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Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments, England - 2012-13, Annual report

Publication date: 09:30 August 20, 2013

Summary

The Mental Capacity Act Deprivation of Liberty Safeguards (MCA DoLS), which came into force on 1 April 2009, provides a legal framework to ensure people are deprived of their liberty only when there is no other way to care for them or safely provide treatment. They were introduced as an amendment under the Mental Health Act 2007 but form part of the Mental Capacity Act.

This report provides information on uses of the legislation across the whole year from 1 April 2012 - 31 March 2013. This report also references the expected figures included in the planning assumptions made by the Department of Health.

IMPORTANT: Please note that some minor changes to the report were made in December 2013 in order to correct three errors caused by innacurate rounding. No other figures in the release (including reference data tables and underlying data) were affected. The corrections were:

Page 5, Fourth bullet point of Exec Summary & Page 21, 'dementia accounting for more than half (54 per cent) of all applications' - figure corrcted to 53 per cent.

- Page 16, paragraph beginning 'Regional differences': London has proportionally more adults aged 18-64 (86 per cent) of its population aged 18 and over) than England (79 per cent) - figures corrcted to 85 per cent and 78 per cent.

- Page 22, paragraph beginning 'The proportion of applications granted an authorisation' - 58 per cent, rising to 60 per cent - second figure corrected to 59 per cent.

IMPORTANT: Please note that we were advised of some incorrectly submitted figures after publication which affected Quarter 4 2012-13 returns from Plymouth Local Authority and Plymouth Teaching Hospitals PCT.

- For Plymouth Local Authority (913), the total number of applications for a Deprivation of Liberty should have been 35 rather than 58 (with 10 being granted rather than 18, and 25 not being granted rather than 40). For Plymouth Teaching Hospitals PCT (5F1), the total number of applications should have been 7 rather than 13 (with 3 being granted rather than 5, and 4 not being granted rather than 8).

- For Plymouth Local Authority, the number of urgent authorisations requested should have been 24 rather than 37 (with 4 being granted rather than 6, and 20 being granted rather than 31). In addition, the number of reviews conducted should have been 1 rather than 2. For Plymouth Teaching Hospitals PCT, the total number of requests for urgent authorisations should have been 7 rather than 13 (with 3 being granted rather than 5, and 4 not being granted rather than 8). The number of reviews conducted remains unchanged.

Whilst National totals are not significantly changed, these errors should be taken into account when using breakdowns in the report and reference tables, and relevant cells of the machine readable dataset. Figures for the number of people subject to a standard authorisation are unchanged.


Key Facts

There has been a year-on-year increase in the number of applications completed for deprivation of liberty under (DoLS) since their introduction in 2009-10. There were 11,887 applications in 2012-13, a 4 per cent increase on the 11,382 applications in 2011-12, and a 66 per cent increase on the 7,157 applications in 2009-10. Although application numbers continued to increase, the rate of increase was smaller than in previous years. This pattern of rising applications is contrary to predictions that applications would fall at a constant rate between 2009-10 and 2015-16.

Consistent quarter-on-quarter increases in the number of people subject to standard authorisations at the end of the quarter (from 536 on 30 June 2009 to 1,976 on 31 December 2011) appear to have stalled in the reporting year of 2012-13. This number dropped to 1,667 (a decrease of 16 per cent) on 31 March 2012, decreasing further to 1,575 (-6 per cent) on 30 June 2013. The number of people subject to standard authorisations changed relatively little in subsequent 2012-13 quarterly snapshots.

More than half (55 percent or 6,546) of all applications for deprivation of liberty under DoLS completed in 2012-13 had an authorisation granted, in line with 2011-12 (56 per cent) and 2010-11 (55 per cent) but higher than 2009-10 (46 per cent).  Where authorisations were not granted in 2012-13, this was usually because the supervisory body considered that the 'best interests' assessment had not been met (80 per cent of applications where authorisation was not granted).  

The majority (71 per cent) of applications in 2012-13 were completed on behalf of people with mental health conditions, with dementia accounting for more than half (54 per cent) of all applications made. This is likely to be related to the age profile of people who are subject to application for deprivation of liberty under DoLS (in 2012-13, 27 per cent of applications related to people who were aged 85 and over).

Over half (55.8 per cent) of all authorisations granted in 2012-13 were for a duration of 0 to 90 days; relatively few authorisations (7 per cent) were granted for 365 days or more. LAs granted a higher proportion of authorisations with duration of more than 180 days (27 per cent) than PCTs (4 per cent). This may reflect differences between the care needs of hospital patients and care home residents.

Across England as a whole, 28.3 applications per 100,000 people aged 18 and over were made in 2012-13. Application rates rose sharply with age, ranging from 9.6 per 100,000 people for 18-64 year-olds to 265.3 per 100,000 people for those aged 85 and over. Substantial variations by region and ethnic group were observed, in part reflecting differences in age structure by region and by ethnic group.


Coverage

Date Range: 01 April 2012 to 31 March 2013
Geographical coverage: England
Geographical granularity: Local Authorities, Primary Care Trusts, Regions

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