Mental Capacity Assessments and COP3 Reports 2026. What the Law Tests, When a Doctor Is Needed and How Assessments Are Done

A mental capacity assessment decides whether a person can make a particular decision for themselves at the time it needs to be made, and under the Mental Capacity Act 2005 the answer is always decision-specific and time-specific. Nobody lacks capacity in general. The Act starts from a presumption of capacity, requires all practicable steps to help the person decide before concluding they cannot, and states that making an unwise decision does not in itself show a lack of capacity. The test is set out in sections 2 and 3 and was clarified by the Supreme Court in A Local Authority v JB in 2021, which confirmed the functional question comes first. Can the person understand the information relevant to the decision, retain it long enough to decide, use or weigh it, and communicate the decision. Only if they cannot does the assessor ask whether that inability is caused by an impairment of, or disturbance in the functioning of, the mind or brain. The most common formal use is the COP3 form, the assessment of capacity required by the Court of Protection when a family member or professional applies to become a deputy for property and financial affairs or for health and welfare. The Wellness Medico-Legal Wing provides capacity assessments and COP3 reports, including home visits for people who cannot travel, from £950 plus VAT. Fees appear further down this page.

Reviewed by the medical team at The Wellness. Last updated 25 September 2026.

Arrange a capacity assessment on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.

The 5 principles and the test

Section 1 of the Mental Capacity Act 2005 sets out 5 principles that govern every assessment. A person is assumed to have capacity unless it is established that they lack it. A person is not treated as unable to decide unless all practicable steps to help them have been taken without success. A person is not treated as unable to decide merely because they make an unwise decision. Anything done for a person who lacks capacity must be in their best interests. And before acting, regard must be had to whether the purpose can be achieved in a way less restrictive of the person's rights and freedom.

The functional test in section 3 asks whether the person can understand the information relevant to the decision, including the reasonably foreseeable consequences of deciding one way or another or not deciding at all. Whether they can retain it long enough to make the decision, which need not be for long. Whether they can use or weigh it as part of the process of deciding. And whether they can communicate the decision by any means, including speech, sign language or simple muscle movements.

If the person cannot do one or more of those, the assessor then asks whether that inability is because of an impairment of, or disturbance in the functioning of, the mind or brain, which may be permanent or temporary. The causal link must be shown rather than assumed. A diagnosis of dementia, a learning disability or a mental illness does not on its own establish a lack of capacity.

The standard of proof is the balance of probabilities.

What a COP3 is and when it is needed

The COP3 is the Court of Protection's assessment of capacity form. It is required with most applications to appoint a deputy, which is needed where a person has lost capacity to manage their property and financial affairs or their health and welfare and did not make a lasting power of attorney while they could.

The applicant completes the first part, and a practitioner completes the assessment. The form can be completed by a registered medical practitioner, a psychologist, a psychiatrist, a social worker, a nurse, an occupational therapist or another suitably qualified professional who has assessed the person. The Court does not require a doctor in every case, but a doctor's assessment is often preferred where the picture is complex, contested, or bound up with a medical condition affecting fluctuation.

The assessment must address the specific decisions in the application, which is where many forms fall short. Capacity to manage property and affairs is different from capacity to decide where to live, which is different from capacity to consent to a particular treatment. A form stating in general terms that someone lacks capacity is frequently returned.

Lasting powers of attorney are a separate route. A certificate provider confirms that the donor understands the LPA and is not being pressured, and that certificate provider does not need to be a doctor, but where capacity at the time of signing may later be challenged, a contemporaneous medical assessment is strong protective evidence.

Ask whether you need a COP3 or LPA assessment on WhatsApp or email team@thewellnesslondon.com.

How a good capacity assessment is carried out

Preparation first. The assessor establishes the specific decision, the relevant information the person needs to understand, the realistic options, and the history, including diagnosis, medication, fluctuation and any previous assessments. Records are reviewed rather than summarised.

Timing and setting. Capacity can fluctuate with infection, medication, fatigue, time of day and distress, particularly in dementia and delirium. Assessments are arranged at the person's best time and in a familiar setting where possible, which is why home visits are common, and a second assessment is arranged where the first is inconclusive.

All practicable steps to support the decision. Hearing aids and glasses in place, a quiet room, information in simple language, visual aids, an interpreter where needed, and enough time. Section 1 requires these steps, and an assessment that did not take them is open to challenge.

The conversation itself tests each element of the functional test with open questions rather than questions that suggest the answer, records the person's own words, and explores their reasoning rather than whether the assessor agrees with the choice.

The report then sets out the decision in question, the information the person was given, how each element of the test was assessed, the evidence of any impairment and the causal link, the steps taken to support the person, and a clear conclusion on the balance of probabilities for each decision.

Related capacity questions

Testamentary capacity, the capacity to make a will, is judged by the common law test from Banks v Goodfellow rather than the Mental Capacity Act, and is covered in its own guide. Contemporaneous assessment at the time of signing, sometimes called the golden rule, protects a will from later challenge.

Capacity to litigate, to marry, to enter a contract, to make a gift, and to consent to or refuse medical treatment are each decision-specific and have their own relevant information.

Deprivation of liberty questions for people in care homes and hospitals raise capacity as to residence and care, and the statutory framework for authorising deprivation of liberty continues to be reformed, so current requirements should be confirmed at the time.

