The Health Overview and Scrutiny Panel of Kingston upon Thames Council met on Thursday 9 July 2026 to discuss significant upcoming changes to the Mental Health Act 2025 and the Mental Capacity Act. Key discussions focused on how these legislative reforms will impact local services and residents, with a particular emphasis on patient rights, detention criteria, and the evolving definition of deprivation of liberty.

Update on Changes to the Mental Health Act

The panel received a comprehensive update on the Mental Health Act 2025, which received Royal Assent in December 2025. This legislation aims to modernise the Mental Health Act 1983, strengthen patient autonomy, address racial inequalities in detention, and prevent the inappropriate detention of individuals with autism or neurodiversity. The reforms are being rolled out gradually over a ten-year period, with a new code of practice expected in 2027-2028.

Key changes include:

• Stricter Detention Thresholds: The Act introduces a serious risk and therapeutic benefit test for detention, meaning individuals will only be detained if they are at risk of causing serious harm and will receive therapeutic benefit from hospitalisation.
• Exclusion of Autism and Learning Disabilities: People with autism or learning disabilities will no longer be detained under Section 3 of the Act unless they have a co-occurring mental illness requiring hospital treatment. Community-based alternatives will be prioritised.
• Nominated Person: The role of the Nearest Relative will be replaced by a Nominated Person, giving patients greater choice and control over who represents them. This nominated person will have legal rights to object to detention and be involved in care planning.
• Advanced Choice Documents: Patients will be able to create Advanced Choice Documents when well, outlining their treatment preferences should they become unwell in the future. South West London and St George's Mental Health NHS Trust (SWLSTG) has piloted a format for these documents.
• Increased Advocacy: Patients will automatically be offered an Independent Mental Health Advocate (IMHA) unless they decline.
• Places of Safety: Police stations and prisons will no longer be used as places of safety for individuals in mental health crisis. They must be taken to health-based settings, which may increase demand on services like A&E and crisis teams.
• Workforce Implications: The changes will necessitate significant training and potential workforce expansion, particularly for Approved Mental Health Professionals (AMHPs) and those involved in tribunals. The recommissioning of IMHA services in Kingston is noted as a positive step.

Adriana Lazdins, Corporate Head of Service for Adult Social Care at Kingston Council, and Zoe Mears, Head of Social Work and Chair of the Trust Mental Health Law Governance Group at SWLSTG, along with Dr Felix Mendez, Consultant Psychiatrist and Mental Health & Mental Capacity Law Lead Consultant at SWLSTG, provided detailed explanations. They highlighted that the full implementation of these reforms is dependent on the forthcoming Code of Practice and that resourcing plans will be developed as national requirements become clearer.

Councillor Roger Hayes raised questions about Key Performance Indicators (KPIs) and milestones to measure the success of these changes. The panel was informed that specific KPIs are still being developed and will be clearer once the Code of Practice is published. Councillor Peter Higgins requested a bullet-point summary of the differences between the new and old Acts, which the officers agreed to provide. Councillor Jane D'Souza inquired about the role of the police and places of safety, and Councillor Rizwana Malik asked about the treatment of mental health issues co-occurring with drug abuse.

Verbal Update on the Mental Capacity Act

The panel also received a verbal update on changes to the Mental Capacity Act, specifically concerning the Liberty Protection Safeguards (LPS). The planned rollout of LPS, which aimed to streamline the authorisation process for deprivations of liberty and extend protections to 16 and 17-year-olds and community settings, has been significantly disrupted by a UK Supreme Court judgment on 2 June 2026.

This judgment overturned the previous acid test for deprivation of liberty, established in the Cheshire West case. The new ruling requires a multifactorial assessment, recognising that individuals lacking legal capacity can still give valid consent to their care arrangements if they express contentment and show no objection to their environment.

Katie O'Driscoll, Director for Adult Social Care Operations, explained that Kingston Council and SWLSTG are currently navigating this change and operating under the existing Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005 frameworks. An advice note has been disseminated to support alignment with the Supreme Court ruling. Robust joint processes for capacity assessments and best interests principles remain in place, and decisions for children under 16 continue to be evaluated using Gillick competency principles. The council has also developed a local advocacy guide to support residents.

Ed Montgomery, Managing Director at Your Health Care, noted that the fundamental processes for supporting individuals with learning disabilities would likely remain similar, with a continued multi-agency approach to safeguarding.

Appointment of Advisory Members

The panel agreed to the reappointment of three advisory members for the life of the Council (2026-2030): Kathryn Yates, Chair of Healthwatch Kingston; David Still, Deputy CEO of Kingston Carers' Network; and Dr Jane D'Souza, GP Advisory Member.