Key considerations for governance, assurance and implementation

This briefing highlights the practical organisational considerations arising from the Mental Health Act 2025 and the UK Supreme Court judgment in A Reference by the Attorney General for Northern Ireland of a devolution issue under paragraph 34 of Schedule 10 to the Northern Ireland Act 1998 [2026] UKSC 16 (AGNI deprivation of liberty judgment). This briefing is intended to support assurance and readiness discussions.

A changing landscape

Mental health and wider health and care providers continue to prepare for significant legislative and regulatory developments, including the Mental Health Act 2025 and the deprivation of liberty implications arising from the AGNI judgment.

These developments raise different legal and operational considerations. The Mental Health Act 2025 represents a substantial programme of reform, while the AGNI judgment has prompted organisations to consider their deprivation of liberty arrangements. They nevertheless present a shared challenge for providers: ensuring that change is translated into effective governance arrangements, workable operational processes and clear, defensible decision-making.

Areas for organisational readiness

1. Governance and ownership - Clear leadership, responsibility for implementation, reporting routes and oversight of progress and emerging guidance across both the Mental Health Act reforms and deprivation of liberty arrangements.
2. Policies and operational processes - Current, approved and communicated policies, pathways, patient information and decision-support tools, including those relevant to deprivation of liberty.
3. Identification and review of affected cases - A documented and proportionate method for identifying relevant patient groups and prioritising reviews, including cases potentially affected by the deprivation of liberty implications arising from AGNI.
4. Individualised and defensible decision-making - Records that clearly evidence the person’s circumstances, wishes and feelings, consent, restrictions, proportionality and alternatives considered.
5. Workforce capability - Practical guidance, case scenarios and tools that support consistent application across clinical and administrative teams.
6. Digital systems and information - Systems that identify affected cases, monitor deadlines, capture decisions, retain evidence and support governance reporting.

Questions for Providers

1. Do we understand which services, processes and patient groups are affected by the Mental Health Act 2025 reforms and the deprivation of liberty implications arising from the AGNI judgment?
2. Have we reviewed the policies, pathways, information and documentation used by staff, including those relating to deprivation of liberty?
3. Do we have a proportionate method for identifying and prioritising cases requiring review?
4. Can our records demonstrate individualised, proportionate and defensible decision-making, particularly where restrictions may amount to a deprivation of liberty?
5. Does our governance structure provide assurance that changes have been communicated, implemented and embedded?

The key question is not simply whether documents have been updated, but whether the organisation can demonstrate that the Mental Health Act reforms and the deprivation of liberty implications arising from the AGNI judgment have been translated into safe, lawful and person-centred practice.

How MIAA can support

MIAA can support organisations in assessing readiness for the Mental Health Act 2025 reforms and the deprivation of liberty implications arising from the AGNI judgment through a range of assurance and advisory services tailored to local needs.

• Organisational readiness reviews: A focused readiness review can provide independent assurance on governance, implementation plans, policy and procedural updates, workforce communication, digital arrangements and the management of implementation risks across Mental Health Act reform and deprivation of liberty arrangements.
• Targeted caseload and documentation audits: Targeted sample testing can assess whether local deprivation of liberty arrangements are being applied consistently in practice. This may include evidence of consent, wishes and feelings, the rationale for restrictions, consideration of less restrictive options, statutory documentation and the clarity of clinical and administrative decision-making.
• Governance and assurance reviews: A governance review can assess whether Boards and committees receive sufficient information to oversee implementation and ongoing compliance. This may include ownership and accountability, reporting routes, risk escalation, action-plan monitoring, assurance mapping and the quality of performance reporting.
• Policy and process reviews: Reviews can consider whether Mental Health Act, Mental Capacity Act and deprivation of liberty policies, operational procedures, discharge and recall pathways, patient information and decision-support documentation reflect current requirements and can be applied consistently.
• Workforce capability and training reviews: MIAA can assess whether relevant staff have the knowledge, guidance and support needed to apply changing requirements. Work may include training compliance and effectiveness, staff interviews, competency or scenario-based testing, review of decision-support tools and identification of gaps across different staff groups.
• Digital, information and reporting reviews: Reviews can assess whether systems support case identification, statutory deadline monitoring, complete and traceable recording, management reporting and governance oversight. This may include data-quality testing, system-control reviews and assessment of dashboards or trackers.

Important note
This publication is intended to support organisational assurance and readiness. It is not legal advice. Organisations should consider the primary legislation, commencement regulations, the full AGNI judgment, current national guidance and any specific implications for deprivation of liberty, and obtain legal advice where required.

If you have any queries about this briefing or how MIAA can support your organisation please do not hesitate to contact Sarah Dowbekin, Associate Director – Continuous Improvement.