How to Use an LPA With the NHS

Written by James Tyrrell · Reviewed by Anthony Dalton · Last reviewed 16 March 2026

Your father has been admitted to hospital after a stroke and cannot communicate. You have a Health and Welfare LPA — but what do you actually do with it? Knowing you have an LPA and knowing how to use it within the NHS are two very different things. This guide explains how to present your LPA to NHS staff, what decisions you can and cannot make, and how to ensure the donor's wishes are respected in medical settings.

When Can a Health and Welfare LPA Be Used With the NHS?

Unlike a Property and Financial Affairs LPA, which can be used as soon as it is registered (with the donor's permission), a Health and Welfare LPA can only be used when the donor lacks the mental capacity to make a specific decision for themselves. This is a crucial distinction that NHS staff will be aware of.

Mental capacity is assessed on a decision-by-decision basis. The donor may lack capacity to make complex treatment decisions while still being able to decide simpler matters such as what to eat or wear. Medical professionals will carry out a capacity assessment before accepting that an attorney can make a particular decision.

For a detailed explanation of how capacity works in practice, see our guide on LPAs and medical treatment.

Presenting Your LPA at a Hospital

If the donor is admitted to hospital and cannot make their own medical decisions, you will need to present the LPA to the medical team. Here is how to do this effectively:

• Bring a certified copy of the registered LPA (keep the original safe at home)
• Ask to speak to the consultant or senior doctor responsible for the donor's care
• Request that a copy of the LPA is placed on the donor's medical file so it does not need to be presented repeatedly
• Provide your contact details so the medical team can reach you when decisions need to be made
• Bring photo ID to confirm your identity as the named attorney

Most hospitals have a process for recording LPA details on patient records. Once the LPA is noted on the file, ward staff and other departments will be able to see that you have authority to make decisions. However, it is worth checking that the information has been properly recorded, especially if the donor is transferred between wards or departments.

Using Your LPA at a GP Surgery

Registering the LPA with the donor's GP surgery is one of the most important things you can do as a health and welfare attorney. The GP is often the first point of contact for medical care, and having the LPA on file ensures that the surgery knows to involve you in decisions about the donor's treatment.

To register with the GP surgery:

• Visit the surgery in person with a certified copy of the LPA and your photo ID
• Ask the practice manager to add a note to the donor's medical records
• Provide your contact telephone number and email address
• Ask whether the surgery can scan a copy of the LPA onto the donor's electronic record

Once registered, the GP surgery should contact you when significant medical decisions need to be made and the donor lacks capacity. You may also be able to access the donor's medical information, attend appointments on their behalf, and discuss their care with practice nurses and other healthcare professionals.

Emergency Situations and A&E

Emergency medical situations present unique challenges for LPA attorneys. In a genuine emergency where the donor's life is at risk, doctors are legally entitled to provide life-saving treatment without waiting for the attorney's consent. This is an important safeguard — medical staff cannot delay emergency treatment while trying to locate an attorney.

However, once the immediate emergency has passed and the donor is stable, the medical team should involve the attorney in any ongoing treatment decisions if the donor lacks capacity. If you arrive at A&E and the donor is already being treated, introduce yourself to the senior nurse or doctor, explain that you hold a Health and Welfare LPA, and ask to be included in discussions about further treatment.

It is a good idea to carry a small card or letter in the donor's wallet or handbag that states they have a Health and Welfare LPA and gives the attorney's contact details. Paramedics and A&E staff can then contact you as quickly as possible.

In a life-threatening emergency, doctors can treat the donor without the attorney's consent. The LPA comes into play for ongoing treatment decisions once the immediate danger has passed.

What Medical Decisions Can an LPA Attorney Make?

A Health and Welfare LPA can cover a wide range of medical and care decisions. As an attorney, you may be asked to make decisions about:

• Whether the donor should have a particular medical treatment or surgical procedure
• Which medications the donor should take
• Where the donor should live — for example, whether they should move into a care home
• The donor's daily care routine, diet, and activities
• Whether the donor should receive particular therapies or rehabilitation

If the LPA specifically grants authority over life-sustaining treatment, the attorney can also make decisions about whether to consent to or refuse treatment that is needed to keep the donor alive. This is a significant power, and doctors will check the LPA carefully to confirm whether this authority has been granted. For more detail on the scope of an attorney's medical powers, see our guide on whether attorneys can make medical decisions.

There are some decisions that even a health and welfare attorney cannot make. These include consenting to a marriage or civil partnership, consenting to a relationship, voting on the donor's behalf, or consenting to treatment under the Mental Health Act 1983 where specific provisions of that Act apply.

Mental Health Services and LPAs

Using an LPA within mental health services requires particular care. If the donor is receiving treatment for a mental health condition, the interplay between the LPA and the Mental Health Act 1983 can be complex.

In general, a Health and Welfare LPA allows the attorney to make decisions about the donor's mental health care, including whether they should receive counselling, therapy, or medication for mental health conditions. However, if the donor is detained under the Mental Health Act (sectioned), certain treatment decisions are governed by the Act rather than the LPA, and the attorney's authority may be limited in those specific areas.

If the donor is receiving community mental health services, the attorney should introduce themselves to the donor's care co-ordinator and community mental health team. Ensure that the LPA is recorded on the donor's mental health records, and ask to be involved in care planning meetings and reviews.

For a comprehensive overview of what a health and welfare LPA covers, read our health and welfare LPA guide.

Practical Tips for Dealing With NHS Staff

Most NHS professionals are familiar with LPAs, but awareness and understanding can vary. Here are some practical tips for making the process as smooth as possible:

• Always carry a certified copy of the LPA when attending medical appointments or visiting the donor in hospital
• Keep a small, laminated summary card listing the key details: donor's name, your name as attorney, the type of LPA, and your contact number
• Be patient and clear when explaining what an LPA is — some junior staff or agency workers may not have encountered one before
• If staff seem unsure, ask to speak to the ward manager, patient liaison service (PALS), or the hospital's legal team
• Request that the LPA details are added to the donor's electronic NHS record so they are visible across different departments and services
• Follow up in writing (email or letter) after any significant conversation to create a paper trail

If the NHS Refuses to Recognise Your LPA

NHS staff are legally required to recognise a valid, registered Health and Welfare LPA. If a healthcare professional refuses to involve you in decisions or does not accept the LPA, take the following steps:

• Calmly explain that the LPA is a legal document registered with the Office of the Public Guardian
• Ask to speak to a senior clinician or the hospital's patient liaison service (PALS)
• If the issue is not resolved, make a formal complaint through the NHS complaints procedure
• Contact the Office of the Public Guardian for support and guidance
• In serious cases, seek legal advice from a solicitor specialising in mental capacity law

It is worth noting that healthcare professionals can challenge the validity of an LPA if they have genuine concerns — for example, if they suspect the donor was under duress when they made it. However, they cannot simply ignore a valid LPA because they find it inconvenient or are unfamiliar with the process.

If you also hold a Property and Financial Affairs LPA and need to manage the donor's finances, see our guide on how LPAs work with banks for the registration process.

What People Ask About LPAs and the NHS

This guide was last reviewed and updated on 16 March 2026. Information is based on current legislation and OPG guidance for England and Wales.

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