How a patient is treated depends on whether they have mental capacity to make their own choices.

Patients who have mental capacity can make any decisions they want to; as long as they have been properly informed and the decision is voluntary. In this training programme we will look at mental capacity assessments, consider what constitutes a voluntary decision and learn how much treatment information should be given.

If a patient lacks mental capacity he or she will be treated under the common law, or pursuant to the provisions of the new Mental Capacity Act 2005 (MCA). We will be looking at both areas in detail.

We will also consider specific patient groups, such as children and mental health patients, where treatment rules differ from those set out in the flow chart below. There is also a new module, which deals specifically to consent issues relating to the Human Tissue Act and postmortems.

The flow chart is a useful starting point for whenever you have a consent query. It illustrates the stages you should go through (and document) when obtaining informed consent or treating those who cannot give you informed consent. [Note: the flow chart summarises the legal framework and should be regarded as an exposition only]

You can remind yourself of this flowchart by clicking the "chart" button at the top of the page at any time.

The training programme will take you through 21 modules, each containing approximately 5 case studies.

Each case study will present you with a question and will ask you to select an answer. Once you have selected an answer you will be told whether you are right or wrong and the principles and law will be explained.

Your selected answers will determine your score for the module, and your score (as a percentage) is displayed within the module menu page, where you have the facility to print out your progress and score. You may wish to keep a record of your performance in your education and training diary.

Once you have started a module you will not be able to “back track” to previous questions, until you have completed the module in it’s entirety and the “completed” box is ticked on the module menu page. Once a module has been completed in full, then you can revisit and revise this module as many times as you wish, however your subsequent answers will not affect your original score. If you do wish to “archive” your earlier stored answers and be re-scored for the training, then you will need to contact the Trust ICON Administrator(s), , who can facilitate this for you.

Please bear in mind that each case study has been designed to test your application of the principles of consent, not your clinical knowledge. You will therefore be able to complete the case studies even if you have no direct knowledge of the clinical settings being examined. For example, even if you never treat children or those under section you should still complete these modules. The programme is designed to be cumulative and each module will re-affirm key learning points.

We wish you an enjoyable and challenging learning experience.

About the authors

Kate Hill
Kate is a practising solicitor at RadcliffesLeBrasseur, and has been an associate partner since 2000. She specialises in medical law and ethics, with a background in clinical negligence. She advises Trusts, Private Healthcare Organisations and Professional Bodies on risk management, policy and procedure and generally deals with the "weird and the wonderful". She is also a member of the RadcliffesLeBrasseur's mental health team where she assists clients at inquests and with untoward incident management. Her particular areas of interest are consent and clinical research on which she has written and lectured extensively in the UK and worldwide.

In an independent evaluation conducted in November 2004 over 1,000 healthcare professionals rated Kate as one of the leading and most effective healthcare trainers in the UK. Kate is Managing Director and Senior Trainer at InPractice Training, a subsidiary of RadcliffesLeBrasseur.

Joanne Haswell
Joanne is a barrister (non-practising). She specialises in the provision and development of legal training and education specifically for the healthcare sector.

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InPractice & Dumas 2008