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  • 19/04/19
    (2245)
    : Case (). Hounslow Clinical Commissioning Group v RW [2019] EWCOP 12 — "This is an application brought by the Hounslow Clinical Commissioning Group concerning RW a 78-year-old man, suffering from vascular dementia. ... I would very much have liked to have been able to endorse a plan which permitted RW to return home. There is no doubt at all, as the history of this case shows, that RW would want to die at home. I do not know whether he would survive the transition but I should have been prepared to take that risk. However, PT would, in my judgement, continue to try to give his father food and water. As I speak these words he indicates to me that this is precisely what he would do. I have been told by Ms I that, at this stage, if PT were to attempt to feed his father there is a real risk that he would asphyxiate on any food given. I cannot permit RW to be exposed to the risk of ending his life in this way and, if I may say so, I would not be prepared to take that risk for PT either, especially having regard to all the loving care he has provided for his father. I endorse the applicant's plan. I indicate that it is in RW's best interest to have his sons with him as much as possible. I am not prepared to be prescriptive of the times and the circumstances in which the sons may visit. In this I reject the applicant's proposals in this respect."
  • 19/04/19
    (2240)
    : Case (Amputation). East Lancashire Hospitals NHS Trust v PW [2019] EWCOP 10 — "This is an application by East Lancashire NHS Trust for orders under the Mental Capacity Act 2005 that PW lacks capacity "to make a decision regarding whether to undergo the leg amputation surgery to address his high risk of sepsis"; and that it is lawful to carry out that surgery having regard to his best interests. Before dealing with the substantive issues in this case I will deal with the timing of the application."
  • 19/04/19
    (2157)
    : Case (Damages for unlawful psychiatric detention). PB v Priory Group Ltd [2019] MHLO 17A Part 36 offer of £11,500 plus legal costs was accepted in this claim brought for unlawful detention and breach of Article 5. The patient had been detained under s5(2) when not an in-patient, and this section had lapsed for nearly seven hours before detention under s2 began.
  • 18/04/19
    (2225)
    : Case (Appointment of property and affairs deputy). NKR v The Thomson Snell And Passmore Trust Corporation Ltd [2019] EWCOP 15 — "The application before the Court is for the discharge of the appointment of an existing professional property and affairs deputy, and the appointment of another instead. The discharge of the current deputy is agreed but there is an issue as to who should be appointed instead. ... In the matter of Re AS; SH v LC [2012] MHLO 113 (COP), [2013] COPLR 29 at paragraph 22 Senior Judge Lush set out "generally speaking" an order for preference of various candidates for appointment as deputy. A panel deputy is included "as deputy of last resort," after "a professional adviser, such as the family's solicitor or accountant." ... I am not aware of any previous appointments of a barrister as professional deputy (as distinct from a family member who just happens to be a barrister by profession but is appointed on the usual non-remunerated basis of a family member). Not being considered by the Bar Council as 'a legal service', discharge of the functions of deputyship is apparently not subject to the Bar Council's full regulatory force. However, the risk of property and affairs deputyship lies chiefly in misappropriation of funds. It seems to me beyond debate that misappropriation of MBR's funds whilst acting as deputy would count as "behaviour which diminishes trust and confidence" in Ms. Sood individually and her profession generally, and so Ms. Sood's holding of deputyship appointment would be subject to some professional regulation. ... On the information presently available to me, I am willing to accept that Ms. Sood is personally and professionally a suitable person to hold a deputyship appointment. Her appointment is however not the only option before the Court. A panel deputy has also been identified as willing to act ... Taking all matters into consideration, I conclude that it is in the best interests of MBR for Mr. Kambli to be appointed as replacement deputy upon discharge of the appointment of TSPTC."
  • 17/04/19
    (1346)
    : Advance decision-making. Gareth Owen et al, 'Advance decision-making in mental health - suggestions for legal reform in England and Wales' (2019) 64 Intl JL & Psychiatry 162 — Publisher's abstract: "This paper argues that existing English and Welsh mental health legislation (The Mental Health Act 1983 (MHA)) should be changed to make provision for advance decision-making (ADM) within statute and makes detailed recommendations as to what should constitute this statutory provision. The recommendations seek to enable a culture change in relation to written statements made with capacity such that they are developed within mental health services and involve joint working on mental health requests as well as potential refusals. In formulating our recommendations, we consider the historical background of ADM, similarities and differences between physical and mental health, a taxonomy of ADM, the evidence base for mental health ADM, the ethics of ADM, the necessity for statutory ADM and the possibility of capacity based ‘fusion’ law on ADM. It is argued that the introduction of mental health ADM into the MHA will provide clarity within what has become a confusing area and will enable and promote the development and realisation of ADM as a form of self-determination. The paper originated as a report commissioned by, and submitted to, the UK Government’s 2018 Independent Review of the Mental Health Act 1983."
