Mental Capacity Act reform stalled: urgent action needed as system unravels - SCIE press release 26th August 2025
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Mental Capacity Act Reform Stalled: Why Urgent Action Is Needed
The Mental Capacity Act (MCA) underpins some of the most sensitive decisions in care – from medical treatment to financial control, and from safeguarding to lawful deprivation of liberty. Yet, the system is now in crisis.
A new analysis by the Social Care Institute for Excellence (SCIE) shows how failure to act on long-promised reforms is leading to unlawful detentions, preventable deaths, and widespread human rights risks.
A System Under Strain
The Deprivation of Liberty Safeguards (DoLS), introduced to protect people in hospitals and care homes, have collapsed under rising demand. In 2023/24 there were 332,000 DoLS applications, compared with the Government’s original forecast of just 21,000 per year.
Only 19% were completed within the 21-day legal deadline.
Many people wait 12–18 months for assessments.
67% of local authorities inspected by CQC were told to improve their DoLS arrangements.
Staff shortages and outdated guidance are leaving councils overwhelmed.
The result? Thousands of people with dementia, learning disabilities, autism or serious illness are deprived of their liberty without legal authority.
Reform Frozen
The Liberty Protection Safeguards (LPS), designed to replace DoLS, were passed into law in 2019 but implementation has been paused since 2020. Five years on, nothing has moved forward – leaving services trying to operate within a framework widely acknowledged as broken.
This instability also threatens new legislation. The Mental Health Bill 2025 and the proposed Terminally Ill Adults (End of Life) Bill both rely on the MCA to function. Yet without a robust, updated MCA framework, these reforms risk being built on shaky ground.
What Needs to Happen
SCIE’s Chief Executive, Kathryn Marsden OBE, is calling for urgent steps now – not in another five years’ time:
A clear Government roadmap for MCA reform and LPS implementation.
Updated Codes of Practice (unchanged since 2007).
Investment in training, supervision and workforce development.
Stronger CQC oversight of how the MCA itself is applied.
Revisiting LPS principles to make safeguards more flexible and person-centred.
Why This Matters
Every day, people are deprived of their liberty without proper safeguards. This isn’t just a bureaucratic backlog – it’s about rights, dignity and protection for the most vulnerable in society.
The message is clear: the MCA is the bedrock of our care system. Without urgent reform, everything built on it – from safeguarding to new mental health and end-of-life laws – risks collapse.