What we can and cannot do
GPs are frequently asked to carry out mental capacity assessments relating to Lasting Power of Attorney (LPA), finances, property, welfare, and social care decisions.
To help our patients and families, we want to clarify what is covered under our NHS contract and what falls outside of it.
Core NHS Care (what we do)
Under the General Medical Services (GMS) contract, GPs are only contractually obligated to provide essential services (the management of patients who are or believe themselves to be ill) and clinical care.
As part of this NHS role, GPs routinely assess a patient’s capacity in relation to medical investigations, treatments, and healthcare decisions within the surgery.
Important note on capacity:
- It is decision-specific and time-specific: Any assessment applies only to the particular healthcare decision being made at that specific time.
- It can fluctuate: A person’s capacity can change from day to day, or even hour to hour (for example, due to conditions like dementia, delirium, or infection). A person may lack capacity to make a decision at one moment, but regain it later.
Non-NHS services (what we cannot do)
Assessments relating to finances, property, legal matters, overall welfare, or social care fall outside the NHS GMS contract. These assessments are often highly complex, carry significant legal implications, and require specialist legal expertise and specific indemnity cover which our practice does not hold. Those carrying out these assessments for legal purposes must be appropriately trained and experienced in this area.
Consequently, the practice is unable to undertake mental capacity assessments for:
- Lasting Power of Attorney (LPA)
- Financial or property matters
- Legal proceedings or Court of Protection
- Social care or housing welfare decisions
Alternative routes for support
If you require an assessment for one of the areas listed above, please use the following appropriate routes:
- For LPA and Legal Matters: We recommend contacting a solicitor. They can arrange an assessment through a suitably qualified professional, such as a private psychiatrist or an independent GP who specialises in mental capacity assessments.
- For Social Care Assessments: The correct route is to contact your local Social Services department or the patient’s designated social worker.
- Further Reading: Additional guidance is available via The Law Society: Working with clients who may lack mental capacity.
We appreciate this policy may cause inconvenience for some patients and families. However, our priority must remain the delivery of core NHS medical services and safe patient care.