  • 10/04/19
    (1255)
    : Mental health sentencing consultation. Sentencing Council, 'Overarching Principles: Sentencing Offenders with Mental Health Conditions or Disorders: Consultation' (9/4/19) — Extract from introduction: "The Council has developed a draft guideline for courts to use when sentencing offenders with mental health conditions, neurological impairments or development disorders. The aim of the guideline is to consolidate and explain information which will assist courts to pass appropriate sentences when dealing with offenders who have either a mental health condition or disorder, neurological impairment or developmental disorder, and to promote consistency of approach in sentencing. "
  • 05/04/19
    (2149)
    : Case (Withdrawal of CANH; advance decision). NHS Cumbria CCG v Rushton [2018] EWCOP 41 — "This is an application regarding the proposed withdrawal of clinically assisted nutrition and hydration in respect of Mrs Jillian Rushton, who is now 85 years of age. Since sustaining a traumatic head injury in December 2015, Mrs Rushton has suffered from a prolonged period of disorder of consciousness. Insofar as a label is relevant, the consensus of medical opinion, in respect of which there is no dissent at all, is that she is in a persistent vegetative state (PVS). In their recent guidance, ‘Clinically-assisted nutrition and hydration (CANH) and adults who lack the capacity to consent’, the Royal College of Physicians and the British Medical Association have noted that the importance of obtaining a precise and definitive diagnosis has reduced. It is recognised by the Courts and clinicians that drawing a firm distinction between vegetative state and minimally conscious state is frequently both artificial and unnecessary. In practice, when assessing best interests, information about the patient’s current condition and prognosis for functional recovery and the level of confidence with which these can be evaluated is invariably of greater importance than a precise diagnosis. ... It perhaps requires to be said, though in my view it should be regarded as axiomatic, that the medical profession must give these advanced decisions the utmost care, attention and scrutiny. I am confident the profession does but I regret to say that I do not think sufficient care and scrutiny took place here. The lesson is an obvious one and needs no amplification. Where advanced decisions have been drawn up and placed with GP records there is an onerous burden on the GP to ensure, wherever possible, that they are made available to clinicians in hospital. By this I mean a copy of the decision should be made available and placed within the hospital records with the objective that the document should follow the patient. It need hardly be said that it will rarely, if ever, be sufficient to summarise an advance decision in a telephone conversation. ... The family have ... made it clear to me that she would not have regarded her present situation as tolerable. Whilst I have no doubt that she would understand the commitment of her son, Tim and his profound resistance to letting her go, I have equally no doubt that she would want to be let go and I have no hesitation in concluding that it is my responsibility to respect this."
  • 25/03/19
    (1412)
    : Event. Edge Training: Liberty Protection Safeguards - London, 28/6/19 —This one-day course aims to provide a detailed analysis of the Liberty Protection Safeguards contained in the Mental Capacity (Amendment) Bill. The course considers the differences between DoLS and LPS and looks at what the new process will be and who will be affected. Speaker: Steven Richards. Cost: £140 plus VAT. See Edge website for further details and booking information.
  • 25/03/19
    (1411)
    : Event. Edge Training: DOLS MH Assessors Annual Refresher Course - London, 24/6/19 —This refresher course has been designed to meet the needs of DoLS Mental Health Assessors. It will cover key topics that cause uncertainty or dilemmas for MH Assessors and go over the main basic requirements of this challenging role. Common Mental Health Act and DoLS interface issues will also be addressed such as the law around the provision of mental health treatment under DoLS. Speaker: Aasya Mughal. Cost: £195.00 plus VAT. See Edge website for further details and booking information
  • 25/03/19
    (1409)
    : Event. Edge Training: DOLS Authorised Signatories Training Course - London, 21/6/19 —This course aims to provide guidance on the role of signatories and to update designated signatories in relation to the latest case law around their specific role within the DOLS procedures. Please note: this course is not designed for BIAs but specifically the role of local authority managers acting as authorised signatories. Speaker: Steven Richards. Cost: £140 plus VAT. See Edge website for further details and booking information.
  • 25/03/19
    (1407)
    : Event. Edge Training: Mental Capacity and Best Interests Assessments (Advanced) - London, 17/6/19 —This course considers practice issues under the Mental Capacity Act such as record keeping, disputes, unwise decisions and balancing risk. The course also conveniently disseminates the body of court judgments that apply to mental capacity assessments and best interests. It looks at some of the more complex cases around special issues in assessing capacity such as risk taking, contact, serious treatment, residence, vulnerable people and the inherent jurisdiction. The judgments used are selected to be most useful to health and social care staff and will provide a practical knowledge base they can refer to in daily practice. Speaker: Aasya Mughal. Cost: £140.00 plus VAT. See Edge website for further details and booking information.
