Free LPA Health & Welfare Template

LASTING POWER OF ATTORNEY

Health And Welfare  ·  Mental Capacity Act 2005 Ss.9–14, Sch 1  ·  LPA Regulations 2007 (SI 2007/1253)

DONOR

PRIMARY ATTORNEY

SECOND ATTORNEY

This LASTING POWER OF ATTORNEY FOR HEALTH AND WELFARE is made on 2026-03-09 by Margaret Rose Whitfield (also known as Margaret Rose Calloway), of 12 Maple Avenue, Leeds LS1 4AB (the "Donor") pursuant to sections 9 to 14 and Schedule 1 of the Mental Capacity Act 2005 and the Lasting Powers of Attorney, Enduring Powers of Attorney and Public Guardian Regulations 2007 (SI 2007/1253, as amended). The Donor confirms that, at the date of signing, the Donor has the mental capacity required by sections 2 and 3 of the Mental Capacity Act 2005 to make this LPA and understands its purpose, scope and the consequences of executing it. This LPA has no legal effect until it has been registered with the Office of the Public Guardian ("OPG") and may only be used when the Donor lacks the mental capacity to make the relevant decision (MCA 2005 s.11(7)(a)).

The Donor hereby appoints David James Whitfield, of 8 Oak Street, Leeds LS2 7TH (Son) as attorney to act in relation to the Donor’s personal welfare and health under section 9 of the Mental Capacity Act 2005. The Donor also appoints Susan Clare Whitfield, of 4 Pine Close, York YO1 2AB (Daughter) as a further attorney. The attorneys shall act jointly and severally: they may act together or independently on any health or welfare decision. This is the most resilient arrangement: if any attorney becomes unable or unwilling to act, the remaining attorneys may continue.

This LPA for Health and Welfare may be used only when the Donor lacks the mental capacity to make the relevant decision, as provided by section 11(7)(a) of the Mental Capacity Act 2005. Capacity is to be assessed in accordance with the two-stage functional test in sections 2 and 3 of the Mental Capacity Act 2005 and chapters 3, 4 and 7 of the MCA 2005 Code of Practice. The attorney(s) must assume capacity unless the contrary is established and must support the Donor to make the decision themselves where practicable (MCA 2005 s.1(2)–(3)). The five statutory principles in section 1 MCA 2005 apply throughout: presumption of capacity, support for decision-making, right to make unwise decisions, best-interests obligation, and least-restrictive alternative.

Subject to any restrictions below and to the MCA 2005, the attorney(s) may make any decision about the Donor’s personal welfare that the Donor could make if they had capacity, including without limitation: where the Donor lives (including moves to a care home, sheltered accommodation or hospital); day-to-day care (diet, dress, routine, social contact); consent to or refusal of medical treatment (subject to clause 4 on life-sustaining treatment and clause 6 on any ADRT); access to medical and care records under section 3 of the Access to Health Records Act 1990 and Articles 15 and 23 UK GDPR; and engagement with social services, NHS bodies, hospices and the Court of Protection. The attorney(s) may not, however, make decisions that would unlawfully deprive the Donor of liberty (see clause on Deprivation of Liberty if included).

The Donor hereby EXPRESSLY AUTHORISES the attorney(s) to give or refuse consent to the carrying out or continuation of life-sustaining treatment on the Donor’s behalf, pursuant to section 11(7)–(8) of the Mental Capacity Act 2005. The attorney(s) may exercise this authority only where they reasonably believe that doing so is in the Donor’s best interests under section 4 of the Mental Capacity Act 2005, and must not be motivated by a desire to bring about the Donor’s death (MCA 2005 s.4(5)).

The attorney(s) must at all times act in the Donor’s best interests in accordance with section 4 of the Mental Capacity Act 2005. They must: (a) consider all relevant circumstances; (b) take into account the Donor’s past and present wishes, feelings, beliefs and values, including any written statement made when the Donor had capacity; (c) consult, so far as it is practicable and appropriate, anyone named by the Donor as someone to be consulted, any unpaid carer, anyone interested in the Donor’s welfare, and the replacement attorney(s) (if any); (d) consider whether the decision can be deferred until the Donor regains capacity; (e) encourage the Donor’s participation; and (f) not make a best-interests determination merely on the basis of the Donor’s age, appearance, condition or behaviour. The attorney(s) must also comply with the principles in section 1 MCA 2005 and the MCA 2005 Code of Practice (chapter 7).

