Compendium of acronyms and terms I have come across when dealing with the English Mental Health System


Please be aware these details are from my memory and experiences when dealing with these Laws and Institutions (they may not be fully accurate).

I state English in the title as there are slight variations in meaning and implementation depending on where the person who lacks Mental Capacity resides within the UK.

This post intends to provide a simpler explanation for the listed terms in a single reference so they are easier to understand. However, this information is a starting point, if you find yourself in the same situations as I did you'll need to delve deeper.

I have placed my thoughts within { Curly brackets }

Court of Protection

LPA - Lasting Power of Attorney

A person (when they have the Mental Capacity) can grant a trusted relative or friend control of their Health and Welfare, Property and Financial Affairs, or both.
When this is done, the trusted relative or friend is entitled to make decisions on behalf of the person lacking capacity as though they are the person lacking capacity.
These arrangements can be registered with the Court of Protection.

If a Lasting Power of Attorney has not been put in place before the person loses capacity, the Court of Protection can:

  1. Determine if a person lacks mental capacity.

  2. Appoint Deputies to manage the affairs of a person who lacks mental capacity, however other close relatives get a say on whether they want them to perform this duty.
    Both or one of the following can be asked for: Health and Welfare or Property and Financial Affairs, however, Health and Welfare are allegedly very difficult to obtain.

  3. Consider objections to DoLS (Deprivation of Liberty / Safeguarding), when an objection is raised under Section 21a of the Mental Health Act.

  4. Consider and agree to big one-off decisions such as buying or selling property on behalf of the person who lacks capacity.

Order - A document containing the terms and conditions that must be adhered to by the Deputies when carrying out their duties.

Deputy Bond - Insurance Policy required by Deputies that pays out if the Deputy is found to have abused their position - The premium is paid from the funds of the person who lacks capacity.

Joint Deputyship - Decisions, payments etc have to be agreed upon and signed by all Deputies.

Joint and Several Deputyship - Deputies can operate autonomously and only one needs to agree or sign.

CQC - Care Quality Commission

A department of the Local Authority that assists with locating and overseeing Care Services in the local area.

If you have concerns regarding the care your relative is receiving, it can be reported to this department and they will investigate the concerns.

DoLS - Deprivation of Liberty Safeguarding

This is a legal requirement for the State to Deprive a person who is deemed to lack capacity of their liberty without the person's consent.
DoLS is overseen by the Local Council.


  1. DoLS Authority - Location / Professionals where the Deprivation of Liberty is enforced, if the Relevant Person changes location a new DoLS must be requested by the new Authority.

  2. DoLS Team - Department of the local Council that deals with DoLS requests.

  3. DoLS RPR - A person who becomes the Relevant Persons Representative (The Relevant Person is the person who is deprived of their liberty).

  4. DoLS Advocate - If the DoLS RPR is not a Social Services Professional, then an Advocate can be appointed to assist the RPR in their responsibilities.

  5. DoLS S21a Challenge - If the Relevant Person displays any indication of wanting to leave the DoLS Authority this Section (21a) should be invoked by the DoLS RPR.
    This triggers a Court of Protection hearing to determine the best interest decision for the Relevant Person and where they should live to meet their needs.

  6. DoLS Form #1 - Document filled in by a DoLS Authority that deems a DoLS is required. This document starts the process of requesting a DoLS to legally deprive someone who is deemed to lack Mental Capacity of their liberty.
    The first DoLS will expire after 3 months, and the second after 6 months. After this, a DoLS is granted for 12-month periods.

  7. DoLS Form #3 - Document completed by a DoLS Best Interests Assessor to determine if the DoLS is in the Relevant Person's best interests to be Deprived of Liberty.

  8. DoLS From #4 - Document completed by a Medically Qualified Psychologist to assess a person's capacity to make reasoned decisions for themselves.

  9. DoLS Form #5 - Form presented to the RPR for them to accept the responsibility of the post of RPR.

  10. DoLS Form #10 - Document raised by the DoLS Authority to change the conditions imposed by the DoLS, for instance how and when measured responses can be made during difficult behaviour.

  11. Emergency DoLS - If a DoLS is required in a new Authority, a 7-day DoLS can be imposed immediately without officially applying. A second 7 days can be imposed, but agreement must be sought from the DoLS Team. If a longer DoLS is needed a DoLS From #1 must be submitted.

NHS - Healthcare

Adult Safeguarding - Contact this Hospital Team if you have Safeguarding concerns during your relative's stay at the Hospital.

{ Like when they try to send your relative home in a Taxi, and they are the subject of a DoLS )

Community Mental Health Team - Team responsible for taking over from the RITT team.

RITT - Rapid Intervention and Treatment Team - A team of mental health medical professionals, who are initially called in to deal with a situation, after the initial period is over responsibility will be passed to the Community Mental Health Team.

Titration - Gradually introducing a patient to a drug in incremental amounts.