  • 25/03/19
    (1405)
    : Event. Edge Training: BIA Legal Update (Annual Refresher) - London, 10/6/19 —This course aims to provide an essential update on case law in relation to the role of the BIA. Learning outcomes: (1) Consider the latest DoLS news, research and guidance; (2) Examine the latest case law relevant to DoLS and the BIA role; (3) Reflect on how the information covered affects BIA practice. Speaker: Aasya Mughal. Cost: £140.00 plus VAT. See Edge website for further details and booking information
  • 25/03/19
    (1404)
    : Event. Edge Training: MHA and MCA Interaction - London, 3/6/19 —This course aims to enable health and social care staff to consider the impact of the Mental Capacity Act 2005 on their work and its relationship to the use and application of the Mental Health Act 1983. Speaker: Steven Richards. Cost: £140 plus VAT. See Edge website for further details and booking information
  • 25/03/19
    (1402)
    : Event. Edge Training: Liberty Protection Safeguards - London, 13/5/19 —This one-day course aims to provide a detailed analysis of the Liberty Protection Safeguards contained in the Mental Capacity (Amendment) Bill. The course considers the differences between DoLS and LPS and looks at what the new process will be and who will be affected. Speaker: Steven Richards. Cost: £140.00 plus VAT. See Edge website for further details and booking information
  • 25/03/19
    (1400)
    : Event. Edge Training: DOLS MH Assessors Annual Refresher Course - London, 29/4/19 —This refresher course has been designed to meet the needs of DoLS Mental Health Assessors. It will cover key topics that cause uncertainty or dilemmas for MH Assessors and go over the main basic requirements of this challenging role. Common Mental Health Act and DoLS interface issues will also be addressed such as the law around the provision of mental health treatment under DoLS. Speaker: Aasya Mughal. Cost: £195.00 plus VAT. See Edge website for further details and booking information
  • 23/03/19
    (1713)
    : Case (Injunction against publication of video). Southern Health NHS Foundation Trust v AB [2019] EWCOP 11 — "This is an application to prevent publication of a video of a patient, AB, in her treating hospital. ... At times she is catatonic and lies in a foetal position on the floor. She has a history during these periods of self-harm, and for that reason she wears protective headgear at all times. In the light of AB's condition and the difficulties in accommodating her appropriately, the Trust has had to adapt the room in which she has been living urgently, and it is true to say that the condition of the room therefore looks somewhat poor. ... On about 20 January 2019, AB's son, W, who is the second respondent, took a video recording of his mother in her room. ... I am clear that it is appropriate in these circumstances to make the order. First of all, having seen the video, it is apparent that AB can be identified, even if pixilated, and would be identifiable from the information that Mail Online intend to publish. ... Secondly, it is clear from Dr Marlowe's statements that AB does not currently have capacity ... Thirdly, I have no doubt, having watched it, that the video would be an interference with AB's privacy and her private life. ... The draft order provides for W being able to apply to the court at a full hearing if he wishes to do so to seek to lift the injunction, and argue that it is in her interests to publish the video. Further, according to Dr Marlowe, AB may well regain capacity herself relatively shortly, i.e. within a matter of weeks, and if she then wishes for publication, that will be a matter for her."
  • 20/03/19
    (2139)
    : Case (Withdrawal of CANH). SS v CCG [2018] EWCOP 40 — "The application seeks a declaration pursuant to section 15 (that it is lawful and in B's best interests for CANH to be withdrawn) and, secondly, an order pursuant to section 16 for such withdrawal and for B to receive palliative care only. If granted, it is anticipated that B will pass away. ... In support of granting the application there are a number of important factors. It is consistent with her previously expressed feelings and wishes. It supports her right, I suspect strongly held, to self-determination. She has no quality of life. Therapeutically, her life is futile, there is no hope of recovery. There is no hope. If I allow the application and make the declarations, it will bring to an end the invasive and, in my judgment, burdensome medical treatment from which she, B, obtains no benefit. It is consistent with her Muslim religion. It is consistent with her devoted husband's views of his wife's best interests. It is consistent with the unanimous views of those that are responsible for caring and treating her, whether it be the clinical or the support team. Is there any factor which weighs in the scales against granting the application? There is. It is the powerful principle that if I make the declarations, it will inevitably lead to B's death, so offends against the very strong principle of the sanctity of life. Having taken time to consider the matter, it seems to me clear that the direction of travel is all one way. It is with my very greatest sympathy to the family and B's husband in particular that balance falls very clearly in favour of me granting the application and making the declarations as sought, and I do so."
