The National Mental Capacity Forum is an initiative run by the Ministry of Justice and the Department of Health and Social Care. It aims to work with stakeholders to identify issues and solutions to improve the implementation of the Mental Capacity Act (2005) in everyday practice across England and Wales.
The National Mental Capacity Forum has just published its annual report for the period 2023–2025. In this blog, we give an overview of the report, and key findings relevant to professionals working in this area of practice.
Overview
The report paints a stark picture of the ongoing needs surrounding the application of the Mental Capacity Act, and the consequences for individuals who often lack sufficient protections or may have their rights unlawfully impeded. As the introduction makes clear: ‘The status quo remains less than perfect. The backdrop is one of persistent health and social care delivery constraints which have legitimated agendas once thought unimaginable’ (p. 3)
However, despite these well documented challenges, the Forum continues to ask:
- How do we change, modify, remedy, do better?
- How do we bring the MCA to a wider audience?
Deprivation of Liberty Safeguards (DoLS)
In this section of the report, Lucy Series gives a succinct and vital overview of the history of DoLS, and the issues faced when applying DoLS in practice. There is also an important update pending from the updated Mental Health Bill (2025) that will impact upon the MCA, and specifically, those with autism and learning disabilities.
The section also includes several case studies and commentaries that help to illustrate the application and impact for people in practice.
Back to the Basics of Schedule A1’s Requirements
Linking on from the section on DoLS, Lorraine Currie reports on the responsibilities of relevant parties in applying for DoLS – advising that practitioners get ‘back to the basics’ and ‘do what is essential’. This includes a focus on communication and good record keeping.
In particular, the author highlights the needs for Managing Authorities such as Care Homes and Hospitals to only request authorisation when the necessary conditions are met, to keep records of the request, and inform the relevant person to ensure they understand its effects and their rights. There is also guidance for Local Authorities, and then Best Interests Assessors and Mental Health Assessors.
Coroners, Prevention of Future Deaths Reports and Mental Capacity Concerns
The 17 cases presented in this section are particularly moving, and highly relevant for anyone working in this area. From these case studies, the authors Keywood and Flynn highlight the following issues:
- Inattention to the perspectives and potential input of family members and informal caregivers (not consulting relevant parties)
- Inadequate or entirely absent mental capacity assessments
- Inadequate investigations resulting from a death
- Lack of evidence of learning as a result of the above
Court of Protection – A Year in Cases
While there have not been any Supreme Court cases directly considering the Mental Capacity Act in the past 12 months, there have been two important Court of Appeal cases. These are expertly summarised by MCA expert Alex Ruck Keene
- Hemachandran & Anor v Thirumalesh & Anor [2024] EWCA Civ 896
- Re A (Covert Medication: Residence) [2024] EWCA Civ 572
The report then goes on to consider some implications from the lower courts around the way we communicate specific questions around capacity where information may need to be considered in order to make a specific decision. In the example given, there is often a particular problem in the context of residence and care, where information about care needs should also be considered as part of the relevant information required in order to make a decision about residence (p. 31).
Developing a Consensus Statement about DNACPR
In this section, Margaret Flynn brings together various perspectives in order to try and form a consensus statement around ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR). This statement comprises 12 points that outline the nature of CPR, and its potential impacts on a patient, and its likelihood of success (or otherwise). As the final point reminds us: ‘A compassionate and respectful consultation about end of life care is essential.’
The author then offers a reflection on the consensus statement, which provides useful context, and explains the thinking behind the wording of the 12 points.
Partnerships, networks and further learning
In the final sections of the report In this section Margaret Flynn outlines some of the learning opportunities made available to its members. There is also then a list of webinars that members attended in 2024, demonstrating strong attendance, with four of the five webinars achieving more than 1,000 attendees.
Read the full report
The National Mental Capacity Forum Annual Report can be downloaded via the Government website.
If you would like support with any element of the Mental Capacity Act (2005), please do get in touch. We provide assessments and training, and can also provide bespoke consultancy services as required. Please do visit our services pages or get in touch to find out more.