1. 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)