Capacity Assessment, Informed Consent and Attorneys

I am very concerned about the way the NHS acute hospitals are undertaking capacity assessments, recording informed consent in medical records and liaising with attorneys.

Last year my mother (92 years old, with a diagnosis of vascular dementia, and severe hearing impairment) was admitted to an NHS acute hospital. Two capacity assessments were undertaken by two different consultants. Both capacity assessments determined that my mother had capacity with respect to a decision. However the capacity assessments as recorded on the forms seemed to be wholly inadequate. I want to understand whether this is a common experience and why this situation is tolerated? I would also like to know how I could obtain an independent expert opinion regarding the quality of these capacity assessments.

I have accessed my mother’s full medical records for the period of her stay in hospital. I can find no entries in her notes that record her providing informed consent for any of her treatment nor can I find any evidence of any discussions with my mother concerning her treatment. I want to understand how widespread this lack of recording of informed consent might be in medical records and what can be done to ensure that all patients are involved in meaningful discussions regarding their treatment.

I am one of my mother’s four attorneys for health and welfare. During my mothers stay in hospital the hospital took no interest in the existence of the attorneys. Indeed it seems that there is no agreed method within the NHS for hospitals to determine whether attorneys exist and to proactively access information regarding attorneys as held in primary health care records. The hospital seemed indifferent to the existence of attorneys. I am interested to know whether this is a common experience and what could be done to address this problem.

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Request a Advanced Care directive to be added to care plan to show who has power of attorney with contact details.

I’m also one of 3 attorneys for my partner, and have experienced similar issues with conflicting mental capacity assessments carried out by the hospital and by a care provider on discharge from hospital. The hospital wasn’t interested in knowing about attorneys and didn’t know how to consult with us throughout his admission.
At first they refused to give me any information by phone as they were only interested in whether I was
Next of Kin, who, if I have understood correctly, have no legal authority to make decisions for the donor.
I have also seen documents which indicate that the person lacks capacity to make a specific decision, but there is no accompanying documentation to evidence how that assessment was conducted or what attempts were made to support the person to make a decision.
This is my personal experience and not a professional one.

Thank you for your reply. What action can people who experience this kind of treatment do so that things might change? I have found it impossible to obtain a considered response from the hospital. I would really like to bring this set of issues to the attention of someone within NHS England but I do not know how to do this. I would welcome any ideas on this.