SCIE opinion - 8 February 2012

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Photograph of Rachel Griffiths

Rachel, the Agony Aunt: Can my staff sign consent forms for medical treatment, on behalf of service users?

Rachel Griffiths, SCIE Provider Development Manager

As part of my work with SCIE and the English Community Care Association (ECCA) I write a column in the monthly ECCA newsletter. I like to think that the column is helpful to the type of manager or care worker who's been on training, but now wants the confidence to put the the Mental Capacity Act 2005 (MCA) into practice.  To that end, I try to offer straightforward answers that link the law to everyday practice.

All the questions are about the Act; as an MCA Agony Aunt, what questions am I asked most often?

You might be surprised how frequently care providers ask me whether their staff can sign consent forms for medical treatment, on behalf of service users.

Well, the law is clear that nobody can sign consent forms for another person.  This applies to the person's relatives and friends, unless they have a Lasting Power of Attorney for personal welfare. It equally applies to care staff. So, if anyone asks for a signature and doesn't seem to mind who's signing, then they must be reminded of the law.

All of us who work in health or social care, including staff, doctors and nurses, are bound by the Mental Capacity Act. 

This law says staff must try their best to help people to make decisions for themselves; they must explain clearly about what needs doing and why, what will happen if they don't act, whether it will hurt someone and what they can do to help with that.  If they need to get help communicating with the person, they must seek it, perhaps from a relative or care staff member who knows the person well.

If medical staff decide the person lacks capacity to consent to (or refuse) treatment, they must act in the person's best interests, which may mean giving the person the treatment if healthcare staff believe it is necessary.  The NHS has a form for them to record this: the doctor or nurse who will give the treatment signs to say they believe the treatment is in the person's best interests.  This is why it's not good enough just to ask a relative or care worker to sign a consent form.

I'm currently working on a guide to creating good care plans.  So if you have examples of excellent person-centred care plans, that fit well with the MCA, do contact me

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