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Medical treatment cases (87) · Other capacity cases (56) · Miscellaneous cases (56) · Deprivation of liberty (49) · Upper Tribunal decisions (48) · Deprivation of liberty - children (35) · Inherent jurisdiction cases (32) · Sex and marriage cases (29) · Best interests (28) · Powers (20) · Repatriation cases (17) · After-care (16) · Inquest cases (16) · Litigation capacity cases (14) · Deputyship cases (14) · Testamentary capacity cases (14) · Reporting restriction order cases (13) · Litigation friend cases (12) · Community care (12) · Prison law cases (12)

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A Borough Council v E [2021] EWHC 183 (Fam)

Deprivation of liberty - children

DOL of child at unregulated placement

The court, with reservations, authorised the deprivation of a child's liberty in a placement unregulated by Ofsted: she was being deprived of her liberty in an inappropriate hospital setting and there were no regulated placements available or willing to meet her identified welfare needs.

A CCG v AD [2021] EWCOP 47

Coronavirus vaccination cases

Coronavirus vaccination

The court decided that it was it was in AD's best interests to be administered two doses of the Oxford coronavirus vaccine: the plan was for a sedative to be given, not only to sedate but also to prevent memory formation, and for a nurse swiftly to enter the room, inject him, then leave, while AD was distracted by his care team. Any booster vaccination, or any care plan involving force, would have to be considered at a future court hearing.

A CCG v DC [2022] EWCOP 2

Coronavirus vaccination cases

Coronavirus vaccination

(1) The judge followed the "official line" and on a fine balance authorised administration of the coronavirus vaccination and boosters to a young man against his parents' wishes - the main reason being "a positive effect on DC's enjoyment of life by allowing him to be more involved in the life of his care home and with his parents" - noting that he could see no reason for the court not to apply to adults under the MCA the same approach taken by the courts to children. (2) Other options were refused: consideration of treatment with ivermectin (as it was not an available option); further evidence to fine-tune the CCG's risk/benefit analysis (owing to the lateness of the application, urgency, and uncertainty about the proposal), and consideration of further evidence on vaccine risk (owing to the lateness of the application and to avoid an adjournment).

A CCG v DC [2022] EWCOP 20

Coronavirus vaccination cases

Coronavirus vaccination

DC had not been vaccinated despite the original court decision that, given the high risk of serious consequences, it would be in his best interests; he had, however, contracted coronavirus (experiencing high temperature, pain, and some respiratory distress) and made a full recovery. On appeal, the judge noted that the parents' anxious reaction to the vaccination process was indirectly one of the factors illuminating DC's best interests, and ordered further evidence before reaching a final conclusion: "(i) How many injections is DC likely to require? (ii) Given that DC was most likely infected by the Omicron variant, is it necessary for him to have both an injection and a booster? (iii) Given his 'clinical vulnerability', is it likely that DC will require any medication or vaccination presently targeted to this particular group? (iv) Is it the case that vaccination, post natural infection by the Omicron variant, is likely to boost immunity?"

A City Council v LS [2019] EWHC 1384 (Fam)

Inherent jurisdiction cases

Secure accommodation and inherent jurisdiction

"Does the High Court have power under its inherent jurisdiction, upon the application of a local authority, to authorise the placement in secure accommodation of a 17 year old child who is not looked after by that local authority within the meaning of s 22(1) of the Children Act 1989, whose parent objects to that course of action, but who is demonstrably at grave risk of serious, and possibly fatal harm. I am satisfied that the answer is 'no'."

A Clinical Commissioning Group v FZ [2022] EWCOP 21

Coronavirus vaccination cases

Coronavirus vaccination

(1) The CCG's plan was for someone to befriend FZ over a number of visits, then for a vaccinator to attend and inject her swiftly before she was able to understand what was happening. No physical intervention and restraint was proposed and the court "would not entertain such an application were it to be made." (2) The court took the usual orthodox view as its starting point, by analogy with the High Court's approach to children: it is "very difficult to foresee a case in which a vaccination approved for use in children, including vaccinations against the coronavirus that causes COVID-19, would not be endorsed by the Court as being in the child's best interests absent a credible development in medical science or peer reviewed research evidence indicating significant concern for the efficacy and/or safety of the vaccine or a well evidenced medical contraindication specific to the subject child". (3) However, wider best interests considerations include how the vaccination would be administered. In this case, FZ would resist, and the plan would likely fail, at least on the first attempt, and result in trauma for her and her family: overall, it was not in her best interests.

A Clinical Commissioning Group v P [2019] EWCOP 18

Medical treatment cases

Withdrawal of CANH

"Having given anxious consideration to this very sad case, and with profound regret, for the reasons set out above I am satisfied this court should declare that P lacks capacity to make decisions regarding CANH. Further, in circumstances where I have concluded that P lacks capacity to decide for herself whether or not to continue to receive CANH, I am satisfied that it is in P's best interests to consent on her behalf to the withdrawal of that treatment, a step that I acknowledge will result in her death. ... In all the circumstances, I am satisfied that the sanctity of P's life should now give way to what I am satisfied was her settled view on the decision before the court prior to the fateful day of her overdose in April 2014."

A County Council v A [2022] EWHC 3572 (Fam)

Deprivation of liberty - children

DOL of child

Owing to the national shortage of secure accommodation placements, the hospital board reluctantly agreed to continue to keep a 16-year-old girl on a mental health ward for a further week pending a further court hearing and further searches for accommodation. Although the ward was "thoroughly inappropriate", as most of the patients were adults, some with behaviours risky to the girl, it was safer than being put out into the community. It was unlikely that the court could have compelled the hospital board, given that the girl was not detainable under s3, it was "not in her best interests to be there", and that other people needed the hospital bed.

A Healthcare and B NHS Trust v CC [2020] EWHC 574 (Fam)

Medical treatment cases

Haemodialysis under s63 MHA 1983

"By reason of the above, the Court finds that: (i) The physical condition CC is now in, by which dialysis is critical to keep him alive, is properly described as a manifestation of his mental disorder. There is a very real prospect that if he [were] not mentally ill he would self-care in a way that would have not led to the need for dialysis. Further, CC's refusal of dialysis is very obviously a manifestation of his mental disorder and dialysis treatment is therefore treatment within the scope of section 63 MHA 1983. (ii) CC's capacity to consent to dialysis treatment fluctuates, however his consent is not required in order to be treated, by way of dialysis treatment, under section 63 MHA 1983. (iii) The decision whether it is in CC's best interests to receive dialysis treatment is a matter for CC's responsible clinician (having consulted clinicians attending to his physical health, including the consultant nephrologist), subject to the supervisory jurisdiction of the Court. (iv) Section 58 has no applicability. Section 62 disapplies section 58 in urgent treatment cases such as this where treatment is immediately necessary to save CC's life, to prevent a serious deterioration of his condition, and to alleviate serious suffering. Section 63 is the appropriate course. (v) As section 63 MHA 1983 can be used as authority to provide medical treatment to CC, including by dialysis treatment and by the use of light physical restraint and chemical restraint (if required), it is unnecessary for the court to exercise its discretion and make a contingent declaration pursuant to section 15(1)(c) MCA 2005 that it is lawful to treat CC in accordance with the proposed dialysis treatment plan in the event that he lacks capacity to make a decision regarding dialysis treatment at the relevant time."

A Local Authority v A [2020] EWCOP 76

Medical treatment cases

Covert medication - closed proceedings

This application was to consider the administration to A of covert medication in relation to primary ovarian failure. (1) It was permissible and proportionate for A's mother not to be informed of the proceedings because she would seek to subvert the medical treatment. (2) The advantages (to achieve adulthood via puberty, the possibility of developing her own family, cognitive development and maturity, proportionate independence and personal autonomy, a hundred percent effectiveness, no associated risk, a normal life expectancy, no death by a serious fracture or cardiovascular disease by 30 to 40 years of age, and the fact that covert administration is the least restrictive approach pursuant to the MCA 2005) outweighed the disadvantages (it was against A's current wishes, if A discovered that she had been covertly medicated she might lose trust or confidence with the placement) and it was in A's best interests to receive the treatment.

A Local Authority v AT and FE [2017] EWHC 2458 (Fam)

Deprivation of liberty - children

Child, no approved secure accommodation available, deprivation of liberty

"Section 25 of the Children Act 1989 makes express and detailed provision for the making of what are known as secure accommodation orders. Such orders may be made and, indeed, frequently are made by courts, including courts composed of lay magistrates. It is not necessary to apply to the High Court for a secure accommodation order. However, as no approved secure accommodation was available, the local authority required the authorisation of a court for the inevitable deprivation of liberty of the child which would be involved. It appears that currently such authorisation can only be given by the High Court in exercise of its inherent jurisdiction. ... I am increasingly concerned that the device of resort to the inherent jurisdiction of the High Court is operating to by-pass the important safeguard under the regulations of approval by the Secretary of State of establishments used as secure accommodation. ... In my own experience it is most unusual that a secure accommodation order could be made without the attendance of the child if of sufficient age and if he wished to attend, and without the child being properly legally represented. It is true, as Mr Flood says, that this is not an application for a secure accommodation order, but the analogy is a very close one. Indeed, the only reason why a secure accommodation order is not being applied for is because an approved secure accommodation unit is not available. It seems to me, therefore, that the statutory safeguards within section 25 should not be outflanked or sidestepped simply because a local authority have been forced, due to lack of available resources, to apply for the exercise of the inherent jurisdiction of this court rather than the statutory order. ... I propose to order that the child now be joined as a party to these proceedings and Cafcass must forthwith allocate a guardian to act on his behalf. ... In my view it is very important that ordinarily in these situations, which in plain language involve a child being 'locked up', the child concerned should, if he wishes, have an opportunity to attend a court hearing. The exception to that is clearly if the child is so troubled that it would be damaging to his health, wellbeing or emotional stability to do so."

