Changes to mental health law and practice are likely to follow the judgment of the House of Lords in L v Bournewood Community and Mental Health trust, in which the law lords approved the practice of informally admitting apparently compliant patients who lack the capacity to consent.

The law lords reversed an Appeal Court judgment forcing thousands of patients with dementia and learning disabilities, previously held informally, to be sectioned. But the case exposed the lack of safeguards for these patients compared with those sectioned under the Mental Health Act.

The Department of Health has issued guidance stressing that compliance should not be assumed if the patient's intentions are unclear. It is consulting with practitioner and patient groups on what extra safeguards should be built into the system.