Consent and Mental Capacity Policy – Private Services & GLP-1 Prescribing

1. Purpose

To ensure that consent is obtained lawfully, ethically, and consistently for private healthcare services, including GLP-1 weight‑management prescribing, and that individuals are supported to make informed decisions in line with the Mental Capacity Act 2005, professional standards, and regulatory expectations.

2. Scope

This policy applies to all staff involved in providing assessment, prescribing, treatment, monitoring, or advice within the private service, including face‑to‑face and remote consultations.

3. Legal and Professional Framework

• Mental Capacity Act (MCA) 2005 and Code of Practice

• Common law principles of consent

• GMC, NMC, HCPC professional standards

4. Key Principles of Consent (Private & GLP‑1 Context)

• Consent must be voluntary, informed, and given by a person with capacity

• Individuals must understand that treatment is private, including costs and prescribing arrangements

• Consent is an ongoing process, particularly for long‑term medicines such as GLP‑1 agonists

• Consent may be verbal or written, but must always be documented

• Individuals may withdraw consent at any time without prejudice

5. Mental Capacity Act – Five Statutory Principles

All staff must apply the following principles:

1. A person is assumed to have capacity unless proven otherwise

2. A person is not to be treated as unable to make a decision unless all practicable support has been given

3. A person is not to be treated as unable to make a decision merely because they make an unwise decision

4. Any act done for a person lacking capacity must be in their best interests

5. Any action must be the least restrictive option

6. Assessing Capacity

Capacity is decision‑specific and time‑specific.

A person lacks capacity if they cannot:

• Understand relevant information

• Retain that information long enough to make a decision

• Use or weigh that information as part of the decision‑making process

• Communicate their decision (by any means)

Capacity assessments are particularly important where:

• Treatment is elective or privately funded

• Medicines carry significant side effects (e.g. GLP‑1 therapies)

• There is concern about coercion, unrealistic expectations, or vulnerability

All capacity assessments must be clearly documented.

7. Informed Consent for GLP‑1 Prescribing

Before initiating GLP‑1 treatment, the prescriber must ensure the individual understands:

• The licensed and/or off‑label status of the medicine (where applicable)

• Expected benefits and realistic outcomes

• Common and serious side effects (e.g. nausea, vomiting, GI symptoms)

• Potential risks and contraindications

• The importance of adherence and follow‑up monitoring

• That medication is part of a wider clinical approach, not a standalone cure

• Financial implications, including ongoing private costs

Written consent is required for:

• Initiation of GLP‑1 medication

• Off‑label use

• Any treatment with significant or ongoing risk

8. Remote Consultations and Digital Consent

Where consultations are conducted remotely:

• Identity must be verified

• Capacity must still be assessed

• Information must be provided in an accessible format

• Consent must be explicitly recorded

Digital or electronic consent is acceptable provided it is auditable and secure.

9. Lack of Capacity and Best Interests Decisions

If a person lacks capacity:

• GLP‑1 prescribing must not proceed unless clinically justified and lawful

• A best interests decision must be made and documented

• Family, carers, or advocates should be involved where appropriate

• Any legal authority (LPA, Court of Protection) must be respected

10. Refusal or Withdrawal of Consent

• A person with capacity may refuse or discontinue treatment at any time

• This must be respected and documented

• Risks of stopping treatment should be explained clearly

• Supportive follow‑up should be offered

11. Documentation and Record Keeping

Records must include:

• Capacity assessment (where applicable)

• Information provided about GLP‑1 treatment

• Consent obtained (verbal or written)

• Any refusal or withdrawal of consent

• Best interests decisions and rationale

Documentation must be clear, contemporaneous, and suitable for inspection.

12. Training and Competency

• All clinical staff must receive training on consent, capacity, and private prescribing

• GLP‑1‑specific consent training must be completed before prescribing

• Training records must be maintained

13. Audit and Review

• Consent documentation will be audited regularly

• This policy will be reviewed annually or following regulatory, legal, or clinical guidance changes

Document Control

Approved by: Caroline Balazs
Role: Lead Clinical Prescriber
Date: 01/01/2026
Review Date: 01/01/2027
Version: 1.1