Where the Donor has made an Advance Decision to Refuse Treatment ("ADRT") under sections 24 and 25 of the Mental Capacity Act 2005, that ADRT generally takes priority over this LPA. However, by virtue of section 25(2)(b) MCA 2005, the LPA prevails if it is made AFTER the ADRT and expressly covers the same treatment. The Donor confirms that no ADRT exists at the date of this LPA. The attorney(s) must not consent to treatment on the Donor’s behalf where that treatment would contravene a valid and applicable ADRT (MCA 2005 ss.24–26). Treating clinicians must satisfy themselves as to the validity and applicability of any ADRT before relying on it.

Each attorney must: (a) act in good faith and within the scope of authority conferred by this LPA and the MCA 2005; (b) keep records of significant decisions taken on behalf of the Donor (including who was consulted, what factors were weighed, and the rationale), and produce them on request to the OPG (section 58 MCA 2005); (c) exercise reasonable care and skill; (d) not benefit personally from the appointment except as expressly authorised by the MCA 2005; and (e) not delegate their authority save as permitted by section 7 of the Powers of Attorney Act 1971 and section 11(7)(a) MCA 2005. Each attorney is subject to the supervision of the Office of the Public Guardian and is liable in equity and at common law for breach of duty.

The Donor appoints Helen Patricia Whitfield, of 22 River Lane, Sheffield S1 3LK, born 1980-02-07 (Daughter-in-law) as replacement attorney, to step in only when all original attorneys have become unable or unwilling to act, so that the LPA continues to operate while at least one original attorney remains able to act. The appointment of a replacement attorney takes effect automatically on the occurrence of the triggering event and does not require a new LPA to be registered, provided the OPG is notified in accordance with the Lasting Powers of Attorney, Enduring Powers of Attorney and Public Guardian Regulations 2007 (Part 2). The replacement attorney assumes the same powers and restrictions as the original attorney(s), including (if granted) the authority over life-sustaining treatment.

In carrying out their statutory duty under section 4(7) MCA 2005 to take into account the views of anyone named by the Donor as someone to be consulted, the attorney(s) shall consult the following persons on significant welfare decisions:

Peter John Whitfield (my brother), 17 Highfield Avenue, Harrogate HG1 2BJ — on significant medical decisions.
Rev Michael Greenfield (parish priest, St Mary's Leeds) — on spiritual / end-of-life matters.

The duty is to consult, not to be bound by the response. Failure to consult on a significant decision may be evidence of a breach of duty in any subsequent complaint to the OPG or application to the Court of Protection.

Instructions (binding on the attorney(s)):
My attorneys must consult my registered GP before consenting to any non-emergency medical procedure.
My attorneys must obtain a second opinion before consenting to any surgery involving general anaesthesia for non-life-threatening conditions.

Preferences (non-binding guidance):
I would prefer to be cared for at home rather than in a care home, where this is safe and reasonable.
I prefer vegetarian meals consistent with my long-standing dietary choices.
I would like to retain access to my parish church (St Mary's, Leeds) for spiritual care where mobility permits.

Note: instructions must be drafted with care — instructions which conflict with the Donor’s best interests, are unworkable, are unlawful, or remove an attorney’s statutory duties will be severed or refused registration by the OPG.

Nothing in this LPA authorises the attorney(s) to deprive the Donor of liberty save to the extent permitted by the Deprivation of Liberty Safeguards in Schedule A1 to the Mental Capacity Act 2005 (and the Liberty Protection Safeguards under Schedule AA1 when commenced pursuant to the Mental Capacity (Amendment) Act 2019). Any deprivation of liberty must be authorised by the supervisory body (currently the local authority or, where the Donor is in hospital, the relevant NHS body) or by order of the Court of Protection. The attorney(s) must report any concern about an unauthorised deprivation of liberty to the relevant supervisory body without delay.

Before this LPA is registered, the following persons shall be notified using Form LP3, in accordance with Schedule 1 paragraph 6 of the Mental Capacity Act 2005 and Part 2 of the LPA Regulations 2007:

Peter John Whitfield (brother), 17 Highfield Avenue, Harrogate HG1 2BJ
Catherine Mary Booth (long-standing friend), 9 Briarwood Lane, Leeds LS6 3DD

Each notified person has three (3) weeks from receipt of the notice in which to object to the registration on a prescribed ground (Form LPA007). Notification persons act as a safeguard against undue influence and fraud; they have no decision-making role thereafter.

