Healthcare Lasting Power of Attorney (LPA)
Healthcare Lasting Power of Attorney: Your Complete UK Guide
We often assume we'll always make decisions about our own healthcare—but life can sometimes take unexpected turns. A Healthcare Lasting Power of Attorney (LPA) ensures someone you trust can speak up clearly for you if you can't do it yourself.
What is a Healthcare LPA?
A Healthcare Lasting Power of Attorney (also called a Health and Welfare LPA) is a legal document that allows you to appoint one or more people—called attorneys—to make healthcare and welfare decisions on your behalf if you lose the mental capacity to do so yourself.
Unlike a Financial LPA which covers money matters, a Healthcare LPA specifically covers decisions about your medical treatment, daily care, and living arrangements. It's a crucial safeguard that ensures your voice is heard through someone you trust, even when you can't speak for yourself.
Healthcare LPA vs Financial LPA: What's the Difference?
Many people confuse these two types of LPA, but they serve very different purposes:
Healthcare LPA:
Medical treatment decisions
Care home choices
Daily care arrangements
Life-sustaining treatment decisions
Where you live
Day-to-day care needs
Financial LPA:
Bank accounts and bills
Property sales or purchases
Investment decisions
Benefit claims
Tax matters
Pension management
You can have both types of LPA, and many people do. They can have the same or different attorneys, depending on who you trust with each type of decision.
Who Needs a Healthcare LPA?
A Healthcare LPA isn't just for the elderly or seriously ill. Consider setting one up if you:
Want control over who makes medical decisions for you
Have specific preferences about medical treatment
Want to avoid family disputes during medical crises
Have a progressive condition like dementia
Simply want peace of mind for unexpected situations
Are over 18 (you must be an adult to create an LPA)
Remember: accidents and sudden illnesses can affect anyone at any age. Having an LPA ensures your wishes are respected regardless of what happens.
What Decisions Can Healthcare Attorneys Make?
Your appointed attorneys can make a wide range of health and welfare decisions, including:
Medical Treatment Decisions
Consenting to or refusing medical examinations
Agreeing to surgery or medical procedures
Decisions about medication
Choosing between treatment options
Accessing your medical records
Daily Living Decisions
Where you live (your home, a care home, or with family)
Your daily routine and activities
What you eat and wear
Who you have contact with
Complaints about your care or treatment
Life-Sustaining Treatment
You can give your attorneys power to make decisions about life-sustaining treatment, but this must be explicitly stated in the LPA. This includes decisions about:
Ventilation and resuscitation
Artificial nutrition and hydration
Organ donation after death
What Attorneys CANNOT Decide
Healthcare attorneys cannot:
Consent to marriage or divorce on your behalf
Make decisions about your children
Override your own decisions while you have capacity
Consent to treatments specifically excluded in your LPA
Make decisions that conflict with an advance decision (living will) made after the LPA
When Does a Healthcare LPA Come Into Effect?
Unlike a Financial LPA (which can be used immediately if you choose), a Healthcare LPA can only be used when you've lost the mental capacity to make a specific decision yourself.
Mental capacity means being able to:
Understand information about the decision
Remember that information
Use it to make a decision
Communicate your decision
Capacity is decision-specific—you might have capacity for some decisions but not others. Healthcare professionals assess capacity for each decision as needed.
Choosing Your Healthcare Attorneys
Selecting the right attorneys is crucial. Consider:
Who Can Be an Attorney?
Anyone 18 or over with mental capacity
Family members, friends, or professionals
Someone who knows you well and understands your values
Someone comfortable making difficult medical decisions
Someone who lives near enough to be practically involved
Who Cannot Be an Attorney?
Anyone under 18
Anyone who lacks mental capacity
Anyone subject to bankruptcy (for Financial LPAs only—they can still be Healthcare attorneys)
Single or Multiple Attorneys?
You can appoint:
One attorney - Simpler but no backup if unavailable
Multiple attorneys jointly - Must agree on all decisions
Multiple attorneys jointly and severally - Can act together or independently
Replacement attorneys - Step in if original attorneys can't act
Most people choose 2-3 attorneys acting jointly and severally, with at least one replacement attorney.
How to Set Up a Healthcare LPA in England & Wales
You can set this up yourself and the only cost would be the fee, however some people choose to use a solicitor, because it's quite a lengthy and formal document. However, the government website https://www.gov.uk/government/publications/make-a-lasting-power-of-attorney has an excellent downloadable step-by-step guide, so there's no point creating a detailed how-to-guide here, and small mistakes can be corrected by the OPG team. What's more, you can call them on 0300 456 0300 if you want some specific guidance.
Here is a summary overview so you know broadly what to expect when you set up an LPA.
