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Health and Welfare LPA

Also known as: Healthcare LPA, Welfare LPA

Definition

A health and welfare LPA is a legal document that lets you choose someone to make healthcare and personal care decisions for you if you lose mental capacity.

Creating a health and welfare LPA ensures the person you trust makes deeply personal decisions about your medical treatment, daily care, and living arrangements according to your values—rather than leaving these decisions to healthcare professionals who don't know you.

What Does Health and Welfare LPA Mean?

Under the Mental Capacity Act 2005, a health and welfare lasting power of attorney (LPA) lets you appoint one or more attorneys to make decisions about your healthcare and personal welfare when you become unable to make these decisions yourself. This is one of two types of LPA—the other covers property and financial affairs. Unlike a financial affairs LPA which can be used while you still have capacity, a health and welfare LPA can only be used after you've lost mental capacity to make the specific decisions in question. The document must be registered with the Office of the Public Guardian before your attorneys can act.

Many people wrongly believe their spouse or adult children can automatically make healthcare decisions for them. This isn't true. In England and Wales, "next of kin" has no legal authority to consent to or refuse medical treatment on your behalf. Without a health and welfare LPA, healthcare professionals and local authorities make decisions based on what they believe is in your best interests—your family can only provide input, not make the final decision. Sarah appointed her daughter Helen as her health and welfare attorney five years before developing advanced Alzheimer's disease. Now Helen has legal authority to make decisions about Sarah's daily care, medical treatments, and whether she should remain in her current care home or move to a nursing home as her needs increase.

Your attorney can make decisions in three main areas: daily routine (what you eat, wear, and your daily activities), medical treatment (consenting to or refusing treatments, accessing your medical records, discussing care plans with doctors), and where you live (staying at home with care support or moving to residential care). If you explicitly grant it in Section 4 of the LP1H form, your attorney can also make decisions about life-sustaining treatment—whether to continue or withdraw treatment that keeps you alive. This authority is optional. Without it, doctors make these decisions. James created a health and welfare LPA appointing his civil partner Michael as attorney, with specific authority over life-sustaining treatment. When James suffered a massive stroke and couldn't communicate, Michael had legal authority to discuss prognosis with doctors and make the decision about continuing life support based on James's values and previously expressed wishes.

The process involves completing form LP1H, having it signed with witnesses and a certificate provider, and registering it with the Office of the Public Guardian (£82 fee, with reductions or exemptions available). Registration takes 10-20 weeks, so don't wait until capacity is at risk—by then it may be too late. Once registered, keep the LPA safe. Your attorneys can only use it after you've lost capacity to make the specific decisions in question, typically confirmed through a capacity assessment. Anyone 18 or older can create a health and welfare LPA—it's not just for elderly people. A 29-year-old in a serious car accident with traumatic brain injury can lose capacity suddenly, and having an LPA already registered means their chosen attorney can immediately make healthcare decisions rather than family having to apply to the Court of Protection for deputyship, which takes months and costs £400+ in court fees.

Common Questions

"When can a health and welfare LPA be used?" A health and welfare LPA can only be used after it has been registered with the Office of the Public Guardian AND you have lost mental capacity to make decisions yourself. Unlike a property and financial affairs LPA, it cannot be used while you still have capacity—your attorneys can only act when you are unable to make health and care decisions yourself.

"What decisions can my attorney make under a health and welfare LPA?" Your attorney can make decisions about your daily routine (washing, dressing, eating), medical treatment, where you live, and what care you receive. If you specifically authorise it in the LPA, they can also make decisions about life-sustaining treatment. They cannot make decisions about your finances—that requires a separate property and financial affairs LPA.

"Do I need both types of LPA?" Most people benefit from having both a health and welfare LPA and a property and financial affairs LPA. They cover different areas—one handles healthcare and personal care decisions, the other handles money and property. Without both, you may not have complete protection if you lose capacity.

Common Misconceptions

Myth: My spouse or children can make healthcare decisions for me automatically, so I don't need a health and welfare LPA.

Reality: In England and Wales, "next of kin" has no legal authority to make healthcare decisions for you. Even your spouse or civil partner cannot legally consent to or refuse medical treatment on your behalf unless you've appointed them as your attorney through a health and welfare LPA. Without an LPA, healthcare professionals make decisions based on what they believe is in your best interests—your family can only advise, not decide.

Myth: A health and welfare LPA can be used immediately once registered, just like a property and financial affairs LPA.

Reality: A health and welfare LPA can only be used once you have lost mental capacity to make the specific decisions in question. This is fundamentally different from a property and financial affairs LPA, which can be used while you still have capacity if you've chosen that option. Your health and welfare attorneys cannot make decisions for you while you're still capable of making them yourself.

  • Lasting Power of Attorney: The broader legal framework under which health and welfare LPA exists as one of two types available.
  • Property and Financial Affairs LPA: The other type of LPA that handles financial decisions and can be used before capacity is lost.
  • Attorney: The person you appoint to make health and welfare decisions on your behalf when you lack capacity.
  • Donor: The person creating the health and welfare LPA whose capacity determines when attorneys can act.
  • Mental Capacity: The threshold that determines when your health and welfare attorneys can begin making decisions for you.

Need Help with Your Will?

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Legal Disclaimer:

This article provides general information only and does not constitute legal or financial advice. WUHLD is not a law firm and does not provide legal advice. Laws and guidance change and their application depends on your circumstances. For advice about your situation, consult a qualified solicitor or regulated professional. Unless stated otherwise, information relates to England and Wales.