  • 20/03/19
    (2042)
    : Case (Retrospective authorisation of DNA swab sample). DCC v NLH [2019] EWCOP 9 — "I concluded it would be appropriate to make a declaration (1) that NLH lacked capacity (a) to make decisions as to the provision of buccal swab samples, the testing of such samples and the profiling of his DNA and (b) to conduct these proceedings, and further (2) that it was lawful for the local authority to arrange for the taking of buccal swabs from NLH for the purposes of performing DNA paternity testing in respect of the child. I further concluded it would be appropriate to make an order, by consent, that the court consented on NLH's behalf for the swab sample to be taken and tested and so that his DNA could be profiled to establish whether he was the father of the child. Shortly before the order was made, however, it emerged that a member of staff from the DNA testing company, Lextox, had already attended at the nursing home and taken the sample, with the agreement of NLH's family, but without either the formal consent of NLH (who lack capacity to provide consent) or the approval of the court. ... I therefore agreed to prepare this short judgment to remind practitioners, carers and those involved in taking samples in these circumstances that, where the patient lacks capacity and an application has been made to the Court of Protection for an order authorising the taking of a sample, it will be unlawful for the sample to be taken without the Court's permission. All practitioners and professionals working in this field ought to be aware that there is always a judge of the Family Division on duty available to sit in the Court of Protection twenty-four hours a day, seven days a week, every day of the year, to deal with urgent applications, usually by telephone. Consequently, there is no excuse for any failure to comply with the obligations to obtain the court's permission in circumstances such as these. As stated, no harm arose on this occasion, but any infringement in future will run the risk not only of attracting severe criticism from the Court but also potentially incurring liability for damages if a breach of human rights were to be established."
  • 19/03/19
    (2156)
    : Case (Whether child had "sufficient understanding" to conduct appeal without Guardian). CS v SBH [2019] EWHC 634 (Fam) — "Thus in determining whether the child has sufficient understanding to give instructions to pursue an appeal and to conduct the appeal I need to consider a range of factors including: (i) The level of intelligence of the child. (ii) The emotional maturity of the child. (iii) Factors which might undermine their understanding such as issues arising from their emotional, psychological, psychiatric or emotional state. (iv) Their reasons for wishing to instruct a solicitor directly or to act without a guardian and the strength of feeling accompanying the wish to play a direct role. (v) Their understanding of the issues in the case and their desired outcome any matter which sheds light on the extent to which those are authentically their own or are mere parroting of one parents position. ... (vi) Their understanding of the process of litigation including the function of their lawyer, the role of the judge, the role they might play and the law that is applied and some of the consequences of involvement in litigation. ... (vii) The court's assessment of the risk of harm to the child of direct participation for the risk of harm arising from excluding the child from direct participation and the child's appreciation of the risks of harm."
  • 18/03/19
    (2235)
    : Case (Residence, contact, tenancy). London Borough of Hackney v SJF [2019] EWCOP 8 — "SJF is a 56 year old woman with a complicated matrix of physical and mental health issues. Apart from frequent hospital admissions, she is presently living in a residential placement. She wants to go home to live in her rented flat with her son. The Court is asked to determine: (a) Whether she has capacity to make decisions about where she lives, how she is cared for, the contact she has with others (notably her son) and whether to terminate and enter into tenancy agreements; and (b) If she lacks capacity in the relevant domains, where she should live, whether her contact with her son should be restricted and whether tenancy agreements should be terminated/entered into."
  • 16/03/19
    (2040)
    : Case (Disproportionate litigation - legal costs, and LIP costs). London Borough of Hounslow v A Father & A Mother [2018] EWCOP 23 — Judge's headnote: "Costs in the Court of Protection - Disproportionate litigation - Whether a litigant in person is entitled to recover costs including loss of earnings"
  • 15/03/19
    (2057)
    : Case (Medical treatment case). King's College Hospital NHS Foundation Trust v FG [2019] EWCOP 7 — "[T]he King's College Hospital NHS Foundation Trust seeks an order in the following terms in relation to FG: (a) a declaration that FG lacks capacity to make decisions regarding the medical treatment for his physical health conditions; (b) that it is lawful and in FG's best interests for him to undergo an operation to repair his right shoulder fracture/dislocation; and (c) that it is in his best interests to receive any sedation and anaesthesia his clinicians think necessary to allow the operation to be done. The matter has come in front of me today as urgent applications judge."
  • 15/03/19
    (2042)
    : Case (Unfair summary disposal of DOL/residence case). CB v Medway Council [2019] EWCOP 5 — "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."
  • 15/03/19
    (0105)
    : Event. RAB: AMHP Refresher and Re-approval course - London, 3/6/19 to 5/6/19 —This 3-day course is based near London Bridge station at the London Councils training venue. It prepares AMHPs for re-approval as well as providing 18 hours of training to meet the annual regulatory requirement. Speakers: Rob Brown and Christine Hutchison. Cost £400 + VAT. Contact Rob Brown on robbrown@btinternet.com for further details and booking information.

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