximately half of the assessments are resulting in authorisations rather than the quarter predicted.
  4. There appears to be a better understanding of the complexities of the case law in relation to the circumstances that may constitute a deprivation of liberty than was anticipated at this, still, early stage in the implementation of the Safeguards.
  5. Fourthly, there are significant variations in activity levels in different areas and, notwithstanding the success of the training and awareness raising, it is likely that activity levels continue to be lower than could be reasonably expected in some areas. DH regional implementation leads continue to work closely with all areas to ensure the legislation is properly applied.

Case law developments

  1. There have been three significant case law judgments that managing authorities (hospitals and care homes) and supervisory bodies (primary care trusts and local authorities) and supervisory bodies (hospitals and care homes) and best interests and eligibility assessors should be aware of. The Department has produced guidance on these judgments.

Emerging practice issues

  1. Five practice issues, in particular, have arisen in the Department’s implementation team’s ongoing work with organisations and individuals:

View this briefing on the Department of Health’s website (PDF)