Indirect payments: when the Mental Capacity Act interacts with the personalisation agenda

Jepson M, Laybourne A, Williams V, Cyhlarova E, Williamson T, Robotham D

Health and Social Care in the Community 2015, 24, 5: 623—630

Available online 30 Apr 2015


This paper reports findings from a study that aimed to explore how
practitioners were bringing together the demands of the personalisation
agenda, in particular the offer of direct payments (DPs), with the Mental
Capacity Act, and to investigate current practices of offering and
administering indirect payments for people who lack capacity to consent
to them, including the use of ‘suitable person’ proxies under the new
regulations (DH, 2009). The study adopted a qualitative interview-based
design; participants were social work practitioners (67) and recipients of
‘indirect’ payments (18) in six local authorities in England in 2011–2012.
The paper reports on five key decision-making points in the indirect
payments process: the decision to take on an indirect payment, the
assessment of mental capacity, the identification of a suitable person, the
establishment of the care recipient’s best interests and the decisions about
how to execute the indirect payment. We found that practitioners and
suitable people had different experiences of the system, although in both
cases, there was overarching support for the benefits of enabling people
who lack capacity to consent to a DP to receive their social care funding
in the form of an ‘indirect’ payment via a proxy suitable person.