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Acute Problems As Officials Struggle To Cope With Demand For 'Living Wills'
A surge in demand for so-called ‘living wills’ has resulted in people planning to refuse life-prolonging care in the event of becoming seriously ill being treated against their wishes.
Research by one of the country’s leading law firms has discovered that the number of Britons making Lasting Power of Attorney (LPA) documents has almost doubled in the last two years.
Elaine Roche, a Partner in the Private Client department at JMW Solicitors, said her study had revealed that the Office of the Public Guardian (OPG), the Birmingham-based body responsible for recording all LPAs, was struggling to cope with the increase.
She explained that delays in processing the documents had already resulted in individuals who had already executed an LPA receiving hospital treatment which went against their wishes.
“The last few years have seen a quite dramatic increase in men and women of all ages making LPAs, due in part to concerns about the impact of dementia and the desire to determine what should happen to them if they should lose the mental capacity to take decisions about their own affairs.
“There is a need to make sure that they formally grant authority to someone to act on their behalf before the worst actually happens. Even so, it is currently taking about three months to have LPAs registered by the Office for the Public Guardian.
“That delay is already creating difficulties because they aren’t valid documents without registration. It means that someone who has possibly already stated their intentions to refuse treatment may lose capacity before their wishes become legally enforceable.
“Such hold-ups also prevent doctors finding out if a patient might have made clear that they want to refuse medical support. I am aware of instances in which that has already happened.
“It’s understandable that a doctor or nurse in a hospital’s A&E department may care for someone in need first and ask questions later but treating someone despite an LPA being in place is now a professional offence.
“As LPAs become even more popular, there is every likelihood that the backlog may get worse and the problems could become even more acute without resources to speed up the registration process.”
Powers of Attorney for financial affairs have existed for a number of years but, since the Mental Capacity Act 2005, people have been able to authorise individuals to make decisions about their health and welfare, including decisions about whether to accept or refuse life-sustaining treatment, should they be unable to do so themselves in the future.
Known as Lasting Powers of Attorney for Health and Welfare, they came into effect in October 2007.
Mrs Roche described how analysis of official data revealed that 510,925 people made LPAs during 2015, up 89 per cent on the figure for 2013. She added that the number of LPAs drawn up by JMW had increased almost three-fold over the same period.
In February 2015, the Prime Minister unveiled plans to make the UK the world’s most dementia-friendly country within five years. His ‘Challenge on Dementia 2020’ set out an ambition to raise awareness of the condition and increase the sums made available for research as well as noting the value of LPAs.
The need for improvement was later made clear by statistics showing that 800,000 people in the UK have dementia, a number which is set to double by 2040.
Whilst the OPG has declared an objective of registering all LPAs within 40 business days, it has admitted taking more than twice as long on occasion to process the forms.
It conceded that the recent rise in applications had placed “significant pressures” on “ageing technology” but said more staff had been taken on and were even working seven days a week to deal with the extra volume.
Mrs Roche, who was speaking ahead of the start of Dementia Awareness Week (May 15th – 21st), said it was currently taking three months for LPAs to be registered and returned to the individuals making them.
In May 2011, the medical regulator, the General Medical Council (GMC), issued guidelines making it a professional offence for a doctor to ignore the requests of such patients, even if they believe they can be saved.
Mrs Roche explained that those making LPAs were encouraged to inform clinicians as soon as they had done so to avoid complications.
“The time taken by health professionals to access the register of LPAs held by the Office for the Public Guardian creates potential uncertainty which could undermine individual intentions.
“Telling your local GP or hospital consultant so that the documents become a matter of medical record is an essential step and one which I believe is helpful to both patient and doctor alike.
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