A Local Authority v B [2020] EWHC 2741 (Fam)

Inherent jurisdiction cases

Inherent jurisdiction - dispensing with service

It was proper to dispense with service of proceedings on B's father in relation to inherent jurisdiction proceedings seeking a declaration authorising the deprivation of B's liberty at a community therapeutic placement following discharge from section 2 detention in hospital.

A Local Authority v BF [2018] EWCA Civ 2962

Inherent jurisdiction cases

Inherent jurisdiction to authorise DOL of vulnerable adult

An interim order made on 10/12/18 required BF to reside at a care home, over Christmas, and not at his own or his son's home, despite BF's having capacity to make decisions about his residence and wanting to return home. The order was expressed to last until a further hearing to take place no later than 31/1/19 (later fixed for 16/1/19) when the judge could hear full argument on what relief could be granted pursuant to the inherent jurisdiction. The local authority appealed on the basis that the order infringed Article 5. Permission to appeal was refused: (1) BF is a vulnerable adult (old, blind, infirm, in a squalid and dangerous home, with undue influence present in relationship with son) who needs protection despite not lacking capacity. (2) The test of "unsound mind" is different from the test of capacity, and there is prima facie evidence that he may be of unsound mind. (3) In an emergency situation, someone may be deprived of their liberty in the absence of evidence of mental disorder without infringing Article 5 (Winterwerp); even if BF is found not to be of unsound mind, his vulnerability is such that he could not be returned home without careful planning, which is a crucial component of the protection afforded by the inherent jurisdiction.

A Local Authority v C [2021] EWCOP 25

Sex and marriage cases

Prostitution

C had capacity to engage in sexual relations and to decide whether to have contact with a prostitute, but lacked capacity in relation to conducting proceedings, residence, care and treatment, internet and social media, and financial affairs. The Court of Protection decided that a care plan to facilitate C's contact with a prostitute could be implemented without committing an offence under s39 Sexual Offences Act 2003 (Care workers: causing or inciting sexual activity).

A Local Authority v C [2021] EWCOP 26

Sex and marriage cases

Prostitution

The Court of Protection, having noted that there was room for argument that there were now two contradictory COP judgments on s39 Sexual Offences Act 2003 (Care workers: causing or inciting sexual activity), granted permission to appeal under Civil Procedure Rules, rule 52.6(1)(b) (some other compelling reason for the appeal to be heard) because of the the tension between general policy considerations in relation to prostitution and the court's interpretation of s39.

A Local Authority v H [2023] EWCOP 4

Sex and marriage casesOther capacity casesReporting restriction order cases

Paedophilia

"H prefers to be referred to by female pronouns. ... H has expressed a sexual interest in pre-pubescent children. ... In the opinion of a highly experienced psychiatrist, instructed in these proceedings, H presents a real risk of sexual harm to children, both in contact with them and online. ... The Court has been asked to consider H's capacity to take decisions in the following areas: (i) Residence; (ii) Care/support; (iii) Contact with others (both adults and children); (iv) Use of the internet and social media."

A Local Authority v JB [2019] EWCOP 39

Sex and marriage cases

Capacity and sexual relations

"Distilled to its essence, the question which it is said remains unanswered is this: does the "information relevant to the decision" within section 3(1) of the Mental Capacity Act 2005 include the fact that the other person engaged in sexual activity must be able to, and does in fact, from their words and conduct, consent to such activity?"

A Local Authority v JB [2020] EWCA Civ 735

Sex and marriage cases

Capacity and sexual relations

"The issue arising on this appeal is whether a person, in order to have capacity to decide to have sexual relations with another person, needs to understand that the other person must at all times be consenting to sexual relations."

A Local Authority v JB [2021] UKSC 52

Sex and marriage cases

Capacity and sexual relations

The joint expert described JB's number one priority as "to get" a woman as a sexual partner, with the sole goal being physical and sexual contact with a woman and any woman, and that JB lacked understanding of concepts of consent by the other person and so posed a risk of sexual offending to women. The Supreme Court (dismissing the Official Solicitor's appeal) decided that in assessing JB's capacity "the matter" was his "engaging in" (rather than consenting to) sexual relations, and that information relevant to that decision includes the fact that the other person must have the ability to consent to the sexual activity and must in fact consent before and throughout the sexual activity. The Supreme Court reiterated that capacity assessments should first ask whether the person is "unable to make a decision for himself in relation to the matter" (which involves formulating "the matter" and consequently identifying "the information relevant to the decision" which includes information about the reasonably foreseeable consequences to the patient and others) and secondly ask whether that inability is "because of" an impairment of, or a disturbance in the functioning of, the mind or brain. In relation to sexual relations "the matter" will ordinarily be formulated in a non-specific way: in this case JB's wishes were non-specific, but in another case "the matter" might be person-specific (e.g. sex between a long-standing couple where one person had a relevant impairment, or between two mutually-attracted people both with relevant impairments). The question of JB's capacity was remitted to the original judge for reconsideration.

A local Authority v P and CCG [2021] EWCOP 48

Sex and marriage casesOther capacity cases

Sex and contact

P had capacity in relation to sex, but lacked capacity in relation to litigation, residence, care and contact. The judge's letter to P included the following explanation: "Sex is a part of contact with other people but in law considered separately. Everyone was prepared to agree you could understand what decisions you and the person you have sex with have to take. However the decision about who is a person who you can trust enough to have sex with is a decision about contact and the evidence shows me that this is something you do not have understanding about."

A Local Authority v ST [2022] EWCOP 11

COP costs cases

Departure from general costs rule

The judge summarised the law on costs in COP welfare cases (the non-exhaustive list of factors in COPR 19.5(2) must be considered when deciding whether to depart from the general rule that there be no order) and ordered that the local authority pay 85% of the costs incurred by the OS relating to an attended hearing that could have been avoided (not including the judicial visit).

A Local Authority v TA [2021] EWCOP 22

Deprivation of libertyOther capacity cases

Removal of family member from home

GA was an 87-year-old woman who lacked capacity to make decisions about her residence, health, or care needs owing to severe and deteriorating dementia. Living with her was her son TA (a controlling presence), daughter XA (visiting to assist TA), and son HA (believed to have schizophrenia). The court ordered TA and XA to leave the home, so that GA could receive social and medical care at home and have contact with other members of the family, and authorised GA's deprivation of liberty there. The court also prevented TA from returning within 100 yds, ordered him not to use GA's Motability car and not to publish information on the internet, limited his correspondence with the local authority and Official Solicitor, and made a civil restraint order for a period of two years. Committal proceedings brought by the local authority were to be considered at a future hearing.

A Local Health Board v Y (A Child) [2016] EWHC 206 (Fam)

Medical treatment cases

Death

"In all the circumstances, therefore, I conclude that the course proposed by the clinicians is in Y's best interests. In accordance with the parties' ultimate agreement, I therefore conclude that (1) It is lawful and will be in Y's best interests for him to be extubated at the point where the clinicians, following discussion with Y's family, consider that his condition is optimal for extubation, and that "optimal" for these purposes is likely to mean when (a) he remains on minimal ventilation: (b) he has a body temperature of less than 37.5 and (c) that he has not required CPR for the previous 12 hours; (2) Upon extubation, it is lawful and in his best interests not to re-intubate him if he is unable to support his own respiration. (3) Upon extubation, it is lawful and in his best interests not to receive CPR (save for stimulation, which may be provided) or ventilation or inotropes."

A Mental Health NHS Trust v BG [2022] EWCOP 26

Medical treatment cases

Non-treatment of eating disorder

(1) The judge decided it was not in BG's best interests to receive further treatment for eating disorder, and she subsequently died. (2) It would not be proper for a decision for this gravity to be made in secret, so the blanket reporting restrictions order was discontinued and publication of some information was permitted.

A Mental Health Trust v ER [2021] EWCOP 32

Medical treatment cases

Anorexia

(1) The parties agreed that ER lacked capacity to make decisions about her anorexia or the litigation, and the judge, having explored her doubts in detail, ultimately came to the same view. (2) It was not in ER's best interests to be forced to accept treatment or inpatient admission, given her renal failure and extreme dislike of eating disorder units and psychiatric hospitals. (3) More support in the community, in particular moving to a supported living placement where she could have dialysis and more support and company, would be in her best interests, and the local authority and CCG were joined as parties and directed to give evidence of proposals for extra support.

A Midlands NHS Trust v RD [2021] EWCOP 35

Medical treatment cases

Non-treatment of anorexia

The Trust had decided not to treat RD's anorexia compulsorily under the MHA (even though that might, in the short term, prevent her death) and applied to the Court of Protection for legal protection. The court decided she lacked the relevant capacity and that further compulsory treatment was not in her best interests ("I am removing any threat of compulsion or compulsory admission to hospital under the Mental Health Act from RD"). The declarations were made under the inherent jurisdiction (as well as the MCA) since questions involving the MHA involve public law matters, in particular that doctors have to take into account the safety of the public.

