Assessing Best Interests – Part 3

After some days back at work, the taught part of the Best Interests Assessor training resumed yesterday  – and almost magically as we were promised, lots and lots of the pieces seem to have fallen into place.

Just as a recap, this is a short university-level course which will enable me to act as a ‘Best Interests Assessor’ under the Mental Capacity Act 2005.  The basic version of it is that UK was found guilty of breaking the European Convention of Human Rights (Human Right Act 1998)  (Article 5 – liberty and security) with respect to people who are detained in residential care or in hospital and who lack capacity to make a decision as to whether they should be there or not.

Some of these people will be being deprived of their liberty and as such, a legal framework needed to have been put into place to ensure that these decisions were not made arbitrarily and that (although this is  probably something I’ll return to) they have some kind of leave to appeal these decisions made through legal processes.

The role of the Best Interests Assessor will be as a part of the process which will be put into place come 1 April to determine whether an order can be granted to deprive an individual of their liberty in this manner – or not.

That is a very brief summary which in fact, needed about a week of training to thrash out – so apologies if it is a bit over-simplistic.


Partly, I think because of how the course has been structured. I have found the content very interesting which surprised me – I didn’t really expect it to be as compelling. 

Although when I was at school, I did want to be a lawyer (as well as the person who quality tests crisps)  so perhaps it is that aspect that is coming to the fore now!

The people attending from a wide variety of boroughs have added enormously to the learning process as there is a massive amount of experience in the room to draw on and with some having been trained through the switch to the 1983 Mental Health Act and through the initial implementation of that legislation with all the attendant procedures.

The training that I am attending is specifically for people who are already working as AMHPs and honestly, I think that having even a little experience of working within the frameworks and procedures  serves as some advantage.

We are also all social workers, although the training allows for nurses, OTs and psychologists to train. I suspect it is because we are doing the training for AMHPs and almost all current AMHPs are social workers. But it will be interesting to see the mix across the board.

My own borough has mostly trained Best Interests Assessors because the issue of payments for people who are not employed by the local authority has not been settled yet.  We, the social workers, are employed directly by the local authority and seconded out to the Mental Health Trust – and the PCT and Local Authority have agreed a joint intake of assessments. The Mental Health Trust has not decided yet how to manage these additional payments to ensure equity.

Although the people involved in the training were very quick to highlight the differences  – they put it in terms that we are more acting like a Section 12 doctor (the independent doctors with additional training in psychiatry that we would be assessing with) where we provide advice and a professional assessment but the responsibility for organising the assessment and making the decisions based on the recommendations we make, remain with the Supervising Authority (which would be either the Local Authority (for registered care homes) or the PCT (for hospitals)).

So yesterday we discussed the detail. What we are actually expected to do as a part of the process of the assessment – from looking through the forms (there are, unsurprisingly, mountains) to the procedures for registering authorisations of deprivations of liberty – and much more discussion about the conditions (or rather the preferred lack of them).

A lot of the questions I had last week have been resolved – at least as best as they can be before the undeniable confusion that will develop in practice.

All this is in the detail and I don’t expect it to interest more than a couple of people but it was probably one of the most useful days that I’ve spent training.

We also had a Q&A session with the person who has been appointed as Best Interest Assessment/Mental Capacity Act lead in our borough (I’m not sure of the exact job title).

So we were told about the processes that have been going on over the last 18 months or so, at least in the London region and how we were actually going to be assigned (and paid for (hurrah!)) assessments. We have been agreed some kind of payment at least – although this might seem a bit mercenary, the work is likely to need a fair amount of time and attention and I didn’t think it was entirely fair (although I had expected it) that we would be expected to carry out an additional role without an additional payment.

The concerns I have now, at least about the process, have diminished considerably and I am starting to see how the pieces will fit together in a much more practical sense.

We have another day of training today though. It includes a legal test among other things.

And then I have some study days scattered over the next couple of weeks to complete the written pieces that we need to submit – just about in time for the 1st April.

Interesting times, indeed.