Lancashire & South Cumbria NHS Foundation Trust & Anor. v AH

Facts

The case concerned a 46-year-old woman, referred to as Anna or AH to protect her privacy, who lives in a city in the North West of England and suffers from type 1 diabetes. Treated properly and consistently with insulin she can live happily and healthily; without it she is at significant risk of serious harm and death. She has a mild learning disability, and there is a suggestion of personality disorder. Having previously lived independently in her own flat, she was admitted to a general hospital at the end of December 2021 with acute confusion and high blood glucose, and then to critical care with developing cardiorespiratory failure secondary to diabetic ketoacidosis, having had no insulin prescribed for several months. District nurse records showed repeated refusals of access and of insulin in late 2020. When she became medically fit for discharge the difficulties of delivering her diabetes care in the community gave rise to these proceedings. The Applicants, an NHS Foundation Trust and a local authority, applied for an order that she be admitted to a care home for assessment, which HHJ Burrows granted, and interim orders as to capacity and best interests followed on the evidence of a clinical psychologist. Capacity assessments during the proceedings differed, so the court directed a single joint expert report from Dr Camden-Smith, and listed a one-day hearing on capacity alone.