20 December 2017

Support people to make decisions if they have capacity but find it difficult, NICE says

Health and social care professionals should support people to make decisions who find it difficult, NICE says in new draft guidance.

Support people to make decisions if they have capacity but find it difficult, NICE says

See end of story for an update on this guidance

They should support people even if they make a decision that they may disagree with. Making an ‘unwise’ or ‘risky’ choice does not mean that a person lacks capacity and decisions need to be made on their behalf, the draft guidance says.

Using visual aids or involving friends and family can help a person communicate their wishes, NICE says.

Nageena Khalique QC, barrister at No5 Chambers and vice-chair of the committee, said: “Our draft guidance will help empower and support people who do have capacity to overcome difficulties they may face when making decisions.

“They should be provided with the right information to support that specific decision. Health and social care professionals should also make sure families, friends and carers are involved in these discussions.”

Having mental capacity means that someone is able to make their own decisions.

If someone is assessed as lacking mental capacity, services should take all reasonable steps to help people be involved in decisions made on their behalf, the draft guidance says.

Advance care plans can help set out a person’s wishes in relation to future care and decisions.

A person can lack mental capacity to make a specific decision about their care or treatment due to an illness or condition, such as dementia or a brain injury. Professionals make decisions on their behalf which will be in their best interest. This in line with the Mental Capacity Act 2005.

Nageena Khalique QC said: “If someone is assessed as lacking capacity to make a decision, we must do everything to keep them involved in the process and take into account their wishes and feelings. They should be at the heart of decisions made on their behalf.”

Professor Gillian Leng, deputy chief executive at NICE, said: “Our advice, once final, will support government legislation and make sure all steps are taken to keep people at the centre of the decision-making process.”

UPDATE: NICE published the final version of this guideline in October 2018

“Our draft guidance will help empower and support people who do have capacity to overcome difficulties they may face when making decisions.

Nageena Khalique QC, barrister at No5 Chambers and vice-chair of the committee

Our advice, once final, will support government legislation and make sure all steps are taken to keep people at the centre of the decision-making process.

Professor Gillian Leng, deputy chief executive at NICE