The government’s response to the Law Commission’s consultation on how the law should regulate deprivations of liberty (DoLS) for people who lack capacity to consent to their care and treatment arrangements. It sets out the government’s provisional view of each individual proposals, including the areas of authorising a DoL, the duration of authorisation, Independent Mental Capacity Advocates and appointment of appropriate persons, challenging authorisations and the role of the Courts, fit with the Mental Health Act and monitoring. The response agrees in principle that the current DoLs system should be replaced and mostly agrees with the Liberty Protection Safeguards model.

Assessment of the amendment, which introduced the liberty protection safeguards to replace the deprivation of liberty safeguards. the liberty protection safeguards (LPS) were introduced in the Mental Capacity (Amendment) Act 2019. LPS will provide the framework to determine whether a deprivation of liberty is necessary and proportionate for the care or treatment of an individual who lacks the mental capacity to consent to their arrangements, in England and Wales. They will replace the deprivation of liberty safeguards (DoLS) system, which was found to be “bureaucratic” and “too complex” by a House of Lords Committee in 2014. This impact assessment is an updated assessment of the Mental Capacity (Amendment) Act 2019. It provides an assessment of DoLS at present and fully funded, as well as for LPS as set out in the act.

Annual report on the use of the Mental Health Act (MHA), looking at how providers are caring for patients, and whether patients’ rights are being protected. The report sets out CQC’s activity and findings from our engagement with people subject to the MHA and review of services registered to assess, treat and care for people detained using the MHA during 2020/21. It is largely based on feedback letters on the 620 remote monitoring letters following reviews of 682 wards carried out during 2020/21. These involved private conversations with 1,895 patients and 1,111 carers. The report highlights three key findings. Firstly, the workforce is under extreme pressure; the pandemic has placed additional stresses on staff, patients and carers; staff are now exhausted, with high levels of anxiety, stress and burnout, and the workforce is experiencing high levels of vacancies. The negative impact of working under this sustained pressure poses a challenge to the safe, effective and caring management of inpatient services and to the delivery of care in a way that maintains people’s human rights. Secondly, community services are key to reducing levels of detention in hospital. Not getting the right help at the right time can lead to symptoms worsening and people needing inpatient care. During the pandemic this has been a particular concern for children and young people. We have seen an increase in the numbers of children and young people being cared for in inappropriate settings while they wait for an inpatient bed. Thirdly, urgent action is needed to address longstanding inequalities in mental health care. We remain concerned that Black or Black British people are more likely to be detained under the MHA, spend longer in hospital and have more subsequent readmissions than White people.

An overview of the Mental Capacity (Amendment) Bill, and the amendments made during the Bills Lords stages, ahead of its Second Reading in the Commons on 18 December 2018. The aim of the Bill is to reform the process for authorising arrangements which enable people who lack capacity to consent to be deprived of their liberty (for the purpose of providing them with care or treatment). This briefing summarises some of the main concerns raised by Peers about the Bill during its passage through the Lords. These include: the definition of deprivation of liberty; the role of care home managers in carrying out assessments, with particular concerns raised about potential conflict of interests in care homes and independent hospitals; the appointment and role of Independent Mental Capacity Advocates (IMCAs); and provisions relating to reviews by Approved Mental Capacity Professionals (AMCPs) and referral to the Court of Protection.

Purpose: This paper aims to examine reform of mental health legislation in England and Wales. It covers the period from the introduction of the 1983 MHA to the proposed reforms outlined in the Wessley Review that was published in December 2018. Design/methodology/approach: This is a literature-based project. Findings: Reform of the mental health legislation reflects two potentially conflicting strands. One is the state’s power to incarcerate the “mad”, and the other is the move to protect the civil rights of those who are subject to such legislation. The failures to development adequately funded community-based mental health services and a series of inquiries in the 1990s led to the introduction of Community Treatment Orders in the 2007 reform of the MHA. Research limitations/implications: The development of mental health policy has seen a shift towards more coercive approaches in mental health. Practical implications: The successful reform of the MHA can only be accomplished alongside investment in community mental health services. Originality/value: The paper highlights the tensions between the factors that contribute to mental health legislation reform.

This document describes the work that has taken place to raise awareness and understanding of the Mental Capacity Act (MCA) across the health and care system in response to the recommendations of the House of Lords Select Committee on the Mental Capacity Act in 2014. Using case studies, the report outlines the progress made in a range of areas, including: national governance, monitoring progress, increasing awareness and implementation, digital resources, professional training, system design and partnership, system regulation, care planning, the Office of the Public Guardian, Independent Mental Capacity Advocates (IMCAs), and Deprivation of Liberty Safeguards (DoLS). The report shows that many localities have seized the opportunity to make real strides forward. With the establishment of the new National Mental Capacity Forum, an opportunity now exists to accelerate progress.