NHS England has released updated guidance to help acute trusts and community health providers better implement the Mental Capacity Act (MCA) 2005 for adults with learning disabilities. The guidance is designed to help frontline healthcare professionals fulfil their legal responsibilities while making reasonable adjustments to support individuals with additional needs.

The document includes tools such as mental capacity assessment checklists and templates for recording best interest decisions, with leadership teams urged to ensure the guidance is well understood and accessible to all staff. It reinforces the importance of collaboration when assessing a person’s capacity - particularly involving those who know the individual best, including carers, family members, and specialist staff.

A key element of the guidance is the two-stage assessment process: first identifying any disturbance in the functioning of the mind or brain, followed by determining whether this prevents the person from making a specific decision, even with support. It also stresses the importance of involving families in decision-making and ensuring they are offered support and advocacy services where appropriate.

However, challenges remain. The guidance highlights ongoing barriers, such as insufficient training, pressures in busy clinical settings, and misunderstandings around conditions and capacity. These issues can lead to poor implementation and undermine the legal rights of individuals with learning disabilities.