The Mental Capacity Act and Deprivation of Liberty: why it matters

 SCIE’s work: Get me to hospital 

The MCA can be used by health and social care practitioners to take a person unable to make decisions for themselves to hospital for urgent, potentially life-saving physical health treatment when they are refusing to go. However, evidence from the 2023/24 ‘LeDeR Annual Report: Learning from Lives and Deaths – People with a Learning Disability and Autistic People’, makes it clear that practitioners struggle to make these decisions and use the MCA correctly, with catastrophic consequences.  

The report, which investigates the death of every adult with a learning disability and autism in England to understand what happened, improve care, reduce inequalities and prevent future premature deaths, demonstrated that people with a learning disability are three times more likely to die from a condition which could have been treated.  

SCIE’s ‘Get me to hospital’ project looks to support both the individual who is at the centre of decisions relating to conveyance to hospital, and the practitioner responsible for arranging, or undertaking, conveyance of them, to address these inequalities.  

Our ‘Get me to hospital’ guide was co-produced with the Stop People Dying Too Young (the LeDeR programme) – Inclusion North group. It explains how to assess decision-making capacity, when the MCA can be used to support decisions about hospital admission, and how to determine best interests lawfully and compassionately. It encourages forward planning instead of crisis response; knowing the person well, understanding how they communicate distress, and having clear plans in place can make these situations safer and less distressing.  

SCIE has also published a ‘Get me to hospital’ e-learning course that is designed to deepen understanding. It takes learners through a potentially life-threatening situation involving care practitioners, healthcare workers and families, and asks how the MCA should be applied to make the best decisions for the person concerned.  

SCIE’s work: Introduction to the Mental Capacity Act and Deprivation of Liberty for professionals working with children and young people  

While the MCA applies from the age of 16, DoLS formally apply only to those aged 18 and over; however, recent years have seen a growing number of cases where courts authorise the deprivation of children’s liberty to keep them safe when no less restrictive options are available.  

This is not a niche concern reserved for specialist lawyers or senior clinicians. It is a reality that a residential support worker, a teacher, a community nurse or a social worker might face on any given day. Yet many practitioners feel underprepared to navigate these situations with confidence. 

That’s why, last year, SCIE developed a course titled, ‘Introduction to the Mental Capacity Act and Deprivation of Liberty for professionals working with children and young people’. The course, designed for practitioners from a wide range of organisations and in a wide range of roles, explores the core principles of the MCA and the legal framework around DoLS, and how they apply to children and young people. Participants are encouraged to hold the legal framework alongside a commitment to rights-based, child-centred practice—asking not just ‘Is this lawful?’ but ‘Is this right for this young person, at this point in their life?’ 

Impact  

SCIE’s work around MCA and DoLS is supporting people to live fulfilling lives and creating a fairer and more equal society, where care maximises people’s choices and removes social inequality. 

Our ‘Get me to hospital’ resource has had a measurable and demonstrable impact, with a frontline professional reporting that it is being actively used to secure hospital admission for people who are frightened or reluctant to go into hospital. This feedback has highlighted that it is influencing practice and improving outcomes for people.  

And participants on our ‘Introduction to the Mental Capacity Act and Deprivation of Liberty for professionals working with children and young people’ course fed back that they left with not just improved knowledge, but a clearer sense of how to apply it—and share it—in their day-to-day work. 

We continue to develop training and guidance in this space. Follow SCIE on social media and sign up to our newsletter to stay informed about new courses, publications, and practice resources.  

To find out more about this area of work and what SCIE does more broadly, read our Impact Report 2025/26, which spotlights key projects over the last year and their outcomes.