As a GP, it is not uncommon to be asked to complete medical reports or assessments for our patients. Many GPs look after patients in care homes with dementia and may be familiar with DoLS assessments. As a result, they may find themselves being asked to complete the mental health assessment for a DoLS authorisation. However, particular care is required to ensure any such assessment would comply with legislation or a DoLS assessment may be legally invalid, and the GP could find themselves subject to scrutiny by the GMC for acting outside of Good Medical Practice guidance.
The legislation governing DoLS assessments is The Mental Capacity (Deprivation of Liberty: Standard Authorisations, Assessments and Ordinary Residence) Regulations 2008
DoLS assessments are carried out by two individuals:
- Best Interests assessor
- Mental health assessor
A GP is most likely to be asked by their local authority to act as the mental health assessor. However, before agreeing to do so the GP must ensure they are eligible to act in this role. Eligibility to be the mental health assessor is set out in paragraph 4 of the legislation:
4.—(1) A person is eligible to carry out a mental health assessment(9) if paragraphs (2) and (3) are met.
(2) The person must be—
(a)approved under section 12 of the Mental Health Act 1983(10); or
(b)a registered medical practitioner who the supervisory body is satisfied has at least three years post registration experience in the diagnosis or treatment of mental disorder.
(3) The supervisory body must be satisfied that the person has successfully completed the Deprivation of Liberty Safeguards Mental Health Assessors training programme made available by the Royal College of Psychiatrists(11).
(4) Except in the 12 month period beginning with the date the person has successfully completed the programme referred to in paragraph (3), the supervisory body must be satisfied that the person has, in the 12 months prior to selection, completed further training relevant to their role as a mental health assessor.
It is important to note that in addition to being a GP of at least three years post registration experience, the doctor must also have completed the Deprivation of Liberty Safeguards Mental Health Assessors training programme made available by the Royal College of Psychiatrists. A failure to have completed this relevant training would result in any DoLS assessment completed being legally invalid and the GP having breached Good Medical Practice paragraph 14:
14 You must recognise and work within the limits of your competence.
The DoLS training is available online on the E Learning for Health Platform available to all NHS employees:
The training programme starts with an assessment of knowledge on Mental Capacity, followed by specific training on the DoLS assessments with a completion assessment of the knowledge gained. Certification of completion of the training is only available after successfully completing all parts of the course.
Any GP working in an area where they are being asked to complete the mental health assessment part of a DoLS application, should either decline to do so on the basis they are not qualified to act in that role or should ensure they have completed the online training and continue to refresh their training on a 12 monthly basis.
Any concerns arising from this matter may be directed to the GP Support Directorate of Londonwide LMCs for further advice.