Lasting Power of Attorney
Appoint trusted attorneys to make decisions about your personal care and medical treatment — so your voice is heard even if you cannot speak for yourself.
When planning for the future, most people focus on writing a will or organising finances. But safeguarding your personal care and medical choices is equally critical. A Health and Welfare LPA ensures that if an illness, accident, or condition such as dementia strips away your ability to communicate your wishes, the people who know you best are legally empowered to act on your behalf.
Without it, these highly personal decisions may be left in the hands of local authorities or medical professionals who, despite their best intentions, do not know your personal values or preferences.
Scope of Authority
Once activated, a Health and Welfare LPA grants your attorneys broad authority across four key areas:
Deciding what you eat, what you wear, and how your daily health management is handled — including dietary requirements and personal hygiene.
Legal authority for care home placement. If you can no longer live safely at home, attorneys can choose an appropriate care facility that aligns with your standards and preferences.
Consenting to or refusing medical treatments, coordinating with your GP, and deciding on the involvement of social services.
You can choose whether to give your attorneys authority to consent to or refuse life-sustaining treatment — or leave that decision to doctors acting in your best interests.
Activation Rules
The activation of a Health and Welfare LPA is strictly governed by the Mental Capacity Act 2005. It can only be used when you have lost the mental capacity to make the relevant decision yourself. The Act is built on three core principles:
A person must be assumed to have capacity unless it is explicitly established that they lack it.
A person cannot be treated as unable to make a decision until all practicable steps to help them do so have been taken without success.
An unwise decision does not automatically mean a person lacks capacity.
| Feature | Health & Welfare LPA | Property & Financial Affairs LPA |
|---|---|---|
| Covers | Care, medical treatment, daily routine, where you live | Bank accounts, bills, pensions, property |
| When usable | Only when donor has lost mental capacity | As soon as registered (with donor's permission) |
| Registration body | Office of the Public Guardian | Office of the Public Guardian |
| Registration fee | £82 (reductions/exemptions available) | £82 (reductions/exemptions available) |
Critical Decision
One of the most significant sections of a Health and Welfare LPA allows you to give or withhold permission for your attorneys to make decisions about life-saving medical care. You have a clear choice:
You give your attorneys the authority to give or refuse consent to life-sustaining treatment on your behalf. Your attorneys will make these decisions based on what they know of your wishes and values.
You choose not to give your attorneys this authority. Instead, doctors will make these decisions based on your best interests, though they will usually still consult your family.
Advance directive vs. Health and Welfare LPA: An advance directive is a written statement outlining specific medical treatments you would refuse in specific future scenarios. A Health and Welfare LPA appoints a person to make a wide range of health decisions as situations arise. If you have both, ensure they do not contradict one another — the most recently signed document generally takes legal precedence on the specific treatments it covers.
Choosing Attorneys
Most people choose a spouse, adult children, or close friends. When appointing multiple attorneys, you must decide how they will make decisions together:
Attorneys must agree unanimously on every single decision.
Attorneys can make decisions together or independently.
Jointly for some decisions, jointly and severally for others.
Consider geographic proximity. While a financial attorney can act from another country via online banking, a health attorney will need to attend hospital meetings, visit care homes, and assess your physical wellbeing in person.
The Process
The process can be completed online via the UK Government website or using paper forms. There are three key stages:
Input your details, your attorneys' details, and any specific instructions or preferences — for example, a preference for vegetarian food, or a desire to live close to a specific family member.
An independent Certificate Provider confirms you understand the LPA and are not under pressure to sign. They can be a professional (GP or solicitor) or someone who has known you personally for at least two years.
The LPA has no legal power until registered with the Office of the Public Guardian. Registration takes up to 20 weeks. The fee is £82 per LPA in England and Wales, with reductions or exemptions available for low incomes.
| Circumstances | Fee |
|---|---|
| Standard fee | £82 per LPA |
| Low income (below £12,000 per year) | £41 (50% reduction) |
| Receiving means-tested benefits | £0 (total exemption) |
The Alternative
Many people falsely assume that being a spouse or next of kin automatically grants them the right to make medical decisions. Under the law of England and Wales, this is not the case.
