P appeal against a range of orders relating to her use of social media and consent to sexual relations. LA's cross-appeal against a decision that the P had capacity to decide on where she lived. Appeal dismissed, cross-appeal allowed.

Judgment was reserved in a case where the question was whether the P ​has the capacity to consent to sexual relations.

Application to prevent publication of a video of a patient, P, in her treating hospital. The application was granted.

The court made declarations both as to capacity and as to treatment of the P that were sought by ​King's College Hospital NHS Foundation Trust.

Application by the P against a decision that he lacked capacity to litigate on his own behalf in proceedings brought by Dorset County Council. Appeal dismissed.

The P was diagnosed as suffering from an impairment of, or disturbance in, the functioning of his mind or brain arising out of a persistent delusional disorder. Dorset County Council had sought the appointment of a deputy to manage the P’s property and affairs on the basis of his apparent inability to do so on his own account. The P wanted to conduct the substantive proceedings on his own account but the court held that he lacked capacity to do so. The P appealed this decision.

The court dismissed the appeal. In relation to the P’s first ground of appeal (no reasonable grounds for believing he lacked litigation capacity), the court could see no basis on which it could be said that his proposed appeal would have a real prospect of success. In relation to his second ground (failure to understand the P’s submissions reduced to writing in his witness statement), again there was nothing in his second ground of appeal which led the court to consider that this ground had any real prospect of success.
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​The court was required to make a range of capacity decisions in relation to the P's capacity to litigate in the proceedings, to manage her property and affairs, to decide where she resides, to decide on her package of care, to decide with who she has contact, to use the internet and communicate by social media and to consent to sexual relations.

​The court was required to make final capacity declarations on the P's residence, contact (with family and others), his care arrangements, his property and financial affairs, his capacity to consent to sexual relations, and his internet and social media use. This judgment in particular focused on the P's access to social media and the risks that posed to him and to others.

Application by a London NHS Trust seeking a declaration that amputation of the left leg through the knee was in the P's best interests. The application was allowed.

The P had a severely gangrenous left foot for which the recommended clinical treatment was amputation of the left leg. The P did not agree to the treatment, his explanation being based on his belief that his foot was not part of the reason his admission to hospital in August 2018 and that it had reached its current state as a result of neglect by the treating team who, in his opinion, should have allowed him to apply ointments and to cover his foot with a dressing. The consultant liaison psychiatrist reported that the P did not understand that there was a very high risk of death unless the operation took place and most importantly that the P had said to her that he does not wish to die.

The court acceded to the application, saying that the P's best interests were best served by proceeding with the proposed amputation.

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The LA was seeking orders to restrict the husband's contact with the P. The court declined to make the orders sought.

​The court agreed that a female clinical psychologist should work with the P in regard to her bad decision-making in relation to sexual partners.

The court, in previous proceedings, determined that the P lacked capacity to; conduct the proceedings; make decisions on her contact with men; make decisions about care and residence; make decisions as to whether to enter or terminate a tenancy; decide whether or not she should access mobile phones or social networking sites. She went on to get married and her husband, on his application, was now a party to the proceedings. A number of men had taken advantage of the P after a plan was proposed such that she could have unsupervised contact with men. At the date of this hearing the P was living in a residential unit with other women.

The court gave permission for a report by a female clinical psychologist to be prepared, to address the issues concerning the P's bad decision-making in relation to sexual activity, with a view to a hearing before the same judge in January 2019.

Read the full text of the judgment on Bailii