A Midlands NHS Trust v RD [2021] EWCOP 36

Reporting restriction order cases

Private hearing

This case (about non-treatment of anorexia) should be held in private, in particular because RD's wish that intensely personal matters be not discussed in public.

A NHS Foundation Trust v An Expectant Mother [2021] EWCOP 33

Medical treatment cases

Agoraphobia and pregnancy

The expectant mother's severe agoraphobia meant she might not be able to travel to hospital even if that became medically necessary. The court decided that: (1) she lacked capacity to make decisions about the location of the delivery of her baby; (2) it was in her best interests to be taken to hospital for a planned delivery, using force and involving deprivation of liberty if necessary; (3) she had capacity to choose between induced labour and Caesarean section, and between local and general anaesthetic.

A NHS Foundation Trust v G [2021] EWCOP 69

Best interests

Residence

G, now 27 years old, had been in a children's hospital since the age of 13. The court decided that it would be in her best interests to be discharged to a care home instead of to her family. The CCG were unprepared to pay the cost of a move home at that point so in reality there were only two options (the care home or the hospital).

A NHS Foundation Trust v G [2022] EWCOP 25

Other capacity cases

Injunctions

G, now 27 years old, had been in a children's hospital since the age of 13. A previous judgment had decided that she should be transferred to a care home prior to any return home, but her father had sabotaged that placement. The Trust sought injunctive relief against G's father, mother and grandmother, in order to put in place clear boundaries to manage their behaviour. The family argued unsuccessfully that the s16(5) MCA 2005 power to make further "necessary or expedient" orders applied only in the context of the appointment of deputies, that s47(1) MCA 2005 (and therefore s37(1) Supreme Court Act 1981) is not apt to cover restricting behaviours in the context of either a hospital or care home, and that little or no weight should be afforded to the hearsay evidence of anonymous nurses about the father's behaviour. The court granted the relief sought.

A NHS Trust v ST [2023] EWCOP 40

Medical treatment cases

Belief and capacity

"The issues for determination at this hearing are ST’s capacity (i) to litigate and (ii) to make her own decisions in relation to future medical treatment. The Trust’s intention is to move to a treatment plan of palliative care. ... In terms of the functional test of capacity, a person’s ability to understand, use and weigh information as part of the process of making a decision depends on him or her believing that the information provided for these purposes is reliable and true. That proposition is grounded in objective logic and supported by case law in the context of both the common law and the interpretation of MCA 2005. ...In this context, and in terms of a patient-centred approach, it is important in my judgment for the court to consider the extent to which the information provided to a person is capable of being established objectively as a “fact” or a “truth”. The less certain the fact or truth, the more careful the court must be when determining whether the presumption of capacity is rebutted."

A NHS Trust v ST [2023] EWCOP 40

Medical treatment cases

Belief and capacity

"The issues for determination at this hearing are ST’s capacity (i) to litigate and (ii) to make her own decisions in relation to future medical treatment. The Trust’s intention is to move to a treatment plan of palliative care. ... In terms of the functional test of capacity, a person’s ability to understand, use and weigh information as part of the process of making a decision depends on him or her believing that the information provided for these purposes is reliable and true. That proposition is grounded in objective logic and supported by case law in the context of both the common law and the interpretation of MCA 2005. ...In this context, and in terms of a patient-centred approach, it is important in my judgment for the court to consider the extent to which the information provided to a person is capable of being established objectively as a “fact” or a “truth”. The less certain the fact or truth, the more careful the court must be when determining whether the presumption of capacity is rebutted."

A PCT v LDV [2013] EWHC 272 (Fam)

Deprivation of liberty

Informal admission

"The two questions considered at the hearing, which form the subject of this judgment, are (1) Do L's current circumstances amount objectively to a deprivation of liberty? (2) When assessing whether L has capacity to consent to her accommodation at WH, in circumstances which amount to a deprivation of liberty, what information is relevant to that decision?"

A v B [2022] EWHC 2962 (Fam)

Other capacity cases

Convention Adoption Order and capacity

This case involved an application for a Convention Adoption Order (under the 1993 Hague Adoption Convention) but mentions capacity in passing when the court dispensed with the consent of the mother. (Section 52(1) Adoption and Children Act 2002 states: "The court cannot dispense with the consent of any parent or guardian of the child to the child being placed for adoption or to the making of an adoption order in respect of the child unless the court is satisfied that (a) The parent or guardian cannot be found or lacks capacity within the meaning of the Mental Capacity Act 2005) to give consent, or (b) The welfare of the child requires the consent to be dispensed with.")

AA v London Borough of Southwark [2021] EWCA Civ 512

Other capacity cases

Discharge of party

Following concerns that if P's mother, AA, were to receive certain information then P would suffer serious harm, the Court of Protection discharged AA as a party without notice, without disclosure of any evidence, without any opportunity to make representations, and without giving any reasons for the decision. The Court of Appeal allowed her appeal, reinstating her as a party, but directed that no further evidence or information be served on her for 28 days to allow the respondents time to decide what course to follow. For part of the hearing AA was represented by a special advocate in a closed session, the first time the Civil Division of the Court of Appeal had adopted that procedure.

AB v CD [2021] EWHC 741 (Fam)

Medical treatment cases

Parental consent for puberty blockers

The two issues in this case (an application by XY's mother that she and the father have the ability in law to consent on behalf of XY to the administration of hormone treatment to suppress puberty) were: (1) Do the parents retain the legal ability to consent to the treatment? (2) Does the administration of puberty blockers fall into a "special category" of medical treatment by which either: (a) an application must be made to the Court before they can be prescribed? (b) as a matter of good practice an application should be made to the Court?

AB v HB [2021] EWCOP 45

Contempt of court cases

Committal for contempt of court

HB had prevented assessments of his father's capacity, contrary to a court order, but having heard from HB (who had a low level of comprehension himself but now understood that he had to comply with court orders) and as an assessment had since taken place it was decided not to punish him for the contempt.

AB v XS [2021] EWCOP 57

Best interestsForeign protective measure cases

Habitual residence and inherent jurisdiction

The judge set out the three issues in the case as: (a) whether XS is habitually resident in England and therefore the Court of Protection retains jurisdiction; (b) whether the High Court can make an order for XS to return to the UK under the inherent jurisdiction; and (c) whether it is in XS's best interests to be brought back to the UK. It was decided that XS was habitually resident in Lebanon, so there was no power under the MCA to make a return order; that to make such order under the inherent jurisdiction would inappropriately cut across the statutory scheme for no principled reason; and that in any event it was in XS's best interests to remain in Lebanon.

Abbasi v Newcastle Upon Tyne Hospitals NHS Foundation Trust [2023] EWCA Civ 331

Reporting restriction order cases

RROs in end-of-life proceedings

"These appeals concern the principles to be applied when a court considers an application to vary or discharge a Reporting Restriction Order ("RRO") made long before in end-of-life proceedings in the High Court. ... The orders made in these cases provide for the indefinite continuation of injunctions against the world prohibiting publication of the names of a small number of clinicians in the Abbasi case and a wide range of health service staff in the Haastrup case. The intense focus on the specific rights being claimed delivers the clear conclusion that the article 10 rights of the parents in wishing to "tell their story" outweigh such article 8 rights of clinicians and staff as may still be in play, long after the RROs were made in the respective end-of-life proceedings. The wider systemic concerns which affect the operation of the NHS laid before the court by representative bodies cannot justify the creation of a practice, not anchored to the specific circumstances of the case, of granting indefinite anonymity to those involved in end-of-life proceedings. Such a step is one that is controversial and intensely political and suitable for Parliament rather than the courts."

ABC v St George's Healthcare NHS Trust [2015] EWHC 1394 (QB)

Medical records cases

Disclosure of patient's medical information

The claimant's father had killed his wife, was detained under s37/41, and refused to allow the Trust to inform his pregnant daughter of his Huntingdon's disease diagnosis. She claimed that the failure to inform her: (a) was negligent and breached Article 8; and (b) had caused psychiatric damage, and (if her daughter also has the disease) additional expense which she would have avoided by an abortion. Her claim was struck out.

ABC v St George's Healthcare NHS Trust [2017] EWCA Civ 336

Medical records cases

Disclosure of patient's medical information

"The Claimant alleges that the particular circumstances of her case mean that the Defendants owed her a duty of care. She says it was critical that she should be informed of her father's diagnosis, firstly presumed and subsequently confirmed, in the light of her pregnancy. This was her first and only child. It was all along known that she would be a single mother with sole responsibility for the upbringing of the child. If informed of her father's diagnosis she would have sought to be tested for Huntington's Disease. If her own diagnosis was confirmed, she would have terminated the pregnancy rather than run the risk that her child might in due course be dependent on a seriously ill single parent or become an orphan, and the risk that in due course her child might inherit the disease. Her diagnosis would have precluded any subsequent pregnancy. The claim therefore includes a 'wrongful birth' claim in respect of the child. The child has an accepted risk of 50 per cent of contracting the disease, but it is not yet possible to reach a diagnosis in her case, one way or another."

