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Deprivation of Liberty Safeguards in England: implementation costs

  • Ajit Shah (a1), Mark Pennington (a2), Chris Heginbotham (a1) and Cam Donaldson (a3)
Abstract
Background

The Deprivation of Liberty Safeguards (DoLS), introduced into the Mental Capacity Act 2005, were fully implemented on 1 April 2009 in England and Wales. The government estimated 20 000 assessments for DoLS at a cost of £600 per assessment.

Aims

To estimate the costs likely to be incurred with the implementation of DoLS in England.

Method

The cost of conducting a single DoLS assessment was estimated using resource-utilisation data ascertained from 37 professionals, secretarial staff and independent mental capacity advocates involved with DoLS assessments in six diverse local DoLS offices.

Results

The estimated average cost of a single DoLS assessment was £1277.

Conclusions

The estimated average cost of a single DoLS assessment was significantly higher than the £600 estimated by the government. However, the allocated budget, based on 20 000 estimated DoLS assessments in the first year of its implementation, is likely to be adequate because a significantly lower number of assessments (only 5200) were conducted in the first 9 months after its implementation.

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Copyright
Corresponding author
Ajit Shah, West London Mental Health NHS Trust, Uxbridge Road, Southall, Middlesex UB1 3EU, UK. Email: ajitshah123@btinternet.com
Footnotes
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The Nuffield Foundation funded this project.

Declaration of interest

C.H. was the Chief Executive of the Mental Health Act Commission until 31 March 2008.

Footnotes
References
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1 HL v UK. European Court of Human Rights (application no. 45508/99). Judgment, Strasbourg, 5 October 2004.
2 Shah, AK, Heginbotham, C. Newly introduced deprivation of liberty safeguards: anomalies and concerns. Psychiatrist 2010; 34: 243–5.
3 Ministry of Justice and Department of Health. Impact Assessment of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards to accompany the Code of Practice and Regulations. Department of Health, 2008 (http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_084984.pdf).
4 Department of Health. Mental Capacity Act 2005 Deprivation of Liberty Safeguards Implimentation/Commissioning Q&A. Department of Health, 2009 (http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_094793.pdf).
5 Shah, AK, Banner, N, Heginbotham, C, Fulford, B. The early experience of old age psychiatrists in the application of the Mental Capacity Act 2005: a pilot study. Int Psychogeriatr 2010; 22: 147–57.
6 Shah, AK, Banner, N, Heginbotham, C, Fulford, W. A pilot study of the early implementation of the Mental Capacity act 2005 in England and Wales: the experience of consultants in Old Age Psychiatry. Med Sci Law 2010; 50: 131–5.
7 Shah, AK, Banner, N, Heginbotham, C, Fulford, B. The application of the Mental Capacity Act 2005 among geriatric psychiatry patients: a pilot study. Int Psychogeriatr 2009; 21: 922–30.
8 Shah, A, Heginbotham, C, Fulford, W, Banner, N, Newbiggin, K, Kinton, M. A pilot study of early experience of consultant psychiatrists in the implementation of the Mental Capacity Act 2005: local policy and training, assessment of capacity and determination of best interests. J Ment Health Law 2009; Winter: 149–64.
9 Department of Health. IMCA Organisations Apppointed: As at 16th October 2009. Department of Health, 2009 (http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@pg/documents/digitalasset/dh_107198.pdf).
10 Raikou, M, Briggs, A, Gray, A, McGuire, A. Centre-specific or average unit costs in multi-centre studies? Some theory and simulation. Health Econ 2000; 9: 191–8.
11 Curtis, L. Unit Costs of Health and Social Care 2009. Personal Social Services Research Unit, University of Kent, 2009.
12 Office for National Statistics. Annual Survey of Hours and Earnings (ASHE) – 2003 Results. Office for National Statistics, 2009 (http://www.statistics.gov.uk/statbase/Product.asp?vlnk=13107&More).
13 National Association for Voluntary and Community Action. Local Authority Mileage Rates 2007/08. NAVCA, 2007 (http://www.voscur.org/system/files/16mileage.pdf).
14 Department of Health. “Bournewood” Consultation. The Approach to be taken in Response to Judgment of the European Court of Human Rights in the “Bournewood” Case. Department of Health, 2005 (http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Consultations/Closedconsultations/DH_4113613).
15 Care Quality Commission. Annex B: Deprivation of Liberty Safeguards. CQC, 2010 (http://www.cqc.org.uk/_db/_documents/20100211_CM100105_Annex_B_Deprivation_of_liberty_safeguards.doc).
16 Cairns, R, Richardson, G, Hotopf, M. Deprivation of liberty: Mental Capacity Act safeguards versus Mental Health Act. Psychiatrist 2010; 34: 246–7.
17 Lepping, P, Sambhi, RH, William-Jones, K. Deprivation of Liberty Safeguards: how prepared are we? J Med Ethics 2010; 36: 170–3.
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  • EISSN: 1472-1465
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Deprivation of Liberty Safeguards in England: implementation costs

  • Ajit Shah (a1), Mark Pennington (a2), Chris Heginbotham (a1) and Cam Donaldson (a3)
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