There are growing numbers of people in England and Wales, estimated as around 2 million, who may lack capacity to make decisions for themselves because of illness, injury or disability.
There are also concerns about variations in quality, consistency and availability of support to facilitate decision making.
The new NICE guideline, Decision making and mental capacity, suggests ways to help people make decisions and maximise personal autonomy. It applies to a range of decisions including care, treatment, financial matters, day-to-day living and emergencies. It includes recommendations on advance care planning, which helps people plan future care when they lose capacity.
NICE also makes recommendations for training and support for staff, interventions to improve decision-making capacity, advocacy and support for decision-making, and mental capacity assessment tools.
To help organisations and individuals put these recommendations into practice, NICE has included links to fact sheets, videos and templates.
The new NICE guideline comes at a time of imminent reform in the law as the Mental Capacity Act amendment Bill is scrutinised by parliament. While it will make some reforms, the empowering ethos and core principles originally introduced by the 2005 Act will continue.
People should be supported to make decisions for themselves when they have the mental capacity to do so, and to remain at the centre of the decision-making process when they do not.
This guideline helps health and social care professionals to do that, and improve the quality of the support they provide.
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