Decision-making and mental capacity

Implementation resource to help you put the NICE guideline into practice

Image of an elderly lady with a carer, looking at a computer tablet. Image of an elderly lady with a carer, looking at a computer tablet.

The Care Quality Commission (CQC) estimates that around 2 million people in England and Wales have an illness, injury or disability that means they may lack the capacity to make certain decisions for themselves at some point.

The Mental Capacity Act 2005 was designed to empower and protect people in these circumstances. However, the CQC found that the Act wasn’t being implemented consistently and staff were not always clear about its requirements. A 2014 House of Lords Select Committee report identified similar issues.

The Department of Health commissioned NICE to develop a guideline on decision-making and mental capacity. The guideline covers best practice in assessing and supporting people aged 16 and older with decision-making, and should be used alongside the Act.

The guideline focuses on the following key areas:

  • advance care planning
  • supporting decision-making
  • assessment of mental capacity to make specific decisions at a particular time
  • best interests decision-making for individuals who are assessed as lacking ​ capacity to make a particular decision at a particular time.

Practical resources

To help you put the NICE guideline into practice we have brought together tools and resources from a wide range of organisations.

These resources have not been endorsed by NICE. If you have any questions about a particular tool, please contact the organisation responsible for it, as listed in the table below.