ABC v St George's Healthcare NHS Trust [2020] EWHC 455 (QB)

Medical records cases

Disclosure of patient's medical information

"By this claim brought against three NHS trusts, the claimant contends that the defendants breached a duty of care owed to her and/or acted contrary to her rights under Article 8 of the European Convention on Human Rights in failing to alert her to the risk that she had inherited the gene for Huntington's disease in time for her to terminate her pregnancy."

Aberdeenshire Council v SF [2023] EWCOP 28

Foreign protective measure cases

Habitual residence

A Scottish patient was transferred to an English psychiatric hospital in 2015, was fit for discharge in 2017, and was eventually discharged in 2022 to a placement in England because nothing could be found in Scotland. Aberdeenshire Council sought to have a Scottish Guardianship Order recognised and enforced in England. All parties agreed that she was habitually resident in Scotland; this judgment sets out the law and explains why the judge agreed.

Abertawe Bro Morgannwg University LHB v RY [2016] EWCOP 57

Medical treatment cases

Minimally conscious state

"On 12th October this year the applicant Health Board applied to this court for declarations both as to 'capacity' and 'best interests' under the Mental Capacity Act 2005, concerning RY, to permit withdrawal of ventilation, withholding of life-sustaining treatment, and provision of palliative care only. RY's daughter has from the beginning asserted that, when ventilation is removed, life-sustaining treatment should be provided. I am asked to approve an order filed with the consent of all the parties which provides for some life-sustaining treatment, but not CPR or further intensive care. ... However, there have been a number of recent videos taken of RY ... which have led [Dr Badwan] to conclude that RY is not in a vegetative state, but is in a minimally conscious state with some signs of being in upper minimally conscious state. ... This morning the very experienced advocates in this case presented a plan, by agreement, in which it was proposed that RY underwent a tracheostomy under general anaesthetic and, transferred to a suitable unit for further treatment and/or assessment. ... As a Judge sitting in the Court of Protection, I have experience of litigants seeking very extensive assessments and re-assessments, in a way that occurred in the Family Division in Children Act 1989 proceedings, most particularly in public law care proceedings. The reasons for both strike me as similar, namely that the decisions the Court is asked to make are of such great importance and carry such profound consequences that there is, I think, a forensic instinct to leave no stone unturned. I am bound to say however, that I sometimes feel that I am being asked to authorise a petrological survey on the upturned stone. Just as the Family Justice reforms have re-emphasised the real dangers to vulnerable children caused by avoidable delay, so to, it seems to me, practitioners in this field must recognise that delay which is not, on a true analysis, either constructive or purposeful is almost certainly damaging and thus inimical to P's welfare. Though avoidance of delay is not a statutory imperative in the Mental Capacity Act 2005 the principle is now so deeply embedded in the law of England and Wales and across every jurisdiction of law that it should be read into Court of Protection proceedings as a facet of Article 6 and 8 ECHR. It requires to be restated that the Court of Protection Rules provide for the Court to restrict expert evidence and assessment, application must be made by completing form COP9. ... Given the scale of the hypoxic damage, the preponderant evidence suggests that any significant improvement may be rather a forlorn hope. I think RY's family should be under no delusion as to the prospects. That 'flicker of hope', says the Official Solicitor, is one that should be pursued on RY's behalf. Ultimately, I have acceded to that submission but I do so on a very particular basis and that is that the assessment process, which has been outlined in framework this afternoon, is carefully monitored..."

AC v Cornwall Partnership NHS Foundation Trust [2023] MHLO 1 (UT)

PowersUpper Tribunal decisions

Adjournment and recommendations

The tribunal panel refused the s3 patient's adjournment request (which was on the basis of a lack of aftercare planning) though it indicated that it would be revisited if aftercare information proved necessary to decide on discharge. It refused to make a statutory recommendation but made an extra-statutory recommendation about transferring hospital and appropriate accommodation. Permission to appeal having been refused by the FTT and UT, the patient now renewed her application for permission. (1) The patient argued that the adjournment refusal was procedurally unfair, but the UT decided that: (a) in high-level terms, case management rulings should only be interfered with when "plainly wrong"; and (b) specifically, the panel's decision was consistent with caselaw in the mental health jurisdiction. (2) The patient also argued that the type of recommendation made undermined the purpose of the statute, given that a statutory recommendation was possible, but the Upper Tribunal decided that the panel had concisely explained a rational basis for its decision and was entitled to take the view that it should not get involved in the onward supervision of the patient's care. (3) The UT set out the test to be applied for permission to appeal: "I must find that the proposed grounds of appeal are arguable, in the sense that there is a realistic prospect of success in showing that the First-tier Tribunal went wrong in law in some way." [The Court of Appeal has expressed this differently: "The court will only refuse leave if satisfied that the applicant has no realistic prospect of succeeding on the appeal. ... The court can grant the application even if it is not so satisfied. ... For example ... public interest ... or ... the law requires clarifying."] (4) The UT noted the courts' approach to expert tribunals' decisions: (a) it is probable that such a tribunal got the law right, decisions should be respected unless it is quite clear the tribunal misdirected itself on the law, and courts should not rush to find misdirections just because of the tribunal's conclusions on the facts (the UT judge christened this "the Lady Hale principle"); and (b) judicial restraint should be exercised when reasons are being examined, and the court should not assume a misdirection too readily just because not every step in its reasoning is fully set out (christened "the Lord Hope principle").

ACCG v MN [2013] EWHC 3859 (COP)

Best interests

Best interests and available options

The Court of Protection may, exceptionally, in determining whether a local authority has breached convention rights, consider best interests beyond the available options. Extract from judgment: "[86] I find therefore that: (i) As restated by Baroness Hale in Aintree 'the court has no greater powers than the patient would have if he were of full capacity'. (ii) Judicial review remains the proper vehicle through which to challenge unreasonable or irrational decisions made by 'care providers' and other public authorities. (iii) There may be rare cases where it appears to those representing a party that a public authority, in failing to agree to provide funding for or a particular form of care package, is acting in a way which is incompatible with Convention rights. In those circumstances, notwithstanding the fact that such an option is not available and before the court, the court may exceptionally, pursuant to a formal application made under s7(1)(b) HRA, conduct an assessment of the person's best interests beyond the scope of the available options, in order to determine whether the public authority has acted in a way which is disproportionate and incompatible with a convention right. (iv) Protection of the Article 8 rights of the parties are otherwise protected by a consideration of them by the court as part of all the relevant circumstances when carrying out a section 4 MCA 2005 best interests assessment. [87] In all the circumstances I accept the submission of ACCG that, contact at the family home is not an available option now or in the foreseeable future and that the court should not now embark upon a best interests analysis of contact at the parents' house as a hypothetical possibility. Looking at the care plan and taking into account all matters set out in s4 MCA2005 I am satisfied that the contact programme put forward by ACCG and approved by the Official Solicitor is in his best interests"

AD'A v Cornwall Partnership NHS Foundation Trust [2020] UKUT 110 (AAC)

Change of status casesUpper Tribunal decisions

Change in status - s3 to guardianship

When the patient had been transferred from s3 detention to s7 guardianship, the tribunal had been wrong to strike out her case for want of jurisdiction. The tribunal's jurisdiction arose from the s3 application, and none of the subsequent changes (including a new right to apply to tribunal, different tribunal powers, and different parties) affected that jurisdiction.

Aderounmu v Colvin [2021] EWHC 2293 (QB)

Litigation capacity cases

Litigation capacity

The claimant, in a negligence case against his GP, argued that the limitation period had not started to run since he had lacked capacity to conduct the litigation (alternatively that he did not obtain the requisite knowledge more than three years before issuing the claim, or that the limitation period should be disapplied by the court). The court held that the limitation period had expired but allowed the claim to proceed.

AH v West London MH NHS Trust [2010] UKUT 264 (AAC)

MHT public hearing casesUpper Tribunal decisions

Factors relevant to holding public hearing

(1) The normal practice that Tribunal hearings are held in private is justified; and the relevant factors in deciding whether to direct a hearing in public are: (a) is it consistent with the subjective and informed wishes of the applicant (assuming he is competent to make an informed choice)? (b) will it have an adverse effect on his mental health in the short or long term, taking account of the views of those treating him and any other expert views? (c) are there any other special factors for or against a public hearing? (d) can practical arrangements be made for an open hearing without disproportionate burden on the authority? (2) The First-tier Tribunal decision not to grant a public hearing was set aside. (3) The question will be determined by the Upper Tribunal following a further hearing (at which the Department of Health is invited to appear) for the purpose of considering further evidence as to: (a) the practicalities and potential cost of providing a public hearing (including by use of video facilities); (b) how often public hearings have been applied for in the last five years, the number of occasions on which they have been granted and in practice been held, and how they have been managed; (c) (so far as readily available) practices elsewhere in the United Kingdom, in Europe, and in other common law countries.

