Pan-London NHS: MCA lead toolkit

Produced by: NHS London Purchased Healthcare Team
Hosted on: National Mental Capacity Act (MCA) Directory


An objective of the London NHS Commissioner MCA Board is to support commissioners to implement MCA assurance and compliance. MCA leads have identified a number of tools/documents to support them to gain MCA assurance. These tools have been compiled into a toolkit for NHS MCA leads in line with the MCA compliance framework shown below

Chart showing make up of MCA compliance

The MCA framework outlines what is required to ensure MCA compliance from a provider and commissioner perspective.

It is important that providers have:

  • MCA policies and procedures in place that provide the correct framework for staff to follow.
  • MCA training and support to translate MCA policies and procedures into practice.
  • Quality assurance mechanisms in place that check MCA processes are carried out appropriately.

Good practice provider MCA training and support and quality assurance should involve service users. For example, service users should be provided with information to understand the MCA and feedback about their experience should be collected.

CCGs have a responsibility to ensure they commission healthcare that is compliant with the MCA for service users in the CCG’s area. The MCA framework shows how this can be achieved through the contract monitoring process, where commissioners assess the quality of providers’ MCA policies, procedures, training and assurance mechanisms. If any areas require improvement, commissioners should support providers to reach acceptable standards of MCA compliance.

Commissioners need to be trained to understand what providers should be doing regarding the MCA and commissioners’ role to monitor this. Networking involves commissioners sharing issues and best practice as well as keeping updated on any changes in legislation taking place.

Commissioner training


Case studies

Contract monitoring



Policies and procedures

Care homes


MCA policy examples for Acute providers

Provider training



Good practice MCA implementation/awareness support documents

Barnet, Enfield and Haringey CCGs

Barts Health

Croydon CCG

Camden and Islington Foundation Trust

NHS London

NELFT NHS Foundation Trust

Quality assurance

Audit tools