An NHS Trust v XB & Ors [2020] EWCOP 71

The Trust was seeking a declaration regarding the P's capacity and that it was in his best interests to covertly administer certain antihypertensive medication in accordance with the Covert Medication Care Plan. The declaration was made.

The P suffers from severe hypertension with systolic blood pressure readings of over 200. These give rise to a very significant risk of serious complications such as heart attack, stroke, heart failure, peripheral vascular disease and end stage renal disease. This condition requires urgent medication with antihypertensives which the Trust wish to administer to the P, but he is refusing to take it. Over the last several months the Trust has covertly been administering the medication, hence the reason for the application for the court to make a declaration that it was in the P's best interests to continue this practice.

The court made the declaration sought that the P lacks capacity to consent to antihypertensive medication and it is lawful for him to be given antihypertensive medication covertly, in accordance with the Covert Medication Care Plan dated March 2020. The medical evidence is clear that if the P does not receive that medication going forward there is a very serious risk to his health, including his death. The P lacks the capacity to make that decision regarding medical treatment as he does not accept he has hypertension due to his mental ill-health and consequently is unable to weigh the advantages and disadvantages of taking the medication prescribed.

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