There are many different types of legal powers that a person can get that will allow them to manage the affairs, access information and make decisions for another individual who does not have the capacity to undertake these tasks. The most common one is Lasting Power of Attorney, although there are other such as Deputies and Litigation Friends (see national guidance on the Government's website).

Lasting Power of Attorney (LPA)

LPA is a legal document that lets an individual appoint one or more people (known as ‘attorneys’) to help them make decisions or to make decisions on their behalf. This gives them more control over what happens to them if they have an accident or an illness and can’t make their own decisions (they ‘lack mental capacity’). An individual must be 18 or over and have mental capacity (the ability to make their own decisions) when they make their LPA.

To be legal and valid, the LPA must be registered with the Office of the Public Guardian (OPG)

There are two types of LPA:

  1. Health and Welfare
  2. Property and Financial affairs.

An individual can choose to make one type or both. Both types of LPA allow an attorney to make a subject access request (SAR) on behalf of the individual, although such a request should be relevant, necessary and in the individual's best interests. 

If an individual is requesting access to a patient’s records using a LPA, then staff must check it is registered with the Office of the Public Guardian (OPG) by either:

  • Confirming it is stamped with ‘VALIDATED-OPG’ (if the individual has made an LPA online, they may have registered it at the same time. It is registered when OPG has stamped it with ‘VALIDATED-OPG’),
  • Checking via the online LPA summary if an LPA access code has been provided by the donor or attorney, or;
  • Contacting and checking directly with the OPG.

Please note that if a patient dies, then any LPA is not longer valid or applicable.

A health and welfare LPA gives an attorney the power to make decisions for an individual about things like:

  • Health and medical care
  • An individual’s daily routine, for example washing, dressing, eating, etc.
  • Moving into a care home
  • Life-sustaining treatment

It can only be used when the individual is unable to make their own decisions.

A property and financial affairs LPA gives an attorney the power to make decisions for an individual about money and property for things like:

  • Managing a bank or building society account
  • Paying bills
  • Collecting benefits or a pension
  • Selling their home

It can be used as soon as it is registered, with the individual’s permission.

An individual can choose one or more people to be their attorney. If they appoint more than one, they must decide whether the attorneys will make decisions separately or together. An attorney must be 18 or over and have the mental capacity to make their own decisions. An attorney could be:

  • The individual’s husband, wife or partner
  • Relative
  • Friend
  • A professional, for example a solicitor.

If an individual appoints more than one attorney, they must decide whether the attorneys will make decisions:

  • separately or together (sometimes called ‘jointly and severally’) – which means attorneys can make decisions on their own or with other attorneys, or
  • together (sometimes called ‘jointly’) – which means all the attorneys have to agree on the decision.

An individual can also choose to let attorneys make some decisions ‘jointly’ and others ‘jointly and severally’. Attorneys who are appointed jointly must all agree or they cannot make the decision.

Deputies

Someone can apply to become a patient's deputy if the patient ‘lacks mental capacity’. This means they cannot make a decision for themselves at the time it needs to be made. They may still be able to make decisions for themselves at certain times.

People may lack mental capacity because, for example:

  • they have dementia
  • they have severe learning disabilities
  • they’ve had a serious brain injury or illness

A deputy will be authorised by the Court of Protection to make decisions on their behalf. There are two types of deputy:

  1. Personal welfare deputy - gives power to makes decisions about medical treatment and how someone is looked after.
  2. Property and financial affairs deputy - gives power to do things like pay the person’s bills or organise their pension.

It can only be used to make decisions as specified in the court order.

Someone cannot become a patient's personal welfare deputy if they're under 16 years of age. Legal advice would need to be sort in such cases if it is felt that a court needs to make a decision about their care.

The court will usually only appoint a personal welfare deputy if:

  • there’s doubt whether decisions will be made in someone’s best interests, for example because the family disagree about care.
  • someone needs to be appointed to make decisions about a specific issue over time, for example where someone will live.

Litigation Friends

Children under the age of 18 and certain protected parties (those deemed to lack the mental capacity) cannot legally represent themselves in a court of law. They are represented instead by a Litigation Friend, somebody who acts on their behalf.

A litigation friend is someone appointed by a court to make decisions about a
court case for either:

  • An adult who lacks the mental capacity to manage their own court case either with or without a solicitor, or
  • A child.

The court can appoint anyone to be a litigation friend, for example:

  • Parent or legal guardian
  • Family member or friend
  • Solicitor
  • Professional advocate (e.g. an Independent Mental Capacity Advocate)
  • Court of Protection deputy
  • Someone who has a Lasting Power of Attorney
  • They are responsible for attending court if there is a hearing but they cannot

They act as the other person’s solicitor. They ‘direct the proceedings’ on behalf of
the other person. This means that they:

  • Make decisions in the persons’ best interests.
  • Do everything they can to tell them what is happening in the case and find out their wishes and feelings.
  • Talk to their solicitor about what’s happening, get advice from them and give instructions to them in the other person’s best interests.