An Example of a Successful Health and Welfare Deputyship Application

A Health and Welfare Deputyship authorises a Deputy to make decisions about a protected person’s medical treatment, care arrangements, residence and day‑to‑day welfare when that person lacks capacity and has not made a relevant health and welfare lasting power of attorney. Given the impact of those decisions, health and welfare deputyships are rare and the Court of Protection prefer that professionals and families work in unison to make decisions under the best interests framework or for the Court itself to determine disputed issues, rather than confer ongoing decision‑making powers. As a result, only a very small minority of Deputy appointments relate to health and welfare. Current Office of the Public Guardian data indicates there are around 1,000 health and welfare deputies in England, representing well under 2% of all deputyships.

It follows that, when a person is appointed as a health and welfare Deputy, their powers are often narrow and bespoke, most commonly excluding decisions relating to life‑sustaining treatment unless expressly authorised. Deputies are required to act in the person’s best interests in which it is essential to consult with professionals, where appropriate, and comply with close Court and OPG supervision.

Whilst the Court of Protection prefer not to appoint a person as a health and welfare Deputy, if the circumstances provide this is necessary, appointments will be made. An example of an appointment can be seen in the case of Parr v Cheshire East Council and another company[1]. The case concerned Ruby Parr, an 18‑year‑old woman with profound and lifelong disabilities, including severe epilepsy and other complex medical needs requiring constant care. Until Ruby turned 18, decisions about her health and welfare were made under parental responsibility by her mother, Alison Parr. Shortly before Ruby’s eighteenth birthday, Ms Parr applied to the Court of Protection to be appointed as Ruby’s health and welfare deputy. Ms Parr referred to the absence of a health and welfare lasting power of attorney and that Ruby’s lack of capacity prevented her from being able to make welfare or treatment decisions or appoint an attorney.

The application arose against a background of frequent, urgent health and care decisions, extensive involvement from multiple agencies, high staff turnover and concerns about inconsistent communication and decision‑making by professionals once Ruby became an adult. Ms Parr sought deputyship to secure formal authority and recognition when advocating and making decisions on Ruby’s behalf in an ongoing and structured way.

The Court of Protection granted the Deputyship, concluding that this was one of the limited cases where delegation was justified under the Mental Capacity Act 2005. The Court accepted that Ruby permanently lacked capacity to make health and welfare decisions and that no health and welfare LPA could be put in place. Crucially, the Court found that Ruby’s circumstances required frequent, urgent and interconnected decisions, rather than isolated issues suitable for one‑off court orders.

The judge emphasised that the appointment of a Deputy would not undermine Ruby’s autonomy, as she had never had decision‑making capacity in these domains. Weight was given to Ms Parr’s exceptional familiarity with Ruby’s complex needs, her professional background and the practical difficulties that arose when she lacked formal authority. The Court accepted that repeated applications to resolve disputes would be disproportionate and that appointing a Deputy would promote consistent, timely and effective best‑interests decision‑making within an overstretched care system.

This case demonstrates how the Court considers health and welfare Deputyship applications and the factors that will support the appointment of a Deputy. It is clear a key requirement for a health and welfare deputy to be appointed is the need for regular decisions as this causes difficulty if the Court were to determine each and every decision to appear before them. It should also be noted that Ms Parr was a previously qualified nurse, putting her in a position to make informed medical decisions.

[1] [2026] EWCOP 1