Step 1: Complete the Forms
Use the official LP1H form from the Office of the Public Guardian
Complete online at www.gov.uk/power-of-attorney or request paper forms
The online system guides you through each section
Step 2: Choose Your Certificate Provider
You need someone to confirm you understand what you're doing. This can be:
Someone who's known you personally for 2+ years, or
A professional (GP, solicitor, social worker)
They cannot be:
Your attorney or replacement attorney
A family member of you or your attorneys
An unmarried partner or boyfriend/girlfriend of you or your attorneys
A business partner or employee
Anyone who owns or manages a care home where you live
Step 3: Sign in the Correct Order
The LPA must be signed in this specific order:
You (the donor)
Your certificate provider
Your attorneys
Your replacement attorneys (if any)
Each person must sign in the presence of a witness.
Step 4: Register the LPA
Send to the Office of the Public Guardian with £82 fee
Registration takes 8-10 weeks (20 weeks if errors need correcting)
You may get a 50% discount if on certain benefits
Free if claiming Universal Credit, income support, or similar
Step 5: Notify People (Optional)
You can list people to be notified when you register the LPA. They have 3 weeks to raise concerns about validity or appropriateness.
Healthcare LPA in Scotland
In Scotland, the equivalent is a Welfare Power of Attorney with some key differences:
Must use Scottish forms from the Office of the Public Guardian (Scotland)
A solicitor, doctor, or registered professional must certify you have capacity
Registration fees vary (around £87)
Different witnessing requirements
Can include financial powers in the same document
Visit www.publicguardian-scotland.gov.uk for Scottish forms and guidance.
Costs and Timeframes
Registration Fees
England & Wales: £82 per LPA (reduced to £41 for low incomes, free for some benefits)
Scotland: £87 for welfare powers
Additional Costs
Solicitor fees: £200-£1,000 if you use one (not required)
Certificate provider: Usually free from someone you know, £50-£150 for professionals
Certified copies: £35 each from OPG
Timeframes
Completion: 1-2 hours with all information ready
Registration: 8-10 weeks standard, up to 20 weeks if corrections needed
Urgent registration: Not available—plan ahead!
Using Your Healthcare LPA
Once registered, your attorneys can make decisions when you lack capacity. In practice:
Healthcare professionals assess your capacity for specific decisions
If you lack capacity, they consult your attorneys
Attorneys make decisions based on your best interests
Attorneys show the LPA to healthcare providers (original or certified copy)
Best Interests Decisions
Attorneys must always act in your best interests, considering:
Your past and present wishes
Your beliefs and values
Other relevant factors
Consulting with family and carers
The least restrictive option
Common Questions About Healthcare LPAs
Can I cancel or change my Healthcare LPA?
Yes, while you have mental capacity you can:
Cancel (revoke) it entirely using a deed of revocation
Make a new LPA that replaces the old one
Remove attorneys using a partial deed of revocation
What if family members disagree with my attorney's decisions?
Your attorneys have legal authority once the LPA is registered and you lack capacity. However, they must:
Act in your best interests
Consult with interested parties where practical
Consider all relevant circumstances
Serious disputes can be referred to the Court of Protection.
Do I need both Healthcare and Financial LPAs?
You don't need both, but most people benefit from having both types. Healthcare decisions and financial matters often overlap—for example, choosing a care home involves both welfare and financial considerations.
What happens if I don't have a Healthcare LPA?
Without an LPA, if you lose capacity:
Family cannot automatically make decisions for you
Healthcare professionals make medical decisions in your best interests
For major decisions, applications to the Court of Protection may be needed
This process is slower, more stressful, and more expensive than using an LPA
Can my attorney override my advance decision (living will)?
No, if you make an advance decision (living will) AFTER creating your Healthcare LPA, it takes precedence for the specific treatments it covers. However, if the LPA was made after the advance decision and gives attorneys power over life-sustaining treatment, the LPA takes precedence.
How many certified copies should I get?
Consider getting 2-3 certified copies. Your attorneys may need to show the LPA to:
Hospitals and GP surgeries
Care homes
Social services
Other healthcare providers
Healthcare LPA and Other Documents
Your Healthcare LPA works alongside other important documents:
Living Will/Advance Decision - Specifies treatments you want to refuse
Financial LPA - Covers money and property decisions
Your Will - Distributes assets after death
Letter of Wishes - Provides guidance to attorneys and executors
Store these documents together in your document storage system.
Next Steps: Creating Your Healthcare LPA
Discuss with potential attorneys - Ensure they're willing and understand your wishes
Gather information - Full names, addresses, and dates of birth for everyone involved
Decide on restrictions - Any decisions you don't want attorneys making
Complete the forms - Online or paper, following the step-by-step guide
Register promptly - Don't wait for a crisis
Remember, creating a Healthcare LPA isn't about expecting the worst—it's about ensuring the best possible care if the unexpected happens. It's a gift of clarity to your loved ones and peace of mind for yourself.
Ready to start? Visit the Official Government LPA Service.