The use of the Mental Capacity Act among hospital patients: findings from a case study of one Acute Hospital Trust in England

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 Trust policies 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.

Citation

Phair, L. and Manthorpe, J. (2012), "The use of the Mental Capacity Act among hospital patients: findings from a case study of one Acute Hospital Trust in England", The Journal of Adult Protection, Vol. 14 No. 6, pp. 259-270. https://doi.org/10.1108/14668201211286020