Consent to examination and treatment - Barts Health NHS Trust

COR/POL/046/2012-001
capacity at some point in the future. Before a LPA can be used it must be
registered with the new Office of Public Guardian. If treatment is to be given to
an incapable person who has previously established a LPA, the consent of their
Attorney must be obtained for the patient, and the same considerations apply in
relation to the Attorney as would apply to a competent adult making decisions on
their own behalf. www.publicguardian.gov.uk
Independent Mental Capacity Advocate (IMCA)
3.15 Where the patient has no friends or family to consult, decision makers in Local
Authorities and NHS Trusts (for example social workers and doctors) must
instruct an Independent Mental Capacity Advocate (IMCA) in situations where:
The decision is about providing, withholding or stopping ‘serious
medical’ treatment provided by the NHS.
It is proposed by the NHS body or a Local Authority that the person be
moved into long-term care of more than 28 days in a hospital or 8 weeks
in a care home
A long-term move (8 weeks or more) to different accommodation is being
proposed by an NHS body or Local Authority.
3.16 The only exception to the requirement to consult an IMCA before taking such a
decision can be in situations where an urgent decision is needed.
3.17 Serious medical treatment is defined as treatment that involves giving new
treatment, stopping treatment that has already started, or withholding treatment
that could be offered in circumstances where:
a single treatment is proposed and there is a fine balance between the
likely benefits and the burden to the patient, and the risks involved or
a decision between a choice of treatments/clinical care is finely balanced
or
what is proposed is likely to have serious consequences for the patient
(Refer to the Code of Practice for some examples of serious medical treatment)
3.18 An IMCA may be instructed in the following circumstances:
care reviews or
an adult protection case.
3.19 Occasionally, there will not be a consensus on whether a particular treatment is
in an incapacitated adult’s best interests. Where the consequences of having, or
not having, the treatment are potentially serious, a court declaration may be
sought. (See Appendix B for details of how to do this.)
3.20 For further information relating to the Mental Capacity Act 2005 please refer to
the Mental Capacity Act 2005 Code of Practice.
4 TISSUE
4.1 The text in this section replaces the material previously included in the 2001 NHS
Model Consent Policy, to reflect the requirements of the Human Tissue Act 2004
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