AH v West London MH NHS Trust [2011] UKUT 74 (AAC)

MHT public hearing casesUpper Tribunal decisions

Public hearing

(1) Once the threshold tests for establishing a right to a public hearing have been satisfied, Article 6 ECHR (reinforced by Article 13 CRPD) requires that a patient should have the same or substantially equivalent right of access to a public hearing as a non-disabled person who has been deprived of his liberty; such a right can only be denied a patient if enabling that right imposes a truly disproportionate burden on the state. (2) The threshold tests are: (a) is it consistent with the subjective and informed wishes of the applicant (assuming he is competent to make an informed choice)? (b) will it have an adverse effect on his mental health in the short or long term, taking account of the views of those treating him and any other expert views? (c) are there any other special factors for or against a public hearing? (d) can practical arrangements be made for an open hearing without disproportionate burden on the authority? (3) How the right to a public hearing can be practically and proportionately be achieved will depend on the facts of each individual case, including the hospital's facilities. (4) The Tribunal directed that AH was to have a public hearing, not within Broadmoor hospital, with the press, public, AH and his representatives enabled to attend in person in the same hearing room. (5) It was likely that in future cases, if detailed evidence of how video-link and public-notification arrangements would work in practice is provided, that a video-link to off-site premises would suffice.

AM (Afghanistan) v SSHD [2017] EWCA Civ 1123

Litigation friend casesRepatriation cases

Immigration tribunal - fair hearing, litigation friends

In this judgment the Court of Appeal gave guidance on the general approach to be adopted in FTT and UT immigration and asylum cases to the fair determination of claims for asylum from children, young people and other incapacitated or vulnerable persons whose ability to effectively participate in proceedings may be limited. In relation to litigation friends, despite there being no provision in the tribunal rules for litigation friends, the court decided that: "[T]here is ample flexibility in the tribunal rules to permit a tribunal to appoint a litigation friend in the rare circumstance that the child or incapacitated adult would not be able to represent him/herself and obtain effective access to justice without such a step being taken. In the alternative, even if the tribunal rules are not broad enough to confer that power, the overriding objective in the context of natural justice requires the same conclusion to be reached."

AMA v Greater Manchester West MH NHSFT [2015] UKUT 36 (AAC)

MHT capacity casesUpper Tribunal decisions

Deputyship and MHT

A personal welfare deputy cannot appoint himself (or anyone else) as a representative unless the order appointing him expressly provides for this. This case related to the withdrawal of a tribunal application, and was followed up by Tribunal Policy: Withdrawals (23/2/15).

AMDC v AG [2020] EWCOP 58

Other capacity cases

Expert evidence guidance

The court was critical of the jointly-instructed psychiatric reports in this case and provided detailed guidance on how experts' reports on capacity can best assist the court.

An ICB v RN and TN [2022] EWCOP 41

Coronavirus vaccination cases

Coronavirus vaccination

RN had already contracted coronavirus and recovered, and his mother objected to administration of a coronavirus vaccination. The court decided that it would be in his best interests, primarily because of government guidance (which the doctors followed) and because the court should take the same approach to adults lacking capacity as to children, and partly because the "altruistic argument" that receiving the vaccine would help others "is a powerful factor that is likely to be a strong argument for the vaccine for people in a risk group such as RN".

An NHS Foundation Trust v AB [2019] EWCOP 26

Medical treatment cases

Abortion

"This is an application by the NHS Trust for an order in respect of a 24 year old woman AB who is 22 weeks pregnant and, who the Trust say lacks capacity and in whose best interests it is said to have a termination of pregnancy. ... I would like to record my unhappiness about the lateness of this application. AB is now estimated to be 22 weeks pregnant and therefore the cut-off date under the Abortion Act 1967 of 24 weeks is imminent. ... I am acutely conscious of the fact that for the state to order someone to have a termination, where it appears that they do not want it, is immensely intrusive and certainly interferes with her Article 8 rights. ... In my view the balance in terms of AB's best interests lies in her having the termination."

An NHS Foundation Trust v Kwame [2023] EWHC 134 (Fam)

Medical treatment cases

Death

Kwame was found unresponsive at his home after what it seemed was an attempt to take his own life, and for the following 20 months remained on a ventilator on a Paediatric Intensive Care Unit. The court declared: "(i) It is not in Kwame's best interests to continue to receive mechanical ventilation; (ii) It is in Kwame's best interests that there be defined limits on the treatment provided to him after that withdrawal of mechanical ventilation with the effect that he will be allowed to die and it is not in his interests to receive further life sustaining treatment."

An NHS Trust v P [2021] EWCOP 27

Litigation capacity cases

Subject-matter and litigation capacity

P's psychiatrist initially stated that P lacked subject matter capacity (whether to take HIV medication) yet had litigation capacity. (1) The judge: (a) disagreed with the proposition that if a person lacks capacity to conduct proceedings as a litigant in person she might, nevertheless, have capacity to instruct lawyers to represent her and that the latter capacity might constitute capacity to conduct the litigation in question; (b) thought it virtually impossible to conceive of circumstances where someone lacks capacity to make a decision about medical treatment, but yet has capacity to make decisions about the manifold steps or stances needed to be addressed in litigation about that very same subject matter (it would be as rare as a white leopard). (2) On the facts, P lacked both subject matter capacity and litigation capacity.

An NHS Trust v ST (Refusal of Deprivation of Liberty Order) [2022] EWHC 719 (Fam)

Deprivation of liberty - childrenInherent jurisdiction cases

DOL of child

The High Court was asked under the inherent jurisdiction to authorise the continuing deprivation of a child's liberty on an inappropriate hospital ward, but the judge decided that "to grant the relief sought by the Trust in this case would be to grossly pervert the application of best interests principle."

AO v Home Office [2021] EWHC 1043 (QB)

Repatriation cases

Unlawful immigration detention

Some arguments in this immigration case involved the claimant's mental health.

AP v Tameside MBC [2017] EWHC 65 (QB)

Deprivation of libertyUnlawful detention casesMiscellaneous cases

HRA time limit

"The essence of the claim under Article 5 is that the Claimant was unlawfully deprived of his liberty between the 1st of February 2011 and the 12th of August 2013, a period of some two and a half years. ... In the present case the extension period sought (18 months) represents an extension equal to the whole of the primary limitation period (12 months) and half as much again. ... For all these reasons I decline to grant the Claimant an extension of time under section 7 to bring his human rights claim against the Defendant."

Application by Darlington Borough Council in respect of the Adult: AB [2018] ScotSC 4

Foreign protective measure cases

Scottish capacity case

"The adult, AB, lacks capacity to make decisions as to her care and residence and is subject to Orders made by the Court of Protection in England. During 2017 the Court of Protection decided that it would be in AB’s best interests to move from a care home in Darlington (hereafter referred to as “the English Care Home”) to a care home within the Sheriffdom (hereafter referred to as “the Scottish Care Home”) for a trial period. ... A Summary Application was subsequently submitted to Glasgow Sheriff Court in which the Applicants sought two Orders from the court. Firstly, the Applicants sought an Order under paragraph 7(1) of Schedule 3 to the Adults with Incapacity (Scotland) Act 2000 (hereafter “the 2000 Act”), recognising the Order of the Court of Protection dated 27 April 2017. Secondly, the Applicants sought an Order under paragraph 8(1) of said Schedule 3, directing the Office of the Public Guardian in Scotland to register said Order of the Court of Protection dated 27 April 2017 in the Register of International Measures maintained by the Public Guardian."

AR v West London NHS Trust [2020] UKUT 273 (AAC)

MHT capacity casesMHT public hearing casesUpper Tribunal decisions

Public hearing and capacity

(1) The four factors set out in AH which must be considered in any application for a public hearing under Tribunal rule 38 are merely factors relevant to the ultimate test of whether a public hearing is in the interests of justice. The first factor ("whether it is consistent with the subjective and informed wishes of the patient (assuming that he is competent to make an informed choice") does not mean that a patient must have capacity in order to be allowed a public hearing, although the wisdom of the patient's wishes is relevant to the application of rule 38. (2) The relevant "matter" for the purposes of assessing capacity is not merely the public hearing application but conduct of the proceedings generally, although lack of capacity in relation to the former entails lack of capacity in relation to the latter. (3) The First-tier Tribunal had restricted its capacity assessment to the decision to apply for a public hearing, and had concluded that "[w]ithout being able to make an informed choice [the patient] cannot have a public hearing", so had erred in relation to both points.

Ardron v Sussex Partnership NHS Foundation Trust [2018] EWHC 3157 (QB)

Miscellaneous cases

Employment law

"The Claimant, Dr. Caroline Ardron, is a very experienced consultant psychiatrist employed by the Defendant [Trust]. The Trust considers it appropriate for Dr. Ardron to face disciplinary proceedings for alleged gross misconduct relating to her work at HMP Lewes in late 2015 and early 2016. At that time, Dr. Ardron was the responsible clinician of a young prisoner known as JO, who committed suicide by hanging himself on 12 February 2016. The proposed disciplinary proceedings relate, almost exclusively, to Dr. Ardron's care of JO including her record-keeping in that respect. Dr. Ardron does not suggest that disciplinary proceedings are inappropriate as a matter of principle, or that there is no case of misconduct that could be brought against her. However, she contends that there is no basis for a charge of gross misconduct; a charge which, if established, could potentially lead to the termination of her contract and serious ramifications for her including her prospects of obtaining subsequent employment. On 18 June 2018, an interlocutory injunction was granted by Mr. Pushpinder Saini QC, sitting as a Deputy Judge of the High Court, which restrained the Trust from proceeding until further order with a disciplinary hearing into gross misconduct. The question for resolution now is whether that injunction should be made permanent. That issue depends upon whether Dr. Ardron can prove that the Trust will breach her contract of employment by holding the proposed disciplinary hearing on a charge of gross misconduct. The Trust's intention to proceed to such a hearing was communicated in its letter to Dr. Ardron dated 20 March 2018, and the issue is therefore whether the Trust should be prevented from operating on the basis of that letter. The resolution of that issue depends principally upon the question of whether the facts found in an investigation into Dr. Ardron's conduct could, taken at their highest, amount to gross misconduct."