The Donor expresses the wish that this LPA be reviewed (and, if appropriate, revoked and re-executed) on the occurrence of any material life event, including: Marriage or civil partnership of any attorney; divorce or dissolution involving any attorney; significant deterioration in my health to a degree requiring residential care; estrangement from any named attorney for more than six (6) months; any criminal conviction of an attorney.. The Donor reserves the right under section 13 MCA 2005 to revoke this LPA at any time while the Donor has capacity to do so.

The Donor acknowledges and authorises the use of the Office of the Public Guardian "Use a lasting power of attorney" digital service (lastingpowerofattorney.service.gov.uk). On registration of this LPA, the OPG provides the Donor with a secure access code which the Donor may share with each attorney; each attorney may then grant view-only access to a healthcare provider (general practitioner, hospital trust, care home), a NHS social-care commissioner, or another relying organisation, who can verify the LPA in real time without requiring a certified paper copy. The attorneys are authorised to use this digital sharing facility wherever it is convenient and to use the "Track my LPA" service to monitor application progress. The parties further acknowledge that the Powers of Attorney Act 2023 will, when the Lord Chancellor commences the Schedule, enable LPAs to be made and registered fully online with digital identity verification of donor, attorneys and certificate provider; the digital evidence so generated shall be admissible as evidence of the LPA in any subsequent proceedings to the same extent as the paper form. Nothing in this clause supersedes the requirement under Schedule 1 paragraph 1 MCA 2005 that the original paper or fully-online form (whichever is used) be properly executed and witnessed in person.

Where any attorney appointed under this LPA exercises authority in reliance on, or in response to, an AI tool, machine-learning system or automated decision-making process used by a healthcare provider, care home, NHS trust or care-management platform (including, without limitation, AI-assisted risk-assessment algorithms, automated triage systems, AI clinical-decision-support tools, AI-driven monitoring or alerting systems and AI-assisted scheduling or capacity-planning systems) ("AI Care Tool"), the attorney is directed:

(a) No solely automated decisions. No decision concerning the Donor's health, care, accommodation, treatment or welfare shall be made on a solely automated basis. The attorney shall always provide meaningful human review of any AI Care Tool output and shall record the basis on which the attorney has accepted or rejected the AI output. This reflects the Donor's right under Article 22(1) UK GDPR not to be subject to a decision based solely on automated processing producing legal or similarly significant effects.

(b) Transparency. The attorney shall, on the Donor's behalf, exercise the data-subject rights to meaningful information about the logic involved in any AI Care Tool under Articles 13(2)(f), 14(2)(g) and 15(1)(h) UK GDPR, and shall not be deterred by the provider's assertion of trade-secret protection from seeking sufficient information to evaluate the recommendation.

(c) Welfare paramountcy. Every decision taken by the attorney remains subject to the best-interests test in section 4 MCA 2005 and to the principles in the MCA Code of Practice (revised 2024). An AI Care Tool output is one factor among many to be considered; it does not displace the attorney's duty to consult, where practicable, anyone engaged in caring for the Donor or interested in the Donor's welfare under s.4(7) MCA 2005.

(d) Hallucination and bias. The attorney recognises the documented risks of AI hallucination (fabricated facts or recommendations) and algorithmic bias (especially in age, disability and ethnic-minority cohorts) and shall not act on AI output that is unverified or that conflicts materially with the attorney's direct knowledge of the Donor.

The attorneys acknowledge that, in exercising authority under this LPA, they will routinely process the Donor's personal data — including special-category health data within the meaning of Article 9(1) UK GDPR — when liaising with general practitioners, hospital consultants, mental-health services, social-care commissioners, care-home providers and pharmacies. The relevant data-protection framework is the Data Protection Act 2018 as amended by the Data (Use and Access) Act 2025 ("DUAA 2025"), the bulk of whose Part 5 data-protection amendments came into force on 5 February 2026 by the Data (Use and Access) Act 2025 (Commencement No. 6 and Transitional and Saving Provisions) Regulations 2026 (SI 2026/82); a new statutory complaints duty (s.164A DPA 2018, in force 19 June 2026) applies to every data controller processing the Donor's data.

(a) Lawful basis. The lawful basis for the attorney's processing is the performance of a task carried out in the exercise of official authority vested in the attorney under the MCA 2005 (UK GDPR Art 6(1)(e)), with an Art 9 condition satisfied by reason of vital interest or, where the Donor previously consented while capacitous, by reference to that earlier consent (UK GDPR Art 9(2)(c) / (a)).

