This year has seen several quite significant updates in healthcare legislation, with several important changes for the way we treat and care for patients. While these are not all related to the Mental Capacity Act directly, it’s important that we take note of the changes and how they affect our day-to-day work.
The original purpose of the discharge to assess model was to increase access to wards for people most in need, reduce ‘bed blocking’ and not detain patients in a healthcare environment unnecessarily.
With the updated guidance, there is an renewed emphasis on how discharge planning should start on admission, considering all aspects of the individual’s needs to support recovery and reduce risk of readmission. This therefore required a multi-disciplinary approach in order to ensure all needs are considered.
Reform to care costs
From October 2023 a new lifetime cap on care costs will be introduced. This means the personal costs over a person’s lifetime will be capped at £86,000. This is a huge change, with significant ramifications for the way we look after those in care.
For further reading on this subject, we recommend an excellent analysis by Tim Spencer-Lane, in which he looks at the upcoming reforms in detail, considering practical application in everyday practice, including pros and cons and the broader picture.
Health and Care Act 2022
As a part of the new Health and Care Act 2022, Integrated Care Systems have been established across the UK. Within these Systems they are required to have a Board or Partnership (ICB/P) that serve as statutory organisations to unite NHS service provisions with the aim of improving communication and care provision as a whole.
The NHS Confederation shares that the purpose of the integrated care systems as a whole seeks to be ‘rooted in partnership’ across all areas of health and social care to deliver ‘high-quality NHS services’. Through this they hope that this recognition of individuals as complex beings will help the NHS take a more holistic approach. This has the potential to help further pool budgets and enable more effective use in practice. Considering these budgets, ICB/Ps have commissioning responsibilities from both NHS England and those of the former CCGs.
This segment of the Health and Care Act 2022 came into effect as of 1st July 2022.
Mental Health Act reform
In a new draft Mental Health Bill, published on 27th June 2022, the government seeks to support people in crisis to a higher degree through the application of mental health ambulances and voluntary sector run ‘crisis houses’ amongst other key changes. The proposed new Bill is aimed to be implemented through an increased investment of £150 million provision in across NHS mental health services.
Within the proposals, there is an broader right to independent advocacy, which has been welcomed by many, providing support for inclusion in processes, understanding and their voices within these systems.
In terms of the background and proposed reforms, the Commons Library Research Briefing provides a good overview alongside another piece in Community Care. These articles highlight the stricter in-patient criteria requirements and the clear exclusion of learning disability of autism as criteria for section 3 detention.
The draft Bill has now moved to the next stage of scrutiny before a Joint Committee of Lords and Commons.
Human Rights Bill
The new Human Rights Bill is perhaps one of the most important changes relevant for the Mental Capacity Act and how we protect vulnerable people. This modernisation from the Human Rights Act 1998, is said to ‘endeavour to “restore common sense” to the application of human rights within the UK’, taking account of case law including Cheshire West.
39 Essex Chambers provides a great webinar introducing the proposed Bill, unpicking the elements of change it proposes, possibilities and questions that remain.
Too much at once?
While each of these proposed changes has the potential to make significant improvements to the health and social care system, we should of course view the reforms with a note of caution. Given the sheer volume and impact of all these changes happening over a relatively short period of time (in governmental terms), it is likely that these changes will take some time to filter down through the system to staff working on the front line. Education is of course critical, and should be a key priority for managers in the coming months, for if not, there is risk of misuse, confusion and/or people falling through the gaps.