Mental Capacity Act 2005
Explains how the Mental Capacity Act affects you and how you can plan ahead for when you no longer have the mental capacity to make decisions for yourself. Applies to England and Wales.
Health and welfare decisions
- What types of decisions can be made on my behalf if I lack capacity?
- What are healthcare and medical treatment decisions?
- What if I've made an advance decision or a power of attorney?
- What are welfare and personal care decisions?
- When can't someone make a day-to-day decision for me?
- How can I plan ahead for when I can't make decisions for myself?
- What happens if I don't plan ahead?
What are healthcare and medical treatment decisions?
These could include decisions on whether to have:
- Examinations and tests done by doctors and other healthcare professionals, to diagnose a health problem
- Treatment from a doctor or dentist, including medical operations or surgery
- Restarting your heart
- Breathing, feeding and drinking by artificial methods, such as tubes and machines
- Blood transfusions
- Having samples of blood or other substances taken from the body
- Chiropody, physiotherapy and nursing care
Routine actions
If you lack capacity, there are many other routine actions that carers or professionals can make for you without needing any legal authority or permission from a court.
These routine actions include:
- Giving you routine medication
- Taking you to hospital for treatment or assessment
- Giving you nursing care or emergency first aid or medical treatment
What if I've made an advance decision or a power of attorney?
A carer or professional shouldn't make any healthcare decisions on your behalf if any of the following is true:
- They know that you've made an advance decision and these decisions would go against what you've put in the advance decision.
- They know that you've named an attorney in a lasting power of attorney and this would go against what they've decided.
- Their decision goes against one made by a deputy appointed by a court.
- Their decision goes against one made by the Court of Protection.
What are welfare and personal care decisions?
These are decisions about day-to-day actions which are necessary for your welfare. They include decisions about:
- Where you're going to live or who you'll have contact with
- Washing, dressing or feeding
- Shopping, buying essential goods and arranging personal care services
- Tidying or clearing up your home if you're in hospital or residential accommodation
- Help with communication
- Arranging social care services or a social care assessment
Carers, family members and health and care professionals can usually make these decisions if you’ve lost the capacity to do so. They can do this without needing permission from a court, as long as their decisions are in your best interests.
When can't someone make a day-to-day decision for me?
If any of the following people have made decisions about your day-to-day activities, your carers, family members and healthcare professionals cannot override these decisions:
- An attorney you have named under a lasting power of attorney to make personal and welfare decisions for you
- A personal welfare deputy appointed to you
- A Court of Protection
If you’re sectioned under the Mental Health Act, your responsible clinician may be able to make certain decisions that go against those made by your attorney, your deputy or a Court of Protection. For example, when deciding how to treat your mental health problem.
What happens if I don't plan ahead?
If you lose capacity and you haven't made an advance decision or appointed an attorney, the Court of Protection can:
- Make a one-off decision
- Make several decisions
- Appoint a deputy to make decisions on your behalf
Read more about the Court of Protection.
Deputy
A deputy is a person the Court of Protection appoints to make decisions for you once you have lost capacity to make them yourself. A deputy usually makes decisions about finances and property. The court can appoint a deputy to take healthcare and personal care decisions, though this is relatively rare.
Visit our full listing of Legal TermsCourt of Protection
The Court of Protection makes decisions and appoints deputies to act on your behalf if you are unable to make decisions about your personal health, finance or welfare.
See our pages on the Mental Capacity Act for more information.
Visit our full listing of Legal TermsCapacity
'Capacity' means the ability to understand information and make decisions about your life. Sometimes it can also mean the ability to communicate decisions about your life.
For example, if you do not understand the information and are unable to make a decision about your treatment, you are said to 'lack capacity' to make decisions about your treatment.
See our pages on the Mental Capacity Act for more information.
Visit our full listing of Legal TermsResponsible clinician (RC)
This is the mental health professional in charge of your care and treatment while you are sectioned under the Mental Health Act.
Certain decisions, such as applying for someone who is sectioned to go onto a community treatment order (CTO), can only be taken by the responsible clinician.
All responsible clinicians must be approved clinicians. They do not have to be a doctor, but in practice many of them are.
Visit our full listing of Legal TermsLasting power of attorney
A lasting power of attorney is a legal document that lets you appoint someone, called an attorney, to make decisions for you.
See our pages on the Mental Capacity Act for more information.
Visit our full listing of Legal TermsIndependent mental capacity advocate (IMCA)
An IMCA is a specially trained advocate who can help you if you do not have the capacity to make particular decisions. NHS bodies or local authorities must take an IMCA's views into account when making decisions that affect you if you have lost capacity. They are normally appointed by the local authority in England, and by local health boards or other NHS bodies in Wales. They must be independent people of integrity and good character with appropriate experience and training.
See our page on IMCAs for more information.
Visit our full listing of Legal TermsBest interests
Health professionals must act in your best interests before taking certain steps that affect your care and treatment.
The Mental Capacity Act has a best interests checklist, which outlines what health professionals need to consider before taking an action or decision for you while you lack capacity.
See our pages on the Mental Capacity Act for more information.
Visit our full listing of Legal TermsAdvance decision
An advance decision is a statement of instructions about what medical treatment you want to refuse in case you lose the capacity to make these decisions in the future. It is legally binding.
See our pages on the Mental Capacity Act for more information.
Visit our full listing of Legal TermsMental Capacity Act 2005 (MCA)
The Mental Capacity Act 2005 is the law that tells you what you can do to plan ahead in case you can't make decisions for yourself, how you can ask someone else to make decisions for you and who can make decisions for you if you haven't planned ahead.
See our pages on the Mental Capacity Act for more information.
Visit our full listing of Legal TermsThis information was published in April 2023. We'll revise it in 2026.
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