LPA for Health and Welfare UK 2026

UK adults planning for the possibility of losing mental capacity need to understand the lasting power of attorney for health and welfare: what it covers, when attorneys can use it, how life-sustaining treatment is handled, and what it costs. This guide explains the instrument under current law in England and Wales, citing the Office of the Public Guardian and the Mental Capacity Act 2005. Kael Tripton is an editorial publisher and not a regulated legal services provider. This article is information only and is not legal advice. Anyone making decisions about their own or a relative's care should consult an SRA-authorised solicitor or Citizens Advice.

What an LPA for health and welfare is

A lasting power of attorney for health and welfare is a legal document that lets a person, the donor, appoint one or more attorneys to make decisions about their personal care and medical treatment if they later lose the mental capacity to make those decisions themselves. It is one of the two types of LPA created by the Mental Capacity Act 2005, the other covering property and financial affairs (Mental Capacity Act 2005, sections 9 to 14, legislation.gov.uk). Attorneys must follow the Act's principles, including acting in the donor's best interests and taking account of the donor's past and present wishes, feelings, beliefs, and values.

The health and welfare LPA can cover decisions about daily routine such as washing, dressing, and diet, medical care and treatment, moving into a care home, and consenting to or refusing particular treatments. The donor can also give the attorney authority to make decisions about life-sustaining treatment, but only where the donor has expressly granted that power in the document by completing the relevant section (Office of the Public Guardian, gov.uk, accessed June 2026). Where that authority is not given, decisions about life-sustaining treatment remain with the medical team acting in the donor's best interests.

When it applies and who needs it

The health and welfare LPA differs from the property and financial affairs LPA in a fundamental way: it can only be used once the donor has lost the capacity to make the specific decision in question. While the donor still has capacity, they make their own care and treatment decisions, and the attorney has no role (Office of the Public Guardian, gov.uk, accessed June 2026). This makes the document a safeguard for the future rather than a tool for the present.

It matters most for people who want a trusted person, rather than a medical team or local authority acting alone, to have a formal say in their care if capacity is lost, for example through dementia, a brain injury, or a progressive illness. Without a registered health and welfare LPA, no family member has an automatic legal right to make these decisions, although medical staff must still act in the patient's best interests and consult those close to them. Any adult aged 18 or over with capacity to understand the decision can make this LPA.

The process step by step

1. Choose attorneys. The donor selects one or more attorneys aged 18 or over and decides whether they act jointly or jointly and severally (Office of the Public Guardian, gov.uk, accessed June 2026).
2. Decide on life-sustaining treatment. The donor states whether attorneys may make decisions about life-sustaining treatment by completing the relevant section (Mental Capacity Act 2005, legislation.gov.uk).
3. Complete the LPA. The donor fills in the LPA online or on paper form LP1H, recording any instructions and preferences (Office of the Public Guardian, gov.uk, accessed June 2026).
4. Arrange a certificate provider. An independent certificate provider confirms the donor understands the LPA and is acting freely (Mental Capacity Act 2005, legislation.gov.uk).
5. Sign in the correct order. The donor, certificate provider, and attorneys sign and date the document in the required sequence (Office of the Public Guardian, gov.uk, accessed June 2026).
6. Register with the OPG. The LPA is sent to the Office of the Public Guardian with the £92 fee, and registration usually completes in 8 to 10 weeks where there are no errors, including a statutory 4-week waiting period (Office of the Public Guardian, gov.uk, accessed June 2026).

Costs and fees

The Office of the Public Guardian charges £92 to register the health and welfare LPA, for applications received from 17 November 2025 (Office of the Public Guardian, gov.uk, accessed June 2026). It is a separate document from the property and financial affairs LPA, so a person who wants both must pay two fees. A 50 percent reduction applies where the donor's gross income is below £12,000 a year, and a full exemption applies where the donor receives certain means-tested benefits, claimed on form LPA120 (Office of the Public Guardian, gov.uk, accessed June 2026).