ARF v SSHD [2017] EWHC 10 (QB)

Repatriation cases

Immigration

Unlawful immigration detention.

Atudorei v Romania 50131/08 [2014] ECHR 947

Deprivation of liberty

DOL damages

Breach of Articles 5 and 8, but not Article 8, relating to hospital admission.

B v A Local Authority [2019] EWCA Civ 913

Sex and marriage cases

Overlap between different decisions, sex

(1) "The important questions on these appeals are as to the factors relevant to making the determinations of capacity which are under challenge and as to the approach to assessment of capacity when the absence of capacity to make a particular decision would conflict with a conclusion that there is capacity to make some other decision." (2) The Court of Appeal also decided on what is necessary to have capacity to consent to sexual relations.

BA v SSHD [2017] UKAITUR IA343212013

Repatriation cases

Article 3 immigration case

"The Appellant is a citizen of Nigeria born on 26th February 1980. His appeal against a refusal to vary leave was allowed by First-tier Tribunal Judge Abebrese on Article 8 grounds on 23 rd May 2016. ... The Appellant sought permission to appeal against the Article 3 findings only ... On the basis of the factual findings, the opinion in the Amnesty International Report and the opinion of Dr Bell, the Appellant is likely to suffer a breakdown at some point on return to Nigeria whether that be at the airport or some time later. He is likely to come to the attention of the police if he has such a breakdown and he would not be able to access the psychiatric hospital in Lagos because he is unable to afford treatment there. Accordingly, it is likely that he would be held in prison where the conditions for this particular Appellant with his particular condition would result in treatment in breach of Article 3. ... The Applicant would not be at risk of Article 3 treatment because of a heightened risk of suicide. He would, however, be at risk of inhuman and degrading treatment in breach of Article 3 because of the conditions of return. ... The medical evidence indicates that the Appellant is vulnerable to relapse even in the UK and without the threat of removal. His removal to Nigeria is likely to trigger a relapse and his behaviour will draw hostile attention. His treatment by the authorities in detaining him under the Lunacy Act 1958 would amount to inhuman and degrading treatment. There is a reasonable degree of likelihood that he would be detained in a prison, there would be no treatment for his mental health, his situation would deteriorate, the length of detention is indeterminate, there is no right of appeal and there is no requirement for him to consent to treatment. Accordingly, I allow the Appellant's appeal on Article 3 grounds."

Baker v H [2009] EWCOP B31

Deputyship cases

Deputy security bonds

(1) The judgment sets out a structured general approach to considering the setting of security and its interplay with the terms of appointment of a deputy; (2) On the facts, the level of security was reduced from £750k to £175k.

Baker v H [2009] EWCOP B31

Deputyship cases

Deputy security bonds

(1) The judgment sets out a structured general approach to considering the setting of security and its interplay with the terms of appointment of a deputy; (2) On the facts, the level of security was reduced from £750k to £175k.

Baker v Hewston [2023] EWHC 1145 (Ch)

Testamentary capacity cases

Testamentary capacity test

This case is about the relationship between the common law test of testamentary capacity in Banks v Goodfellow (1870) LR 5 QB 549 and the Mental Capacity Act 2005.

Banks v Goodfellow (1870) LR 5 QB 549

Testamentary capacity cases

Testamentary capacity test

Common law testamentary capacity test.

Bassetlaw CCG (19 006 727a) and Nottinghamshire Healthcare NHS Foundation Trust (19 006 727b) [2019] MHLO 67 (LGSCO)

LGO decisions

Complaint not upheld by LGSCO

LGSCO summary: "The Ombudsmen found no fault by the Council, Trust or CCG with regards to the care and support they provided to a woman with mental health problems. The Ombudsmen did find fault with a risk assessment the Trust completed. However, we are satisfied this did not have a significant impact on the care the Trust provided."

Belfast Health and Social Care Trust v PT [2017] NIFam 1

Deprivation of liberty

DOL in NI

"The court considers that four questions need to be addressed in this [Northern Irish] case: (a) Does PT lack capacity? (b) Is there a gap in the existing legislation, thereby permitting the exercise of the inherent jurisdiction? (c) Is the care plan in PT’s ‘best interests’? (d) Is the care plan compliant with the ECHR? ... There is therefore no difference between the statutory test and the existing common law tests. Hence, in determining the capacity of PT in respect of welfare matters, the court can apply the test set out in the Mental Capacity Act 2005, even though that legislation does not apply in Northern Ireland, as it is in line with the existing common law tests. ... I find that PT lacks capacity to litigate, to make decisions about his care and residence and about whether to leave the home unescorted. ... Therefore, it is clear there is a lacuna or ‘gap’ in the 1986 Mental Health (NI) Order and as a result, a care plan which involves a deprivation of the liberty of a person subject to guardianship, cannot be sanctioned under the Mental Health (NI) Order 1986. Such deprivation of liberty can only be sanctioned by the High Court acting under its inherent jurisdiction. ... I find that continuous supervision by his foster mother JB and the locking of the external doors of the home and car doors whilst it is in motion are in his best interests as they protect his health and physical safety. The provisions also ensure he can continue to live with JB, with whom he has a special bond. For this reason I find that it is in his emotional best interests to remain in this placement. This can only happen if the proposed deprivation of liberty is permitted. ... Therefore, before the court exercises its inherent jurisdiction it must fully address the following questions, in order to be satisfied that any order it makes complies with the ECHR. (a) Is Article 5 is engaged? Does the care plan contain provisions which amount to a deprivation of liberty? (b) If so, are the provisions of Article 5 (1) (e) met? (c) If so, is the detention in accordance with the objective of Article 5 and is it in accordance with a procedure prescribed by law? (d) Is the proposed Order compliant with the provisions of Article 5 (4)? ... I also find that although this is a benign regime, in accordance with the definition set out in Cheshire West, PT’s care plan involves a deprivation of liberty because there is constant supervision and he is not free to leave the home as the external doors are locked and car doors are locked whilst he is present. ... I find that the provisions of Article 5 (1) (e) are met. There is objective medical evidence before the court indicating that PT is of unsound mind, this condition is persisting and is of a kind to warrant his compulsory confinement as PT needs supervision to prevent him causing harm to himself. ... I find that the care plan represents the minimum deprivation necessary to achieve the aim of Article 5, namely to ensure that PT does not cause harm to himself. ... In accordance with the requirements of Article 5 (4) the Court order must provide for adequate review at reasonable intervals. The Trust seeks an order of 12 months duration. I find that this is a reasonable interval to review the order as the Care Plan and Guardianship are reviewed annually. To accord with the requirements of Article 5(4) the Order should also a include liberty to apply at short notice provision. The review provisions must also ensure that there is sufficient medical evidence before the court to enable it to review whether there still persists an unsoundness of mind of a degree or kind to warrant PT’s compulsory confinement. In addition it is necessary to build other safeguards into the Order including PT’s right to legal representation."

Bell v Tavistock And Portman NHS Foundation Trust [2020] EWHC 3274 (Admin)

Medical treatment cases

Competence/capacity and puberty blockers

(1) The relevant information that a child would have to understand, retain and weigh up in order to have the requisite competence in relation to puberty blockers, would be as follows: (i) the immediate consequences of the treatment in physical and psychological terms; (ii) the fact that the vast majority of patients taking puberty blockers go on to cross-sex hormones and therefore that he or she is on a pathway to much greater medical interventions; (iii) the relationship between taking cross-sex hormones and subsequent surgery, with the implications of such surgery; (iv) the fact that cross-sex hormones may well lead to a loss of fertility; (v) the impact of cross-sex hormones on sexual function; (vi) the impact that taking this step on this treatment pathway may have on future and life-long relationships; (vii) the unknown physical consequences of taking PBs; and (viii) the fact that the evidence base for this treatment is as yet highly uncertain. (2) Gillick competence is treatment- and person-specific but the court gave clear guidance that it is highly unlikely that a child aged 13 or under, and very doubtful that a child aged 14 or 15, would ever be Gillick competent to give consent to being treated with puberty blockers. (3) There is a presumption that young people aged 16 or over have capacity to consent but, given the long-term and potentially irreversible consequences and the experimental nature of the treatment, clinicians may well consider that it is not appropriate to move to treatment such as puberty blockers or cross-sex hormones without the involvement of the court, and it would be appropriate to involve the court when there may be any doubt about long-term best interests.

Bell v Tavistock And Portman NHS Foundation Trust [2021] EWCA Civ 1363

Medical treatment cases

Competence/capacity and puberty blockers

The Court of Appeal decided that the High Court should not have: (a) made a declaration about the relevant information that a child under 16 would have to understand, retain and weigh up in order to have the requisite competence in relation to puberty blockers; or (b) given its guidance on likely Gillick competence to give consent and, in relation to children and young people, on court involvement. The Court concluded that "applications to the court may well be appropriate in specific difficult cases, but it was not appropriate to give guidance as to when such circumstances might arise".

