Cervical Screening and the Mental Capacity Act [2005] Statutory requirements of the Mental Capacity Act [2005] All adults should be presumed to have capacity [Mental Capacity Act -2005] unless the opposite has been demonstrated. Consent must be obtained by the person undertaking the procedure and is specific to the decision to be made Guidance from NHS Cancer Screening Programmes 2nd Ed [2009] Call or recall for cervical screening Test for Capacity: Understand the information given to them Retain the information long enough to make the decision Weigh up the information available to make the decision Communicate the decision Does the woman have the capacity to consent Following assessment of Capacity – The woman DOES NOT have capacity Unsure Yes Assess capacity to consent Respect the wishes of the person. Is there an Advance Decision or a Lasting Power of Attorney or deputy? Valid Consent is: Given by a competent person Be given voluntarily Given following receipt of adequate information See Test for Capacity A person with Capacity has the right to make what might be seen to be eccentric or unwise decisions Clarify what is Valid Consent Yes No You must consult The decision to screen or not, must be made in a persons best interests All practicable steps: Consider use of real objects or photographs/ Arrange visits to treatment areas Develop information packages that are accessible Give the person extra time Every person has the right to be supported to make their own decision Has/ ensure that all practicable steps been taken to ensure understanding Arrange a best interests meeting ;and follow the best interests pathway Least restrictive option: Anything done for or on behalf of a woman without capacity should be the least restrictive to their basic rights and freedoms In most cases, the least restrictive option is for the person to remain in the call/recall and receive screening at routine intervals. The invitations can be considered and accepted or declined on each occasion No Can a woman be ceased from the programme Best Interests: Anything done for and or on behalf of a woman without capacity must be in the person’s best interests A best interests meeting should include all relevant parties include the woman, GP/ Doctor, relevant health professionals, and or people who know the woman well Are the reasons for ceasing in line with the guidance from NHS Cancer ~Screening Programmes Ceasing from cervical screening call and recall If a woman has no cervix If an informed decision has been made If a woman has undergone radiotherapy for cervical cancer If a woman lacks capacity to consent and a decision to remove has been made appropriately that it is in her best interests Yes No Is this in the womans best interests and/or the least restrictive option for the woman Author: Allyson Kent (2011)