Royal Bournemouth and Christchurch Hospitals NHSFT v SE  EWCOP 45
Serious medical treatment - delay in making application "Whilst, of course, it is understood emergencies do arise, in this case the emergency was due to the failure to have any effective system in place for securing legal advice for clinicians in the Trusts. I hope that the procedures now put in place (as set out at the end of this judgment) will be replicated elsewhere to avoid this situation happening again. ... [H]er best interests will be met by this court endorsing the Order that has been agreed and giving the applicants permission to be able to carry out the procedures set out in paragraph 4, namely the amputation of her right leg ...
Postscript to judgment
[The following is para 35 of the judgment.]
35. The Chief Executive, Tony Spotswood, of The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust sent a letter to the court dated 20 November 2018. This letter details the changes they had implemented following the experience of this case. They are set out as follows:
1. The Trust's Mental Capacity Act Policy has been amended to provide more detail on the situations where staff may need to make an application to the Court of Protection and who to contact both within and outside of normal working hours to obtain advice, including legal advice. These changes are due to be formally approved at a meeting of the Trust Protection Safeguarding Committee on Friday, 7 December.
2. The changes and the need for timely escalation have been highlighted to staff in the weekly Staff Bulletin on 19 November 2018.
3. Separate briefing sessions on the changes to the Mental Capacity Act Policy have been held with teams in the Emergency Department, Acute Medical Unit, Surgical Assessment Unit and Critical Care, as these are the areas most likely to be involved in these applications.
4. Contact details for the Trust's solicitors have been provided to Adult Safeguarding to support timely access to legal advice from external legal advisers if required. The information held by the Clinical Site Team for out of hours contacts has been checked to ensure that this is up to date.
While these types of applications are not something that the Trust is required to make frequently, we recognise the importance of timely escalation and the provision of appropriate advice for patients and their families. Other Trusts may want to review their procedures and consider the helpful framework set out above.
Published on BAILII on 10/8/19.