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Fears for dementia 'second class citizens' as DoLS hit new record high

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Applications under deprivation of liberty safeguards reached a new record in 2015-16, prompting fears thousands of people may be being wrongfully constrained as the system struggles to cope.

New figures from NHS Digital reveal DoLS applications to councils from care providers increased to 195,840 in 2015-16, from 137,540 in the previous year.

This compares to 13,700 in 2013-14 before a Supreme Court ruling in 2014 changed established practice. This judgement said patients judged to lack the mental capacity to consent to their care should be the subject of a DoLS application when they were under continuous control and not free to leave their care setting.

The report says numbers have now stabilised at around 15,000 applications a month following month-on-month growth during 2014-15.

However, the figures show councils are struggling to get on top of the backlog. Nationally, the total number of applications completed in 2015-16 was 105,055 with dementia cited as the most common primary disability. This was a 68% increase on applications completed in the previous year but means tens of thousands of cases are still awaiting resolution.

In addition, of applications submitted in the last financial year, 27% were not granted.

The Alzheimer’s Society say this led to just under 30,000 people being wrongly deprived of their liberty, as it is general practice to put a care plan in place before the DoLS application process is completed.

Senior policy officer Martine Kane said DoLS were essential to protecting the right to liberty of people with dementia.

She added: “It is disgraceful that nearly 30,000 people were wrongfully deprived of their liberty, and in over a quarter of cases practitioners are still locking people in, sedating them, restraining them or otherwise treating them as second class citizens.”

In normal circumstances, councils are required to process an application within 21 days. But the figures show just under a third were completed within the timeframe.

There is wide variation in time taken across the country, with 40% of applications processed within 21 days in the North East and 18% in the South West and West Midlands.

The figures also show large variations in the levels of applications made across England in 2015-16, with 900 per 100,000 of the population in the North East, compared to 319 in London.

The Local Government Association estimates the increase in DoLS assessments costs councils £170m a year.

The Department of Health has asked the Law Commission to review the current system and in May this year it concluded the existing system of deprivation of liberty safeguards needed to be completely overhauled.

Izzie Seccombe, chairman of the LGA’s community wellbeing board, described the new figures as “alarming”.

She added: “Councils are doing everything they can to protect the rights of the most vulnerable people and will continue to prioritise those most in need.

“But the government needs to fulfil its promise to overhaul the system as a matter of urgency and provide adequate funding so that councils have the time and money to do this properly.”

A spokesperson for the Department of Health said: “We commend the hard work that local authorities are doing to make sure that vulnerable people receive the least restrictive care possible.

“We have asked the Law Commission to review the Deprivation of Liberty Safeguards and expect it to report later this year.”



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