(b) Joint-controller relationship. Where the attorney shares the Donor's health data with a healthcare provider, they may operate as joint controllers within the meaning of Article 26 UK GDPR; the attorney shall not refuse to provide health information to a clinician where the refusal would jeopardise the Donor's safety. The attorney remains responsible for the security of any health data held outside the clinical relationship (e.g. in personal email, cloud storage or family WhatsApp groups) and shall apply appropriate technical and organisational measures (Article 32 UK GDPR).

(c) Donor's rights. The attorney shall exercise the Donor's data-subject rights (access, rectification, erasure, restriction, portability, objection) on the Donor's behalf to the extent reasonable and consistent with the Donor's best interests, and shall preserve any complaint correspondence to the Information Commissioner under the new s.164A DPA 2018 complaints duty in force from 19 June 2026.

Dr Anita Patel, of 15 High Street Medical Practice, Leeds LS1 1AB (General Practitioner, GMC 6534210) has signed Part B of the prescribed form, certifying that, in their opinion: (a) the Donor understands the purpose and scope of this LPA and the consequences of executing it; (b) no fraud or undue pressure is being used to induce the Donor to make this LPA; and (c) there is nothing else that would prevent this LPA from being created. The certificate provider is a person acting in a professional capacity with the relevant skills (for example, a registered medical practitioner, registered nurse, registered social worker, registered psychologist, psychiatrist or solicitor) and who is not a relative of the Donor or of any attorney. The certificate provider is independent of the attorneys, is not a relative of the Donor or any attorney, is not an employee or business partner of any attorney, is not the owner, manager, director or employee of any care home in which the Donor lives, and is not themselves an attorney under this or any other LPA or EPA of the Donor.

Claire Elizabeth Booth, of 3 Station Road, Leeds LS1 2BC (Retired Solicitor) will witness the Donor’s signature in person on the same original prescribed form. The witness is aged 18 or over and is not any attorney or replacement attorney named in this LPA, in accordance with Schedule 1 paragraph 1(1)(c) of the Mental Capacity Act 2005. Each attorney’s signature must likewise be witnessed in person; attorneys may witness each other’s signatures (but may not witness the Donor’s signature) and the certificate provider may witness an attorney’s signature. Signatures cannot be witnessed remotely or by electronic means — all parties must sign the same original document.

This LPA has no legal effect until it has been registered by the Office of the Public Guardian under Schedule 1, Part 2 of the Mental Capacity Act 2005 and Part 2 of the LPA Regulations 2007. Following the Powers of Attorney Act 2023, the application to register must be made by the Donor, either online through the OPG digital service (rolling out in phases) or by submitting paper Form LP1H. The current registration fee is £92 per LPA (in force since 17 November 2025; the Health and Welfare LPA and any Property and Financial Affairs LPA are charged separately). A fee exemption or remission may apply where the Donor’s gross annual income is below £12,000 or the Donor receives certain means-tested benefits (Form LPA120 — note that automatic Universal Credit pass ceased on 2 February 2026). The OPG enters the registered LPA on the statutory register maintained under section 58(1)(b) MCA 2005; searches may be made against the register on payment of the prescribed fee. Registration typically takes 8–10 weeks where the application is error-free.

The Donor may revoke this LPA at any time while the Donor has capacity to do so, by executing a deed of revocation and notifying the OPG and each attorney in writing (section 13 and Schedule 1 paragraphs 17–18 MCA 2005). A registered LPA that has been revoked remains on the statutory register until the OPG removes it following notification. The following events also have effects on this LPA, as set out in sections 13 and 22 MCA 2005: dissolution of the Donor’s marriage or civil partnership with an attorney (terminates that attorney’s appointment unless the LPA provides otherwise); the death or loss of capacity of an attorney; and disclaimer by an attorney in accordance with the LPA Regulations 2007. Bankruptcy of the Donor does NOT affect a Health and Welfare LPA (unlike a Property and Financial Affairs LPA which terminates).

This LPA is made under the laws of England and Wales pursuant to the Mental Capacity Act 2005 and the LPA Regulations 2007 (SI 2007/1253, as amended). Any dispute as to the validity, scope, exercise or revocation of this LPA shall be determined by the Court of Protection under sections 16 and 22 of the Mental Capacity Act 2005. Nothing in this LPA prevents any person with sufficient interest from applying to the Court of Protection for directions, an order, the appointment of a deputy under section 16, or the imposition of safeguards under section 23.