What was the person's situation before working with Advocacy Focus?

Peter was on a mental health ward with a diagnosis of schizophrenia and had a learning disability. 

Following an infection, he was given a course of antibiotics, but his symptoms remained, so staff wanted him to have a blood test to see if he had cancer. 

Peter did not think this was necessary as he had undergone a course of antibiotics and refused to have a blood test. 

One of our Independent Advocates, working under the Mental Capacity Act, was asked to help him to put forward his views and confirmed that Peter did not want to have the blood test. Many staff members who had cared for Peter in hospital had also confirmed that Peter had stressed that he did not want blood tests, other investigations, or treatment. 

Under the COVID-19 restrictions, a Best Interests meeting was held online to decide whether the examination should take place without Peter's consent. They weighed the benefit of having the examination against the detriment of not doing so. All the professionals agreed that it was in Peter's best interests that the examination and blood test should take place, and that he would have to be briefly restrained by 5 staff members to do so, as it was against his wishes.

Our Independent Advocate argued that this was a decision for the Court of Protection because Peter had explicitly said that he did not want treatment and the proposed level of restraint could amount to a deprivation of Peter's liberty. 

However, the hospital's legal team advised that the case did not need to go to court, stating that the restraint would be for a brief period. Our Independent Advocate challenged this and referred to the practice guidance by Mr Justice Hayden’s* guidance on procedures where a decision arises relating to medical treatment and when to bring an application before the Court of Protection. 

The decision-maker therefore agreed to give Peter the opportunity to comply with the treatment before deciding whether or not to use physical restraint. 

What did Advocacy Focus do to help?

Our Advocate ensured that Peter's wish not to have a blood test and examination was taken into consideration at the Best Interest's meeting. They had considered the potential threat to Peter's liberty, effect on his emotional wellbeing and the impact of him being restrained. The Independent Advocate also argued that the Court of Protection was the best way to ensure that Peter's rights under the Mental Capacity Act were met.

 

What was the outcome?

Peter's treatment plan was reviewed and it was concluded that restraint would not be used so readily, and less restrictive options would be tried first. This adheres to the 5th principle of the Mental Capacity Act, which states: 

"Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person's rights and freedom of action" (Mental Capacity Act Code of Practice).

 

How do you think this impacted on Peter’s care and treatment?

Without our Advocate's intervention, Peter would have been physically restrained to complete the examination and blood test, which was expressly against his wishes. Our Advocate provided an essential safeguarding role for Peter.  

 

Why do you think advocacy support was so effective?

Our Independent Advocate highlighted to the professionals involved, the legal requirements under the Mental Capacity Act. This essential safeguarding approach will hopefully be considered in any future treatment that Peter receives.

*Vice President of the Court of Protection