Mental Capacity Act, Level 1

What it covers

What the Act asks of a GP practice: assume the patient can decide, help them to decide, and let an unwise decision stand. The two stage test for one decision at one time, how to record it so it holds up, and what best interests means when somebody cannot decide. Who may lawfully decide instead, what an advance decision does, and where the law on deprivation of liberty stands after the Supreme Court judgment of 2 June 2026.

Who it is for

Everyone in a GP practice, from reception and administration to the GPs, trainees, nurses, healthcare assistants, pharmacists and paramedics who make and record care decisions.

By the end you will be able to

• Say the five statutory principles in the Act's order, and what each changes at the desk.
• Apply the two stage test to one decision at one time.
• Explain why an unwise decision, a diagnosis or someone's age never settles capacity.
• Make and record a best interests decision, consulting the people section 4 names.
• Tell a registered attorney, a deputy and an advance decision apart, and check each.
• Recognise a possible deprivation of liberty, and know who to tell today.

Modules

1. Start by assuming they can
2. Working out if they can
3. When they cannot decide
4. Who else may decide
5. When liberty is in question

The law here is moving. The Deprivation of Liberty Safeguards still operate, the Liberty Protection Safeguards have not commenced, and the Supreme Court changed the test for a deprivation of liberty on 2 June 2026. Law and guidance last checked 20 September 2026.

Content mapped to the Mental Capacity Act 2005 and its Code of Practice. Law named: Mental Capacity Act 2005, sections 1 to 4.

Sources

• Mental Capacity Act 2005, section 1: the principles (legislation.gov.uk, revised text in force)
• Mental Capacity Act 2005, section 2: people who lack capacity
• Mental Capacity Act 2005, section 3: inability to make decisions
• Mental Capacity Act 2005, section 4: best interests
• Mental Capacity Act 2005, section 5: acts in connection with care or treatment
• Mental Capacity Act 2005, section 6: section 5 acts, limitations
• Mental Capacity Act 2005, section 9: lasting powers of attorney
• Mental Capacity Act 2005, section 11: lasting powers of attorney, restrictions
• Mental Capacity Act 2005, section 16: powers to make decisions and appoint deputies
• Mental Capacity Act 2005, section 20: restrictions on deputies
• Mental Capacity Act 2005, section 24: advance decisions to refuse treatment, general
• Mental Capacity Act 2005, section 25: validity and applicability of advance decisions
• Mental Capacity Act 2005, section 26: effect of advance decisions
• Mental Capacity Act 2005, section 37: provision of serious medical treatment by NHS body
• Mental Capacity Act 2005, section 38: provision of accommodation by NHS body (28 days, 8 weeks)
• Mental Capacity Act 2005, section 39: provision of accommodation by local authority
• Mental Capacity Act 2005, section 42: codes of practice and the duty to have regard
• Mental Capacity Act 2005, section 44: ill-treatment or neglect
• Mental Capacity Act Code of Practice (Office of the Public Guardian, published 22 July 2013, updated 14 October 2020)
• UK Supreme Court 2026 judgment on what constitutes a deprivation of liberty (Department of Health and Social Care guidance, 15 June 2026)
• Changes to the definition of deprivation of liberty (Department of Health and Social Care, published 15 June 2026, updated 22 September 2026 only to add links to Mental Capacity Act and DoLS e-learning)
• Improved safeguarding and protections for vulnerable people (Department of Health and Social Care press release, 18 October 2025: the Liberty Protection Safeguards consultation)
• Deprivation of Liberty Safeguards, England, 2024 to 2025: statistical commentary (Department of Health and Social Care, 26 March 2026)
• What are Liberty Protection Safeguards (SCIE, carrying the June 2026 judgment note)
• Independent mental capacity advocates (Office of the Public Guardian and Department of Health and Social Care, updated 26 June 2025)
• Manage a lasting power of attorney: health and welfare attorneys (GOV.UK)
• Manage a lasting power of attorney: prove you are an attorney (GOV.UK, the 13 character access code valid for 50 days)
• View a lasting power of attorney: the service for companies and organisations (GOV.UK)
• Deputies: make decisions for someone who lacks capacity (GOV.UK)
• Report a concern about an attorney, deputy or guardian (Office of the Public Guardian)
• About the Mental Capacity Act (Care Quality Commission, page last updated 30 January 2025)
• The seven principles of decision making and consent (General Medical Council, in effect 9 November 2020)
• Decision-making and mental capacity, NICE guideline NG108 (published 3 October 2018)
• Mental Capacity Act, e-learning for healthcare programme (11 sessions: the national e-learning this course is benchmarked against)
• A Reference by the Attorney General for Northern Ireland of a devolution issue under paragraph 34 of Schedule 10 to the Northern Ireland Act 1998 [2026] UKSC 16 (judgment of 2 June 2026: Cheshire West overruled, paragraphs 53(i) to 53(vii))
• P v Cheshire West and Chester Council [2014] UKSC 19, paragraph 50 (the three factors the old acid test ruled out)
• A Local Authority v JB [2021] UKSC 52, paragraphs 78 and 79 (the order of the two questions under section 2(1))
• Mental Capacity Act 2005, Schedule A1 paragraph 13: the age requirement for the Deprivation of Liberty Safeguards

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