What do NHS staff learn from training on the Mental Capacity Act (2005)?

Abstract

Purpose. Many studies have reported that professionals have a limited understanding of mental capacity issues. Implementation (in England and Wales) of the Mental Capacity Act (MCA) (2005) presents a challenge to services. The aim of this study was to evaluate the extent to which National Health Service (NHS) staff benefited from attending MCA training courses. Methods. Participants were assessed before and after MCA training using a structured interview, which included three scenarios describing mental capacity dilemmas, four vignettes addressing the role of the Independent Mental Capacity Advocate (IMCA), and 16 true–false items. Results. Interview performance improved post‐training, but this could be largely ascribed to an increased awareness of mental capacity issues, with minimal improvements in the knowledge that would be needed to undertake the assessments. Nine areas were identified where there remained significant gaps in participants’ knowledge post‐training. Participants with experience of dealing with mental capacity issues performed better than those without. Conclusions. The results suggest that methods other than formal training events may be needed to prepare health staff to implement new legislation.

How do health and social care professionals in England and Wales assess mental capacity? A literature review

“…Many health and social care professionals lack awareness of the requirements of the MCA and how to assess capacity and may not be confident about their practice [17]. Professionals report finding capacity assessment particularly challenging when it involves service users who have communication difficulties [18].…”

Health and social care practitioners’ experiences of assessing mental capacity in a community learning disability team

“…The current study supports previous studies (e.g. Samsi et al ., and Willner et al ., ) that indicate that the confidence of practitioners in undertaking assessments goes far beyond simply knowing the content of the MCA. It is evident that mental capacity assessments produce a range of challenges that can be difficult for even experienced health and social care practitioners to navigate.…”

“…A study by Willner et al, (2010) found significant gaps in knowledge of mental capacity issues amongst health and social care professionals within a community learning disability team, despite comprehensive training around mental capacity. A subsequent study identified that even with formal training events, some significant limitations with the NHS practitioners' understanding of capacity assessments remained, with evidence that many still performed poorly in relation to the conduct of the mental capacity assessment (Willner et al, 2013). The findings indicated that the main practical effect was to sensitise practitioners to the need to think about mental capacity, with little improvement shown in their practical ability to deal with mental capacity assessments.…”

What Are ‘Best Interests’? A Critical Evaluation of ‘Best Interests’ Decision-Making in Clinical Practice

“…217 However, even where training has been undertaken, an improved understanding of the principles of the MCA is not a given. Willner et al 218 conducted an evaluation of the knowledge and understanding of a group of healthcare practitioners 219 both before and after attending a combined MCA workshop and lecture. They found that although the sample had a good factual recall of key principles of the MCA, 220 they were less competent when applying those principles to practise-based scenarios.…”