British Association for Parenteral and Enteral Nutrition
British Artificial Nutrition Survey (BANS)
BAPEN
Advancing Clinical Nutrition
Guidelines for BANS reporters when patients lack capacity to
consent or refuse permission to enter BANS survey
As a BANS reporter, you will be aware of the regulations relating to inclusion
of patients in the BANS survey. PIAG (Patient Information Advisory Group)
has granted permission for BANS to collect data from those patients unable to
cooperate with providing consent for inclusion as a result of lack of mental
capacity. The new Mental Capacity Act, 2005, is now in force and demands
certain safeguards for such patients.
All patients unable to consent will now need the assent of an
appropriate Consultee before data can be divulged to BANS
The decision to provide artificial nutritional treatment will already have been
made in the patient’s best interests after ascertaining what those might be. At
the same time as that process takes place BANS would advise that similar
discussions take place to ensure that consent can be obtained for data to be
included in BANS. For a patient unable to consent, assent must be sought
from a Consultee who can be one of the following…




Next of kin or available close family member or partner.
Person with Personal Welfare Lasting Power of Attorney under Mental
Capacity Act (MCA), 2005
Independent MCA Advocate under MCA 2005
Anyone with knowledge of an Advance Directive or similar expression
of relevant views
We appreciate that this will require effort and coordination to achieve
maximum yield of data for BANS. It is very important for us to gain insight into
this group of patients but the new rules will make this more difficult. We
suggest that you coordinate with those most likely to be dealing with relatives
or advocates in the consent process for PEG insertion so that the issue of
assent for BANS can also be obtained simultaneously.
We have prepared an information sheet for Consultees available on the BANS
and BAPEN websites [www.e-bans.com and www.bapen.org.uk]. A specific
Assent form to be signed by the Consultee on behalf of the patient is also
available on those websites together with all other relevant forms for BANS
consent.
BANS thanks you for your support.
BANS/BAPEN Dr BJM Jones. 12/08/2007