This questionnaire is designed to help assess compliance with the Mental Capacity Act in general practice and out of hours services. It has been designed by Barnet, Enfield and Haringey CCGs as part of work being undertaken to raise awareness and implementation of the Act.

Mental capacity assessment audit template.

Statement form for advance decision to refuse treatment (A4). An advance decision allows a person over the age of 18 to refuse a specific treatment in the future when they lack the capacity to consent to, or refuse, that treatment.

Key information on what a lasting power of attorney is, including the different types such as health and welfare LPA and property and affairs LPA, plus information on the registration process.

A preferred priorities for care (PPC) statement form (A4), which patients can fill in to state their wishes and care preferences are for the last few months or year of their life.

Statement form for advance decision to refuse treatment (A5). An advance decision allows a person over the age of 18 to refuse a specific treatment in the future when they lack the capacity to consent to, or refuse, that treatment.

Key information on lasting power of attorney, including how it may come into effect, who makes decisions about capacity, who can be an attorney and how to register a lasting power of attorney.

Describes what an advance statement is, and contains an A5 form patients can use to write down their preferred treatments and strategies for care should they have a mental health crisis.

Key information on advance decision to refuse treatment, including the role of doctors, how to ensure an advance decision is valid and the effect of it if you lose your capacity temporarily.

Describes what an advance statement is, and contains an A4 form patients can use to write down their preferred treatments and strategies for care should they have a mental health crisis.