If you lose mental capacity without an LPA in place, your loved ones must apply to the Court of Protection to be appointed as a deputy for personal welfare decisions. This process is:
Often thousands of pounds in legal and court fees, compared to £82 for an LPA.
The application can take many months to be approved, leaving families in legal limbo.
During the application period, the family has no legal authority to direct care or manage disputes.
The solution is simple: make a Health and Welfare LPA now, while you have mental capacity. It is one of the most important legal documents you will ever sign — and one of the most affordable. Compare LPA and deputyship in detail →
FAQs
A Health and Welfare Lasting Power of Attorney (LPA) is a legal document that lets you (the donor) appoint one or more trusted people (attorneys) to make decisions about your personal care and medical treatment if you lose mental capacity. It is one of two types of LPA available in England and Wales — the other being a Property and Financial Affairs LPA.
A Health and Welfare LPA can only be used when you have lost mental capacity to make the relevant decision yourself. Unlike a Property and Financial Affairs LPA, it cannot be used while you still have capacity — even with your permission. This is a strict legal requirement under the Mental Capacity Act 2005.
Once activated, your attorneys can make decisions about your daily routine and personal care, where you live (including care home placement), medical treatment and GP consultations, and — if you choose to grant this power — life-sustaining treatment decisions.
Only if you specifically grant this authority in the LPA. You have a clear choice: either give your attorneys the power to consent to or refuse life-sustaining treatment, or withhold that authority so that doctors make those decisions based on your best interests (usually after consulting your family).
An advance directive (sometimes called a living will) is a written statement outlining specific medical treatments you would refuse in specific future scenarios. A Health and Welfare LPA appoints a person to make a wide range of health decisions as situations arise. If you have both, they must not contradict each other — the most recently signed document generally takes legal precedence on the specific treatments it covers.
No. Under the law of England and Wales, being a spouse or next of kin does not automatically give anyone the right to make medical decisions on your behalf. Without a Health and Welfare LPA, your family may have no legal authority to direct your care — and may need to apply to the Court of Protection for a deputyship order, which is significantly more expensive and time-consuming.
The registration fee is £82 per LPA in England and Wales. If you are on a low income, you may be eligible for a 50% reduction (£41). If you receive certain means-tested benefits, you may qualify for a total exemption. A solicitor can advise on eligibility and handle the registration process on your behalf.
Yes — as long as you still have mental capacity. You must create a formal Deed of Revocation and send it to the Office of the Public Guardian along with the original LPA document. You are then free to draft a new LPA reflecting your current wishes. Once you lose mental capacity, the LPA can no longer be revoked.
Yes — most solicitors recommend making both types of LPA at the same time. They cover different areas of your life, and having both in place ensures that your attorneys can manage every aspect of your affairs if you lose capacity. Making them together is also more cost-effective.
If you lose mental capacity without a Health and Welfare LPA in place, your loved ones must apply to the Court of Protection to be appointed as a deputy for personal welfare decisions. This process typically takes many months, costs significantly more than an LPA, and during the application period your family has no legal authority to direct your care or manage disputes with medical professionals or social services.
Get Started
Our team can guide you through the Health and Welfare LPA process from start to finish — including registration with the Office of the Public Guardian.
Explore Further
Related: Wills, Trusts & Estates
An LPA is an essential part of estate planning — and works best alongside a professionally drafted will. Our wills, trusts and estates team can help you plan ahead so your affairs are in order for every eventuality.
Related: Probate
When a donor dies, the LPA ceases and the executor named in the will takes over. Understanding how LPA and probate interact helps families plan ahead and avoid costly Court of Protection applications.