Brian Gerrard

The MATTERS OF CONCERN relate to (1) the understanding of staff in relation to the proper management of a best interests meeting, (2) the identification of lack of capacity and (3) the implementation of Deprivation of Liberty Safeguarding procedures. All such deficiencies appeared to warrant an amendment of procedures and a requirement for appropriate training.

On 26th September 2014 a best interests, multidisciplinary meeting was called at your hospital to decide upon what action to take to address the fact that the deceased was not eating sufficiently and might be close to death. Those present at the meeting included the deceased’s named nurse who took the minutes of the meeting, the deceased’s wife, a psychiatrist who was the deceased’s responsible clinician and a General Practitioner from the deceased’s medical practice. The meeting decided that it was in the deceased’s best interests to remain at your hospital rather than being transferred to a general hospital for treatment. In that regard the minute of the meeting correctly reflected what had been agreed. However, it was also minuted that the deceased had determined to die and that to achieve this aim he was deliberately not eating and that he had capacity to make such a decision. Such did not represent the opinion of the psychiatrist / responsible clinician nor the opinion of the general practitioner, both of whom were of the view that the deceased did not have capacity and that he had not formulated a plan to die but that his lack of eating was a product of his illness. Thereafter an application for a Deprivation of Liberty Safeguard contained inaccurate and contradictory information and appeared to demonstrate a lack of familiarity with procedures. For instance, the application asserted that the deceased had capacity to make decisions with regard to his care needs when such did not represent the opinions of the clinicians responsible for the deceased’s care.