The use of the Mental Capacity Act among hospital patients: findings from a case study of one Acute Hospital Trust in England
| Published date | 30 November 2012 |
| DOI | https://doi.org/10.1108/14668201211286020 |
| Pages | 259-270 |
| Date | 30 November 2012 |
| Author | Lynne Phair,Jill Manthorpe |
| Subject Matter | Health & social care,Sociology |
The use of the Mental Capacity Act among
hospital patients: findings from a case
study of one Acute Hospital Trust
in England
Lynne Phair and Jill Manthorpe
Abstract
Purpose – This paper seeks to present findings from a review of hospital policies and practices in one
NHS Trust in England.
Design/methodology/approach – The focus of the review was hospital staff policy and practice in
safeguarding the rights of vulnerable patients. A sample of staff was surveyed to investigate their
knowledge of the Mental Capacity Act 2005 in 2010. Interviews, incorporating discussion of a vignette,
were undertaken with a range of staff and findings were analysed thematically. These findings are
contextualised by an analysis of Trustpolicies and the wider literature. The findings of this case study are
used to develop recommendations for the hospital and healthcare sectors.
Findings – Analysis of survey data and interviews revealed limited confidence and knowledge about
the Mental Capacity Act 2005 and uncertainties about its relevance to clinical practice. In relation to
safeguarding, there was limited realisation of the potential of the Act to uphold the rights of patients
lacking capacity and staff responsibilities. MCA training had not made a great impression; hospital
policies were inconsistent and lacked coherence.
Research limitations/implications – This case study was conducted in one Trust and may not be
generalisable. Other hospitals may have different training, policy and procedure systems.
Practical implications – The findings of this case study may be applicable to other hospitals and to
other providers of health and social care services. The relevance of the MCA could be highlighted and
used on several induction and training programmes. The study identifies features of policy and practice
that could be investigated in other organisations.
Originality/value – Few studies have investigated the operationalisation of the MCA in hospital settings.
This study reveals that there are opportunities to refresh MCA and safeguarding training strategies for
hospital staff but these should be accompanied by changes to culture and attention to the coherence
of different procedures. Audits of MCA and safeguarding compliance can be undertaken within
hospitals and a systems approach could be adopted to address any issues identified and to sustain
good practice.
Keywords Mental capacity, Adult safeguarding, Hospitals, Older people, Disabilities, Elderly people,
Disadvantaged groups, Decision making
Paper type Research paper
Introduction
The aim of this paper is to report and discuss the findings from a case study of one
English NHS Acute Hospital Trust’spractice and policy regarding decision making for people
lacking mental capacity in the context of national imperatives to improve adult safeguarding
in healthcare settings. Following a synthesis of the findings of the review and discussion
of their implications, the paper concludes with summary of the lessons learned and
recommendations for other health care providers and safeguarding stakeholders.
DOI 10.1108/14668201211286020 VOL. 14 NO. 6 2012, pp. 259-270, QEmerald Group Publishing Limited, ISSN 1466-8203
j
THE JOURNAL OF ADULT PROTECTION
j
PAGE 259
Lynne Phair and
Jill Manthorpe are based at
the Social Care Workforce
Research Unit, King’s
College London,
London, UK.
Great thanks are due to the
members of staff of the
participating Trust. The views
expressed in this paper are
those of the authors alone and
should not necessarily be seen
as reflecting the views of the
Trust.
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