Freedom of Information Request – Ref: FOI 194-2025
Thank you for your recent Freedom of Information request. Please find our response below.
You asked:
1. Do you have a policy (or policies) which outlines the responsibilities of health and care professionals and the Trust towards a patient who has an Advance Decision to Refuse Treatment (ADRT) or Lasting Power of Attorney (LPA) for Health and Welfare?
This document might include:
– how an ADRT/LPA should be used in decisions about a person’s treatment,
– what to do if there are doubts about the validity and/or applicability of the document,
– how to involve Health and Welfare Attorneys when making treatment decisions
– how or when decisions will be referred to the Court of Protection
If yes, please share a copy with us in any available format.
Our Response:
Yes, we have a guidance document: CLG 170 Advance Care Planning V10, this document includes information relating to advanced decisions to refuse treatment and LPAs for Health and Welfare. In addition to this the MCA leads are currently in the process of drafting a Trust wide Mental Capacity Act(MCA)and Deprivation of Liberty Safeguards(DoLS) Policy, which also includes information relating to LPAs and advanced decisions to refuse treatment. It is hoped that the draft policy will be shared for consultation across the Trust at the end of September 2025 prior to it going to the Clinical Policy Group for ratification. In the meantime, Trust Services have access to the Gloucestershire Multi Agency MCA/DoLS policy. The Trust also has since last year been using new MCA forms and the Best Interest form includes sections directing staff to identify when there is an Attorney or Deputy in place and gives them guidance on who needs to be consulted in relation to best interest decision making.
Link to all documents below:
Best Interest Form FINAL May 24
CLG170 Advance Care Planning V10 issued 29.9.23 (6)_Redacted
CLP143 MCA and Best Interests Disputes V1 issued 9.1.24 (3)_Redacted
DEPRIVATION OF LIBERTY SAFEGUARDS
GLOUCESTERSHIRE MULTI AGENCY MENTAL CAPACITY ACT POLICY_Redacted
New GHC MCA policy draft_Redacted
THE MENTAL CAPACITY ACT AND LASTING POWER OF ATTORNEY
WHAT IS THE MENTAL CAPACITY ACT 2005
You asked:
2. In the event that a patient or family member, or someone using the Trust’s services has a concern about the implementation of an Advance Decision to Refuse Treatment (ADRT) or a Lasting Power of Attorney (LPA) for Health and Welfare, does the Trust/Health Board have a documented process or course of action that would be provided to the person to allow them to resolve their concerns?
If yes, please share a copy with us.
If this information is covered within a policy you have included in the response above, please leave blank.
Our Response:
The Trust has an MCA disputes policy outlining how disputes in relation to decisions about mental capacity or best interest decisions between professionals, other organisations or other interested parties such as patients or family members should be resolved. In addition to this the Trust has recently ratified a number of public facing leaflets in relation to the MCA, LPAs and Deputyship and DoLS, these leaflets are currently with the Communications team for corporate badging and printing.
You asked:
3. Do you have a named individual who is responsible for overseeing the Trust’s compliance with the Mental Capacity Act 2005?
If yes, please share their contact details.
Our response:
Responsibility for overseeing the Trust’s compliance with the MCA 2005 lies with the Director of Nursing & Quality, and this is discharged through the Safeguarding team within which the MCA leads for the Trust sit. There are two part time MCA leads within the Trust, who cover one full time post..
Next steps:
Should you have any queries in relation to our response, please do not hesitate to contact us. If you are unhappy with the response you have received in relation to your request and wish to ask us to review our response, you should write to:
Louise Moss
Head of Legal Services / Associate Director of Corporate Governance
c/o Gloucestershire Health and Care NHS Foundation Trust
Edward Jenner Court
1010 Pioneer Avenue
Gloucester Business Park
Brockworth, GL3 4AW
E-mail: louise.moss@ghc.nhs.uk
If you are not content with the outcome of any review, you may apply directly to the Information Commissioner’s Office (ICO) for further advice/guidance. Generally, the ICO will not consider your case unless you have exhausted your enquiries with the Trust which should include considering the use of the Trust’s formal complaints procedure. The ICO can be contacted at: The Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.