NHS deputy chief executive David Flory has written to chief executives and PCTs urging them to ensure rules on when patients can be deprived of their liberty are followed.

His letter comes after a report by the Care Quality Commission suggested there was a lack of awareness, training and understanding by staff and some managers on when the Mental Capacity Act Deprivation of Liberty Safeguards framework should be used.

Mr Flory’s letter of 4 April also highlighted significant under-reporting by providers and hospitals of the notifications they are obliged to make to the CQC.

He told managers: “Staff need to know when and how to request a DOLS authorisation. PCTs need to continue to encourage, facilitate and audit awareness and compliance with the [Act] in all hospital settings.”

Mr Flory called on managers to ensure relevant staff were made aware of the report, adding: “MCA practitioners and legal advisers in hospitals need to be supported and funded to be able to ensure that there is widespread compliance with all aspects of the MCA including DOLS, and that all departments within hospitals know when to request authorisation, how to do so, and who within the organisation is responsible for the processes including that of notifications to CQC.”

The safeguards on depriving people of their liberty were brought in to force in 2009 and aimed to create a legal framework to protect the human rights of patients who need hospital treatment but are unable to give their consent to measures which could amount to restricting their freedom.

This often includes patients with dementia, brain injuries and people with severe learning disabilities.

The CQC found large variations in practice across the country and while most hospitals had carried out training, this ranged from between 20 and 100 per cent of staff.

A copy of the report can be found at: http://www.cqc.org.uk/dolsreport.

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