VT v NHS Cambridgeshire And Peterborough Integrated Care Board
[2024] EWHC 294 (Fam)
Wiltshire County Council v RB & Ors
23 June 2023
[2023] EWCOP 26
Court of Protection
A woman didn't want to leave the hospital to go back to a place where she was hurt. The judge decided she couldn't make the decision for herself, but a higher court said the judge made a mistake by not looking at the hospital discharge and where she should live as separate issues. They sent the case back to be decided again properly.
Key Facts
- •RB, a 29-year-old woman with Autism Spectrum Disorder, lacks capacity to consent to hospital discharge to a bungalow and to decide on personal care.
- •RB has a history of unsuccessful placements and self-harm.
- •RB's previous stay at the bungalow resulted in self-harm and distress.
- •The hospital wishes to discharge RB, but an alternative placement is needed.
- •The appeal concerns the judge's approach to capacity assessment, specifically the conflation of discharge and living arrangements.
- •Expert evidence was deemed to have insufficient weight given to RB's wishes and feelings.
Legal Principles
The court must correctly identify the matter in issue and the relevant information for a capacity decision, including reasonably foreseeable consequences.
A Local Authority v JB [2021] UKSC 52, paras 68 and 69
Capacity is decision-specific.
MCA 2005 s2 and A Local Authority v JB [2021] UKSC 52 at 67-71
The court must not adopt an 'outcome approach' that is inconsistent with patient autonomy.
R v Cooper [2009] 1 WLR 1786, para 13
A person is presumed to have capacity.
MCA 2005 s1(2)
The decision on capacity rests with the judge, not the expert.
An appeal will be allowed if the first-instance judge's decision was wrong.
Court of Protection Rules 2017, rule 20.14
Outcomes
Appeal allowed.
The judge wrongly conflated the decisions regarding hospital discharge and living arrangements, failing to consider them separately. Insufficient weight was given to RB's wishes and feelings, and the decision regarding personal care lacked adequate reasoning.
Case remitted for rehearing.
The rehearing should address capacity and best interests separately regarding litigation capacity, hospital discharge, living arrangements, and personal care.