Bernard v SW London and St George's MH NHS Trust [2013] UKUT 58 (AAC), [2013] MHLO 26

Bias cases

Medical member not biased

The medical member, questioning the RC, had stated 'I have no issues with the nature; it is chronic, relapsing, etcetera' but he had not formed a preconceived and concluded view (actual bias) or expressed himself in such a way as to give rise to a reasonable apprehension that he had (apparent bias).

Birmingham City Council v D [2016] EWCOP 8

Deprivation of liberty - children

Parental responsibility and DOL

(1) A parent cannot consent to the confinement (i.e. the objective element of Article 5 deprivation of liberty) of a child who has attained the age of 16. (2) The confinement was imputable to the state despite the accommodation being provided under s20 Children Act 1989, as the local authority had taken a central role; in any event, even if D's confinement were a purely private affair the state would have a positive obligation under Article 5(1) to protect him. (3) The judge did not resile from his previous judgment that D's parents could consent to his confinement in hospital when he was under 16.

Birmingham City Council v SR [2019] EWCOP 28

Deprivation of libertyDischarge conditions cases

Deprivation of liberty during conditional discharge

(1) Both patients supported but lacked capacity in relation to the proposed care plans, which involved deprivation of liberty concurrently with a conditional discharge, and those plans were in their best interests. (2) Obiter, the division in the MOJ's post-MM guidance (MCA DOL for incapacitous patients whose risk is to themselves, but MHA s17 leave for incapacitous patients whose risk is to others and for capacitous patients) did not withstand scrutiny as it is in patients' best interests to be kept "out of mischief" and therefore out of psychiatric hospital.

Blackpool Borough Council v HT (A Minor) [2022] EWHC 1480 (Fam)

Deprivation of liberty - children

DOL of 17-year-old

"The background to this matter will be depressingly familiar to those who are involved with proceedings concerning the deprivation of a child's liberty. ... Applications for declarations authorising the deprivation of liberty of a child often come before this court in the context of a dispute (either apparent or real) between the applicant local authority and the relevant NHS Clinical Commissioning Group and NHS England as to whether the subject child should be provided by NHS England with a CAMHS Tier 4 inpatient bed, or be provided with a placement and services by the local authority pursuant to its under the Children Act 1989, with the deprivation of the child's liberty being authorised under the inherent jurisdiction of the High Court. That is the position that has presented itself in this case. It is important to note at the outset that this should not be the position in this case, or indeed other similar cases. The courts have repeatedly emphasised the need for the State agencies engaged in cases of this nature to work co-operatively to achieve the best outcome for the child or young person."

Blankley v Central Manchester and Manchester Children's University Hospitals NHS Trust [2014] EWHC 168 (QB)

Litigation friend cases

Loss of litigation capacity

"These costs appeals raise the question of whether, where a party loses mental capacity in the course of proceedings, such loss of capacity has the automatic and immediate effect of terminating their solicitor's retainer. The question is currently of particular importance for solicitors conducting personal injury claims pursuant to conditional fee agreements entered into before 1 April 2013, in respect of which success fees continue to recoverable from defendants ... If such an agreement is found to have terminated by reason of the supervening incapacity of the claimant ... it would not now be possible to replicate the effect of the original contractual arrangements between solicitor and client given that success fees are not generally recoverable in respect of agreement made on or after 1 April 2013 ... No matter how short the period of incapacity ... nor how quickly a deputy was appointed by the Court of Protection in respect of the claimant, the original CFA would be lost and could not, in real terms, be replaced. ... For the reasons set out below, I have reached the ... conclusion ... that the intervening incapacity of a party does not frustrate or otherwise terminate a solicitor's retainer. Whilst such incapacity does have the effect of removing the authority of the solicitor to act on behalf of the party lacking capacity for the duration of that incapacity, such authority can be restored when a deputy is appointed and provides instructions to the solicitors in that capacity, or otherwise if and when the claimant regains capacity. There is no reason, as a matter of authority or legal principle, why an inability to instruct solicitors in the intervening period (which may be quite short) should be taken to have the effect of immediately ending a solicitor's retainer."

Blankley v Central Manchester and Manchester Children's University Hospitals NHS Trust [2015] EWCA Civ 18

Litigation capacity cases

Loss of litigation capacity

"This case concerns a claimant with fluctuating capacity to conduct legal proceedings. At a time when she had capacity, she retained a firm of solicitors under a conditional fee agreement ('CFA'). The issue is whether the CFA terminated automatically by reason of frustration when she subsequently lost capacity, so that it did not govern the continued conduct of the proceedings by a receiver/deputy appointed by the Court of Protection to act on her behalf. Phillips J, sitting in the Queen's Bench Division with assessors, held in a clear and cogent judgment that the CFA was not frustrated ... At the conclusion of the hearing of the appeal we announced that the appeal would be dismissed for reasons to be given in writing at a later date. These are my reasons for dismissing it."

Blavo and Co Solicitors (SRA decision: closure) [2015] MHLO 70

SRA decisions

Reasons for closure of Blavo & Co Solicitors

The SRA closed down Blavo & Co Solicitors and suspended John Blavo's practising certificate, giving the following reasons: (a) there is reason to suspect dishonesty of the part of a manager or employee of Blavo & Co Solicitors Limited; (b) there is reason to suspect dishonesty on the part of John Blavo in connection with his practice; (c) to protect the interests of clients of Blavo & Co Solicitors Limited.

Bolton Council v KL [2022] EWCOP 24

Deprivation of liberty - children

Re X procedure and 16/17 year olds

This detailed judgment addresses a COP9 application made by Bolton Council prior to the hearing for reconsideration of the decision to take the application out of the streamlined (Re X) procedure. It concluded: "KL's age at the time of the application, his being subject to a care order at the time of the application, his absence of family contact and the imminence of transition to adult services were all reasons which clearly led to the conclusion that he should be independently represented, by joinder as a party and appointment of a litigation friend for him." The judge then explained the court's approach: "(a) the court is unlikely to consider that the streamlined procedure is appropriate for authorisation of deprivation of liberty in the living arrangements of 16/17 year olds; (b) the court is unlikely to be critical of an applicant for bringing an application for authorisation of deprivation of liberty in the living arrangements of a 16/17 year old either by COP1 application to the appropriate hub court, or by streamlined application to the central registry at First Avenue House. It follows from (a) that the procedure adopted post-issue is likely to be substantially the same. If/when an in-person attended hearing is required, consideration will be given to transfer to a local hearing centre."

BP v London Borough of Harrow [2019] EWCOP 20

COP costs cases

Costs in s21A case

"The relevant circumstances of the adjournment of the January hearing are that the Respondent, the London Borough of Harrow, offered at the hearing a trial of BP returning home. ... For the Applicant, it is submitted that this is a case where it is appropriate to depart from the usual costs rule and to order the costs of the January hearing be paid by the Respondent because of the Respondent's consistent failure to offer a trial period at home before the start of and for the duration of the proceedings, and its decision to do so only after the January hearing had commenced. ... Overall, I can see the basis on which the Applicant considers an application for costs to be justified. However, this was a finely balanced case on the Applicant's own submissions in position statements, in particular that of 15 June 2018. I bear in mind the authorities on which the parties rely, in particular the Applicant's reliance on the comments of Hooper LJ in the Court of Appeal. I note the circumstances of Manchester City Council v. G, E and F [2010] EWHC 3385 were quite different. On balance and considering the circumstances as a whole, I am not persuaded that it is appropriate to depart from the general rule on this occasion. I decide this based on the chronological position of the parties set out above and all the circumstances. The Respondent's conduct falls short, to what degree is immaterial, of the necessary test. This case does not represent a blatant disregard of the processes of the Act and the Respondent's obligation to respect BP's rights under ECHR as in the Manchester case (paraphrased slightly)."

Brassington v Knights Professional Services Ltd [2023] EWHC 1568 (Ch)

Deputyship cases

Deputyship and employment dispute

The claimant solicitor had been a salaried partner at the defendant law firm. When she resigned, the firm for the first time sought payment of £211,632.76 so-called "work in progress" which had accumulated over six years, of which £166,468.97 was for time costs which had been disallowed by the SCCO in deputyship cases (it was the firm's practice never to write off these costs). The firm relied on badly drafted engagement letters to argue that she, rather than "P", was their client (stating in litigation that "Knights has no duty or obligation to the various patients whom Katie accepted responsibility for") and that she was personally liable to the firm for all unpaid fees. The court had no hesitation in deciding that that she had been contracting solely as deputy, and as agent, for "P", and had accepted no personal liability: summary judgment was given in her favour.

Briley v Leicester Partnership NHS Trust [2023] EWHC 1470 (SCCO)

Inquest cases

Pre-inquest costs

Legal Aid for an inquest ran alongside CFAs for civil litigation. Pre-inquest work would have been recoverable under Legal Aid but was instead claimed from the defendant at market rates when the litigation concluded successfully. The costs judge decided that this work was recoverable from the defendant.

