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Adult Protection and the Mental Capacity Act

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Adult Protection and the Mental Capacity Act A GP Perspective Dr Will Drever The Mental Capacity Act Boring? Irrelevant? Unknown? Aims and Objectives Introduction ... – PowerPoint PPT presentation

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Title: Adult Protection and the Mental Capacity Act


1
Adult Protection and the Mental Capacity Act A
GP Perspective
  • Dr Will Drever

2
The Mental Capacity Act
  • Boring?
  • Irrelevant?
  • Unknown?

3
Aims and Objectives
  • Introduction
  • Reasons for my involvement
  • Clinic Case
  • Questions
  • Discussion

4
Introduction
  • GP Partner (Hawkesley, Bham)
  • Trainer / TPD South Bham VTS
  • Clinical Lead for Diabetes (BSC CCG)
  • Practice lead for mental health
  • Only formal psychiatry training 6 months SHO
  • Not Section 12 Approved.

5
Reasons for my involvement
  • Personal experience
  • Specific case of Service User
  • Serious Case Review Case A1
  • Coroners Court
  • Outcomes and recommendations
  • Lack of GP knowledge
  • Questions still unanswered

6
Clinical Case
  • Service User A.D. (deceased)
  • 35y male Caucasian
  • Schizophrenia Learning difficulties
  • Carer Mother
  • Medical problem gangrene of the feet
  • Medical input DNs x 6, GP x 4, Psych x 2, Home
    Treatment Team, TVN, Podiatry

7
Clinical Case Key Issues
  • Pt refusing hospital admission
  • Mother with morbid fear of hospitals
  • Potentially life threatening medical problems
  • Psychiatric diagnosis clouding issues
  • Deemed no signs he lacked capacity
  • GP and DNs not aware of Mental Capacity Act
  • Never seen without Mother
  • Never formally assessed under MCA

8
Clinical Case Chronology of events
  • Treated for gangrene over 3 years (06-09)
  • Reviewed by DNs gt 100 times
  • Review by GPs gt 15 times
  • Reviewed by Psych x 3 times
  • Admitted eventually in septic shock
  • Life saving surgery never recovered
  • Died before capacity was formally assessed
  • Corners Court Case / Serious Case Review

9
Clinical Case Outcomes
  • Verdict Death by natural causes
  • Neglect of duty of care on all parties
  • Recommendations raising awareness of MCA
  • PCT wide training offered to all staff
  • Formal training of GPs in our practice
  • Raised profile of Vulnerable Adults Team
  • Personal learning

10
Questions re case
  • Would the same thing happen again today?
  • If deemed to have Capacity what next?
  • If deemed not to have Capacity what next?
  • What would least amount of force look like?
  • Has MCA been used in other cases like this?
  • What was the best good for A.D. ?

11
Discussion
  • Any questions?

12
Thank you
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