Decision making and mental capacity guidelines for consultation

The National Institute for Health and Care Excellence (NICE) has written draft guidelines to help people to support adults, aged 16 years and older, with decision-making activities.

It helps to ensure that people are supported to make decisions for themselves when they have the mental capacity to do so, and where they lack mental capacity to make specific decisions they remain at the centre of the decision-making process. 

This NICE guideline has been commissioned by the Department of Health as a result of historic concerns raised by the Care Quality Commission in England. The Care Quality Commission identified serious issues with the practical implementation of the Mental Capacity Act.

The recommendations are relevant when supporting adults who may in the future lose, or have already lost, mental capacity to make specific decisions about health care, including consenting to medical treatment; social care; or financial matters.

The guideline focuses on the key areas of:

- Advance care planning - supporting people to make arrangements for a time when they may lack mental capacity to make decisions for themselves, so that their wishes, values and beliefs can guide and inform those decisions

- Supported decision-making - ensuring that people who have the mental capacity  to make specific decisions for themselves are given the help and support they need to do so

- Assessment of mental capacity to make specific decisions at a particular time

- Best interests decision-making - using the provisions of the Mental Capacity Act to make decisions for a person who has been assessed as lacking mental capacity to make that specific decision for themselves; maximising the participation of that person in the decision-making; considering their wishes, values and beliefs; and ensuring appropriate access to independent advocacy services.

Available from:

Deadline for comments: 5 February 2018