And retrospective assessments, reviewing the records to give an opinion on capacity at a past date, are sometimes needed in disputes over gifts, wills and financial transactions. These are more limited than contemporaneous assessments and a good report says so.

What do capacity assessments cost

Independent capacity assessments and COP3 completion in England commonly run from around £300 to £900 depending on complexity and whether a home visit is required, with consultant psychiatrist assessments for contested or complex cases higher. Medico-legal reports for Court of Protection disputes, contested wills and litigation run from around £1,500 to £5,000 and above plus VAT. Court attendance runs £2,000 to £4,000 per day.

At The Wellness Medico-Legal Wing each assessment is quoted as one figure. All figures are from prices, plus VAT.

• Complex or contested capacity report for Court of Protection proceedings, with records review and full reasoning, from £3,450.

• Retrospective capacity opinion on records for a disputed will, gift or transaction, from £2,950.

• Testamentary capacity assessment at the time of signing a will, applying Banks v Goodfellow, from £1,950.

• Capacity assessment and COP3 report for a deputyship application, including records review, assessment for each decision in the application and a completed form, from £950.

• Home or care home visit within the M25, additional £395. Second assessment where capacity fluctuates, from £495.

• Written questions answered, from £650. Hourly rate for additional work, £450. Court attendance £3,500 per day.

Assessments at 10 Portman Square, Marylebone, or at the person's home, care home or hospital across London and the South East.

Why The Wellness Medico-Legal Wing is the best choice for capacity assessments

Because the assessment addresses each specific decision rather than capacity in general, which is the commonest reason COP3 forms are returned and capacity evidence is challenged.

Because the law is applied in the right order. The functional test first, as the Supreme Court confirmed in 2021, with the causal link to an impairment of the mind or brain then shown rather than assumed from a diagnosis.

Because the person is given every practicable support to decide, with the right setting, timing, aids and language, which section 1 requires and which protects the conclusion.

Because assessments come to the person. Home, care home and hospital visits are routine, and fluctuating conditions are reassessed at a better time rather than recorded on a bad day.

And because the report is written to be relied on, with the information given, the questions asked, the answers recorded and the reasoning stated, so a court, a family or a professional deputy can see how the conclusion was reached.

Related reading

Testamentary capacity assessment covers wills and the Banks v Goodfellow test, the Medico-Legal Wing sets out the full reporting service, instructing a medical expert witness covers the process for solicitors, and private GP home visits covers doctor visits for older relatives.

Book a capacity assessment on WhatsApp or call 020 3951 3429.

Frequently asked questions

What is a COP3 form

The Court of Protection's assessment of capacity form, required with most applications to appoint a deputy for property and financial affairs or for health and welfare. The applicant completes the first part and a practitioner who has assessed the person completes the assessment of capacity for the specific decisions in the application.

Who can complete a COP3

A registered medical practitioner, psychologist, psychiatrist, social worker, nurse, occupational therapist or other suitably qualified professional who has assessed the person. A doctor is not required in every case but is often preferred where the picture is complex, contested or involves fluctuating capacity.

How is mental capacity assessed

Under sections 2 and 3 of the Mental Capacity Act 2005, the assessor asks whether the person can understand, retain, use or weigh the information relevant to the specific decision and communicate their decision. If not, the assessor asks whether that inability is caused by an impairment of, or disturbance in the functioning of, the mind or brain.

Does a dementia diagnosis mean someone lacks capacity

No. A diagnosis does not on its own establish a lack of capacity. Capacity is decision-specific and time-specific, the person is presumed to have it, and the assessor must show both that they cannot make the particular decision and that this is caused by the impairment.

Can the assessment be done at home

Yes. Home, care home and hospital visits are routine and often produce a more accurate assessment, since capacity can fluctuate and a familiar setting reduces distress. A home visit within the M25 is an additional £395 plus VAT.

How much does a COP3 capacity assessment cost

Independent COP3 assessments commonly run from around £300 to £900. At The Wellness Medico-Legal Wing a capacity assessment and COP3 report for a deputyship application is from £950 plus VAT, with complex or contested Court of Protection reports from £3,450 plus VAT.

The Wellness Medico-Legal Wing provides independent capacity assessments and medico-legal reports from 10 Portman Square, Marylebone, London. All doctors are GMC-registered. Capacity conclusions are decision-specific and time-specific, and whether a person lacks capacity in proceedings is ultimately a matter for the court. Court forms and procedures are set by the Court of Protection and should be confirmed on GOV.UK. This article is general information and not legal advice about any particular case.

Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.

References. Mental Capacity Act 2005, sections 1 to 4 on principles, the test for capacity and best interests. Mental Capacity Act 2005 Code of Practice. A Local Authority v JB, UK Supreme Court, 2021, on the order of the functional and diagnostic elements of the test. Court of Protection form COP3, assessment of capacity, and GOV.UK guidance on deputyship applications. Office of the Public Guardian guidance on lasting powers of attorney and certificate providers. Banks v Goodfellow, 1870, on testamentary capacity. British Medical Association and Law Society, Assessment of Mental Capacity guidance. Published 2026 UK medico-legal and capacity assessment market pricing.