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Mental Capacity Assessments

 

Introduction

GPs are often asked to make Mental Capacity Assessments for patients. These assessments can be requested for a variety of different reasons. As GPs it is an essential part of our role that we are able to perform capacity assessments which relate to decisions regarding medical investigations, treatment and care. However capacity assessments relating to overall welfare, finances and property are often more complex and sit outside our expertise.

The level of risk and responsibility linked to capacity assessments can be extremely high. Decisions such as whether someone’s house is sold or how their life savings are spent can depend on capacity assessments. It is therefore essential that adequate time and attention is dedicated to these assessments.

Assessing Capacity

Medical professionals are best placed to assess capacity for healthcare decisions: If the issue is a medical decision then the capacity assessment can be done by the medical professional who is recommending the treatment or investigation, involved in carrying it out. All adults are presumed to have sufficient capacity to decide on their own medical treatment, unless there’s significant evidence to suggest otherwise.

LPoA is a legal procedure and the best person to assess patient’s capacity to engage with that process is someone with adequate knowledge and training of the law i.e. a solicitor along with a private psychiatrist or a private GP. For social care, the social services/social worker need to assess capacity.

GPs are commissioned to provide NHS services under the General Medical Services (GMS) contract. Assessing capacity for social care, managing finances, overall welfare are not the responsibility of the general practitioner as per the contract, hence GPs are not contractually obliged to conduct such assessments.

We realise that this practice policy may cause some inconvenience to our patients but hope you can understand that our priority must be to our core NHS duties as a health care provider.

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