(Drug Name) PRN - A prescribed drug where the nurses decide situationally when and at what dose the medication should be prescribed. eg Lorazepam PRN

Waterlo - A medical methodology for determining a numeric value to demonstrate how thin a patient's skin is and how likely the skin is to tear. The higher the number, the greater the risk of tearing.

NHS CHC - NHS Continuing Health Care

As far as I can tell, when the NHS was written into UK law it became responsible for The care and aftercare of injuries, diseases and illnesses.

However, if you have a long-standing health issue, NHS CHC has to be applied for and justified before a person becomes eligible for this support that pays all medical costs, including residential costs if necessary.
With Care Home residency costs of £800 or considerably more, this can be a considerable expense.

It may be decided that you are not eligible for NHS CHC, but have some medical needs, in this case, you may be awarded NHS Funded Nursing Care. This will provide a weekly fund for medical treatments depending on the person's needs. Residency costs are not included in this award.

The NHS should provide these services for free at the location they are required.

NHS CHC has been in the media several times and is the subject of BBC Dramatization 'Care' (TM) which aired in the UK on Sunday 9th December 2018.

{ Little did I know when watching this program on TV, that NHS CHC would feature prominently in my life in 2020 / 2021 }


  1. National Framework - A lengthy document stating in detail how NHS CHC applications should be processed.
    { This document is your friend }

  2. NHS CHC Checklist - A process completed by the Hospital or Social Services to determine if there is a good enough case to advance to a Multi-Disciplinary Meeting.

  3. NHS CHC Multi-Disciplinary Meeting - This is a meeting between the multiple disciplines of a Medically Qualified Assessor, Social Services, the Care staff (if Carers are employed) and the person applying for CHC either for themselves or a family member (if the person applying lacks mental capacity).
    { This took me ages to understand as I imagined an NHS Multidisciplinary Meeting for someone with several medical issues would involve representatives from Multiple Medical Disciplines, not a Medical Nurse and Social Services. }
    An arbitrary window of time will be chosen by the Nurse Assessor to review evidence of the person's needs, this can be as little as a week.

  4. DST - Decision Support Tool - A document used in the Multidisciplinary meeting to record the needs of the person being assessed for CHC.
    { This document is not your friend }

  5. NHS CHC Appeal - To be able to Appeal you have to show that the rules weren't adhered to in the Multidisciplinary Meeting.

You cannot as far as I can tell Appeal just because you didn't like the decision made at the Multidisciplinary Meeting, you can only Appeal on a technicality.

Common Technicalities (mistakes) that can lead to an Appeal:

  1. The Nurse Assessor takes control of the meeting and there is little or no input/comments from Social Services, or visa versa.

  2. The list of attendees to the meeting is not accurate. (people joining /leaving partway through the meeting are not recorded)

  3. The period used to determine a person's needs is deemed insufficient. (you can complain about the period used, they decide if it was too short)

  4. Incorrect details for medication, and medical history.
    They deem that only the last 12 months of medical history is relevant, eg 2 instances of falling that are over twelve months old are not a Medical History of Falls, but one fall 11 months ago is.

  5. Evidence submitted by the Family is disregarded / not documented.

  6. The evidence used is shown to be flawed.

{ Yes I know all these reasons because I appealed using all of them! }

OPG - Office of the Public Guardian - An agency of The Ministry of Justice.

When a Lasting Power of Attorney is created it can be registered with the Office of the Public Guardian.

Fees - There is a £100 charge for an initial, introductory (compulsory) meeting to discuss the role and a further £320 per year administration fee.
These fees are paid by the person who lacks capacity.

Lay Deputy Support Team - A Team that supports Deputies in their duties.
{ you email them and they respond within 10 days, that's what they tell you; my experience was different. }

A website has to be updated constantly with Major decisions made by the Deputies, income, outgoings, bank accounts, bank transfers, assets, and Decisions about Care as Deputies are also responsible for the Health and well-being and providing for the person's needs and desires, making sure their money is spent on them for trips or excursions, treats, clothing etc
The Deputies also have a responsibility to make sure they try to get value for money on behalf of the person whose finances they are managing.

The Office of the Public Guardian can be contacted to find out who the Attorney, Deputy or Guardian are of a person who lacks Mental Capacity.

Social Services

Adult Safeguarding - A Team that handles Safeguarding complaints or concerns regarding vulnerable people in the community.


Ink Copy - The original copy of a Will, if you don't have the original ink-signed copy, you don't have the Will.

Dying Intestate - Dying without having a valid Will.

If you have a valid copy of a Will:

Executor - The Person(s) mentioned in the Will who will execute the Will.

Grant of Probate - Executors named in the Will need to Apply for a Grant of Probate before they are allowed to execute the Will.

If Intestate:

Grant of Letters of Administration - This will need to be applied for and will name the successful volunteers to become Executors of the Will and how they must Execute the Will. Only close Relatives of the Deceased can inherit in these circumstances.

Well, that's it, folks, I'm sure I'll think of more after I press submit.