This flowchart describes the steps managing authorities need to take on or prior to admission in relation to DoLS.

This introduction provides an overview of the issues health and social care professionals face when capacity and consent for treatment and care are significant and critical challenges. It covers the legal framework and principles of the Mental Capacity Act 2005; consent to care and treatment; decisions for those who lack mental capacity; best interest decisions; deprivation of liberty; and collaboration and co-operation between professionals.

The focus of this report is on the MHA and its interface with the MCA, Deprivation of Liberty and the implications of the Supreme Court judgment (P v Cheshire West and Chester Council and P and Q v Surrey County Council [2014] UKSC 19). The latter has made it clearer and easier for providers and decision makers to identify where a person is being deprived of their liberty but has also led to a considerable increase in the numbers of people in England and Wales who are considered to be deprived of their liberty for the purposes of receiving care and treatment. The paper summarises the findings from a survey on the court judgment impacted on AMHP practice and service delivery. They show that there has been significant impact on AMHPs and service providers, but the situation appears to be more challenging for certain local authorities where a large proportion of their Best Interests Assessors for DoLS are drawn from the AMHP service. Landmark changes impacting AMHP practice and the local authorities on behalf of which the professionals act have been made as result of the Cheshire West judgement but there remain barriers and challenges in fully implementing these changes arising from the complex and bureaucratic DoLS framework. The Law Commission has been tasked to look for a framework that is simpler, while still protecting the rights of vulnerable people with mental health problems and those who lack capacity, with final report and draft legislation due to be published in summer 2017.

This diagram illustrates how police officers and staff apply the Mental Capacity Act 2005 when making health and social care decisions on behalf of people who lack capacity.