Buckinghamshire County Council v RT [2018] EWCOP 12

Deprivation of liberty - children

DOL - 17-year-old

"I am concerned with a young man who is now 17 ½ years old and who I shall refer to as RT in this judgement. ... RT's behavioural issues are such that it is no longer safe for him at home with his adoptive parents and siblings. The local authority have therefore applied under the Mental Capacity Act 2005 for an order pursuant to section 4 and 16 of that act to deprive RT of his liberty so that he may be placed at [a place]. The arrangements for his care at that placement involve 2:1 supervision during the day and one to one at night. ... Is clear that the arrangements set out in the care plan amounts to a deprivation of liberty within the 'Storck' and Cheshire West cases. The level of supervision described is far in excess of that which might be applied to even the most unruly 17-year-old in a domestic setting. It clearly amounts to continuous supervision and control. ... It is very clear that it is RT's best interests to remain in an environment in which he can be protected from his own impulsivity and where others are protected. The very high levels of supervision are necessary and proportionate in the particular circumstances of this case. He needs intensive support and therapeutic input in order to reduce the risks he faces. This will not be a short-term recess but is likely to take months if not years. I therefore will make a deprivation of liberty order for one year. RT's 18th birthday is clearly a milestone for any teenager but I think has particular significance for RT. I will therefore list a review shortly before his 18th birthday which in particular will enable him to have a say at that point."

Calderdale MBC v AB [2021] EWCOP 56

Deputyship cases

Deputyship and direct payments

The judge agreed with the local authority's uncontested position that the authority granted by the standard property and affairs deputyship order did not make the deputy an 'authorised person' for the purposes of s32(4)(a) Care Act 2014 ('Adults without capacity to request direct payments').

Cambridge University Hospitals NHS Foundation Trust v AH [2021] EWCOP 51

Medical treatment casesCoronavirus cases

Serious medical treatment

AH was, in terms of the neurological impact and complications, "the most complex COVID patient in the world", and the central issue in the case was whether her ventilatory support should continue.

Cambridge University Hospitals NHS Foundation Trust v RD [2022] EWCOP 47

Medical treatment cases

Death

It was in RD's best interests not to be restrained, physically or through medication, and for palliative care to be provided if she were to remove her tracheostomy tube or indicate that she wanted it to be removed.

Campbell v Advantage Insurance Company Ltd [2021] EWCA Civ 1698

Miscellaneous cases

Drunkenness

"The appeal in this very sad case raises a short but interesting point of law about whether a claimant can rely on his own drunkenness, and consequential lack of insight, either to avoid a finding of contributory negligence or to reduce the apportionment of responsibility for his contributory negligence."

Cannon v Bar Standards Board [2023] EWCA Civ 278

Litigation capacity cases

Litigation capacity in disciplinary proceedings

The appellant had been disbarred for professional misconduct. In the Court of Appeal she argued that she had lacked mental capacity to participate in the Bar Disciplinary Tribunal proceedings and to give instructions in relation to her appeal to the High Court, and she sought permission to adduce psychiatric and other evidence which had not been before the court below. Permission to appeal was refused on this and other grounds.

Cardiff and Vale University Health Board v P [2020] EWCOP 8

Medical treatment cases

Dental treatment - delay

"It might seem, from the above account, that some dental assessment was required quickly and now as long ago as November or early December 2019. Plainly, it was. But the application was only made by the Health Board on 20th February 2020. The proposed inspection and/or treatment is not to take place until early March. For anybody who has had toothache, even delay between now and then looks like an eternity. But this young man, it seems, has been suffering, and significantly so, for nearly five months. This is little short of an outrage. It is indefensible. ... An additional complication arose in November when P was taken to the local A&E by his parents with an obvious bruise to his forehead. They believed that his behaviour was so markedly changed that they feared he had some sort of concussion and may have fractured his skull. It is, to my mind, self-evident that there was an urgent medical emergency that should have been investigated within hours or days, but in fact there has, as yet, been no CT scan at all. ... It is, sadly, yet again, a situation in which there has been a fundamental failure to communicate effectively by those responsible for P's care. This message has now been the conclusion of so many reviews, including serious case reviews, that it has become almost trite. There is no point identifying lessons to be learned if they are not, in fact, learned."

Care Quality Commission [2023] UKICO 193752

Miscellaneous cases

FOI request

ICO's summary: "The complainant has requested the Care Quality Commission (CQC) to disclose information relating to Mental Health Act complaints and an inspection of an NHS Trust’s Mental Health Services. The CQC refused to disclose the inspection information citing section 31(1)(g) by virtue of 31(2)(c) of FOIA (law enforcement), section 40, section 41 and section 44 of FOIA. For the complaints information the CQC refused to disclose on the basis of the same exemptions. The Commissioner’s decision is that the CQC is entitled to refuse to disclose the inspection information in accordance with section 31(1)(g), by virtue of 31(2)(c) of FOIA and for the complaints information the CQC is entitled to refuse the request on the basis of section 40(2). The CQC however breached section 10 of FOIA by failing to respond to the complainant’s request within 20 working days of receipt."

Cash v Court of First Instance, Strasbourg, France [2018] EWHC 579 (Admin)

Repatriation cases

Extradition

"At the conclusion of the hearing on 13 March 2018 I allowed the Appellant's appeal and quashed the extradition order made by District Judge Grant on 15 March 2017. I did so on the grounds that it would be unjust and oppressive to extradite the Appellant because he is currently unfit to stand trial and is seriously mentally ill with paranoid schizophrenia, and thus the judge should have decided that extradition is barred by s 25 of the Extradition Act 2003."

CB v Medway Council [2019] EWCOP 5

Deprivation of liberty

Unfair summary disposal of DOL/residence case

"The simple issue is whether the Judge had sufficient information before her to discount, at this stage, any real possibility of CB returning to her home, supported by the extensive and expensive care package that is being mooted. The language of the Judgment itself, to my mind, answers this question in phrases such as “I very much doubt…. I am very sceptical…. The practicalities are…. likely to be extremely difficult….” I share the Judge’s scepticism and I also very much doubt that even with an extensive package of support a return home will be in CB’s best interest. I note too that Dr Ajiteru expressed himself in cautious terms (see para 10 above). However, scepticism and “doubt” is not sufficient to discount a proper enquiry in to such a fundamental issue of individual liberty. ... It is easy to see why the Judge took the course she did and I have a good deal of sympathy with her. She will have recognised, as do I, that the effluxion of time has had its own impact on the viability of the options in this case. However, what is involved here is nothing less than CB’s liberty. Curtailing, restricting or depriving any adult of such a fundamental freedom will always require cogent evidence and proper enquiry. I cannot envisage any circumstances where it would be right to determine such issues on the basis of speculation and general experience in other cases."

CB v SSWP [2020] UKUT 15 (AAC)

Miscellaneous cases

All-male and all-female panels

(1) It was unlawful of the tribunal to hear the ESA appeal in the applicant's absence; the decision was set aside and the case remitted to a new panel. (2) The judgment contains obiter comments about the request for an all-female panel.

CD v London Borough of Croydon [2019] EWHC 2943 (Fam)

Inherent jurisdiction cases

Inherent jurisdiction or s48 interim order

(1) Cobb J discussed the inherent jurisdiction, setting out the following summary: (a) first the inherent jurisdiction may be deployed for the protection of vulnerable adults, (b) secondly in some cases a vulnerable adult may not be incapacitated within the meaning of the 2005 Mental Capacity Act but may nevertheless be protected under the inherent jurisdiction; (c) third that in some of those cases capacitous individuals may be of unsound mind within the meaning of article 5(i)(e) of the European Rights Convention; (d) fourth, in exercising my powers under the inherent jurisdiction I am bound by the European Convention and the case law under the convention and must only impose orders that are necessary and proportionate and at all times have proper regard to the personal autonomy of the individual; and (e) fifth and finally, that in certain circumstances it may be appropriate for a court to take or maintain interim protective measures while carrying out all necessary investigations. (2) In the end he made an interim order under MCA 2005 s48 enabling the Local Authority to gain access to CD's accommodation in order to provide appropriate care and make it safe for human habitation. (3) CD was a vulnerable adult but the order was made under the MCA because the judge was "satisfied that it is more appropriate, where statute provides a route, that the statute is used".

Clitheroe v Bond [2020] EWHC 1185 (Ch)

Testamentary capacity cases

Testamentary capacity

"This is a bitter family dispute between the Claimant brother and Defendant sister as to whether their mother, the deceased, had testamentary capacity to make each of her two wills and in addition or in the alternative whether either or both wills resulted from fraudulent calumny."

Clitheroe v Bond [2021] EWHC 1102 (Ch)

Testamentary capacity cases

Testamentary capacity and delusions

(1) It was not in the interests of justice to allow the question whether testamentary capacity should be determined using the MCA test rather than the Banks v Goodfellow test to be raised on appeal (though the judge would have concluded that the Banks test continues to apply). (2) In relation to delusions (part of the Banks test): "In order to establish whether a delusion exists, the relevant false belief must be irrational and fixed in nature. It not an essential part of the test that it is demonstrated that it would have been impossible to reason the relevant individual out of the belief if the requisite fixed nature can be demonstrated in another way, for example by showing that the belief was formed and maintained in the face of clear evidence to the contrary of which the individual was aware and would not have forgotten."

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