The only additional cost is professional help, if used. Solicitor fees for drafting are set by the firm rather than by statute and are charged on top of the OPG fee. Money Helper sets out the routes available, including the free government online service for making the LPA (moneyhelper.org.uk, accessed June 2026).

Common mistakes and things to watch

A frequent issue is confusing the health and welfare LPA with an advance decision to refuse treatment, sometimes called a living will. The two are different instruments under the Mental Capacity Act 2005, and where both exist the more recent valid document generally takes priority for the decision it covers (Mental Capacity Act 2005, legislation.gov.uk). Another common error is failing to complete the life-sustaining treatment section, which leaves attorneys without authority over those decisions.

The Office of the Public Guardian also rejects applications with signatures in the wrong order, missing dates, or unworkable instructions (Office of the Public Guardian, gov.uk, accessed June 2026). Because this LPA cannot be used until capacity is lost, donors sometimes assume there is no urgency, but an LPA cannot be made at all once capacity has gone, so leaving it too late removes the option entirely.

How this connects to wills and probate

A health and welfare LPA covers personal and medical decisions during the donor's lifetime, and like all LPAs it ends on death (Office of the Public Guardian, gov.uk, accessed June 2026). It sits alongside the LPA for property and financial affairs, which handles money during life, and a will, which handles the estate after death. After death the executor named in the will applies for a grant of probate to administer the estate.

Thinking about all three together is common practice. The two LPAs cover the window during life when capacity may be lost, splitting care decisions from financial decisions, while the will and probate cover the window after death. Setting up the health and welfare LPA at the same time as the financial LPA and a will means a single considered decision covers care, money, and inheritance without leaving a gap.

When to use a solicitor versus doing it yourself

The government online service allows a person to make and register a health and welfare LPA without professional help, and many straightforward cases use this route at no cost beyond the OPG fee (Office of the Public Guardian, gov.uk, accessed June 2026).

Professional advice is more relevant where the donor has strong views about specific treatments, wants to combine the LPA with an advance decision to refuse treatment, or has a complex family situation where care decisions might be disputed. A solicitor can help word instructions clearly and check the document before registration. The Law Society and the Solicitors Regulation Authority maintain registers of authorised solicitors (lawsociety.org.uk and sra.org.uk, accessed June 2026). The choice depends on how clear and uncontested the donor's wishes are, not on any fixed rule.

FAQ: lasting power of attorney for health and welfare

When can a health and welfare attorney start making decisions?

A health and welfare LPA can only be used once the donor has lost the mental capacity to make the specific decision in question (Office of the Public Guardian, gov.uk, accessed June 2026). While the donor still has capacity, they make their own care and treatment decisions and the attorney has no authority. This is different from the property and financial affairs LPA, which can be used earlier with the donor's agreement.

Can my attorney refuse life-sustaining treatment for me?

Only if the donor has specifically given that authority by completing the life-sustaining treatment section of the LPA (Mental Capacity Act 2005, legislation.gov.uk). Where that power is not granted, decisions about life-sustaining treatment are made by the medical team acting in the donor's best interests, taking account of the donor's wishes and the views of those close to them.

How much does a health and welfare LPA cost?

The Office of the Public Guardian charges £92 to register it, for applications received from 17 November 2025 (Office of the Public Guardian, gov.uk, accessed June 2026). A 50 percent reduction applies where the donor's income is below £12,000 a year, and an exemption applies on certain means-tested benefits. It is a separate document from the financial LPA, so registering both means two fees.

Is a health and welfare LPA the same as a living will?

No. An advance decision to refuse treatment, sometimes called a living will, is a separate instrument under the Mental Capacity Act 2005 that records specific treatments a person does not want (legislation.gov.uk). An LPA appoints a person to make decisions instead. Some people set up both, and case-specific legal advice helps ensure they work together rather than conflict.

Does the LPA continue after I die?

No. A lasting power of attorney ends automatically on the death of the donor (Office of the Public Guardian, gov.uk, accessed June 2026). After death, decisions about the estate fall to the executor named in the will, or to an administrator where there is no will, who usually obtains a grant of probate or letters of administration from HM Courts and Tribunals Service.