P-45 Audit of adults with incapacity documentation in an acute palliative care unit

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In-patients receiving palliative care may lack capacity to make decisions regarding their medical treatment for many reasons e.g. delirium, dementia. If it is felt that a person cannot consent to treatment an Adults with Incapacity (AWI) Act (Scotland) Section 47 certificate can be completed, allowing healthcare staff to provide treatment while enshrining a number of safeguards for the patient. In 2016 NHS Grampian introduced new AWI Section 47 documentation and its use was audited in an acute palliative care unit.


Data was collected from all in-patients in an acute palliative care unit over a 1 week period. Information was collected on four domains:


Data was collected on 16 in-patients, 8 male and 8 female, mean age 71 years.


The proportion of patients with an AWI Section 47 certificate is in keeping with the prevalence of delirium in medical wards. There was good compliance with completion of the new AWI Section 47 certificates. Documentation of assessment of capacity/decision making and discussion with relevant others was lacking - these are important principles of the act and further education and training should address these areas.

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