Health & Welfare LPA
Last verified: May 2026 (England & Wales)
Quick-read summary
A Health & Welfare Lasting Power of Attorney is one half of LPA planning. It lets you choose trusted people to make health, care and welfare decisions for you if you cannot make those decisions yourself.
It can cover decisions about care, daily routine, medical treatment, where you live and, if you choose, life-sustaining treatment.
It does not let your attorneys take over while you can still decide for yourself. Capacity is decision-specific. You may be able to make some decisions but not others, and that can change over time.
A Health & Welfare LPA must be registered with the Office of the Public Guardian (OPG) before it can be used.
The OPG registration fee is currently £92 per LPA. Fern Wills & LPAs’ professional fee is currently £250 per LPA.
What is a Health & Welfare LPA?
A Lasting Power of Attorney is a legal document that lets you appoint one or more people, called attorneys, to make decisions for you if you cannot make those decisions yourself.
A Health & Welfare LPA covers personal welfare decisions. These are different from financial decisions, which are covered by the Property & Financial Affairs LPA.
A Health & Welfare LPA can cover decisions about:
care and support;
daily routine, such as washing, dressing, eating and personal care;
medical and dental treatment;
where you live;
moving into a care home or supported accommodation;
contact with professionals involved in your care;
life-sustaining treatment, if you choose to give your attorneys that authority.
Most clients should consider both halves of LPA planning together. Property & Financial Affairs deals with money and property. Health & Welfare deals with care, medical and personal decisions.
When can a Health & Welfare LPA be used?
A Health & Welfare LPA can only be used if:
it has been registered with the OPG; and you cannot make the relevant decision yourself at the time.
This is important.
Your attorneys do not automatically take over your life after the LPA is registered.
If you can still make a particular decision, you make that decision. Your attorneys only step in where you cannot make the relevant decision yourself.
What decisions can your attorneys make?
Your attorneys may be able to make decisions about:
where you are cared for;
what care arrangements are suitable;
day-to-day routine;
medical or dental treatment;
who should be consulted about your care;
whether to consent to or refuse certain treatment, depending on the circumstances and the wording of the LPA.
Life-sustaining treatment is a separate choice in the LPA. You decide whether your attorneys should have authority over that decision.
Preferences and instructions
A Health & Welfare LPA can include preferences and instructions.
Preferences are wishes or guidance. They are not legally binding, but your attorneys should take them into account.
Examples might include:
I would like to stay in my own home for as long as reasonably possible.
I would like my pets to live with me for as long as possible.
If I move into care, I would prefer to be near my family where practical.
I would like regular haircuts, manicures, religious visits or other routines that matter to me.
Instructions are legally binding. Your attorneys must follow them, provided they are workable and valid.
Examples might include:
My attorneys must ensure I am only given vegetarian food.
My attorneys must not decide that I should move into residential care unless my doctor considers that I can no longer live safely and independently at home.
The wording matters. Instructions that are too rigid, unclear or impractical can cause problems later. Fern Wills & LPAs will talk through what you want to achieve and help keep the wording clear and workable.
Why Health & Welfare LPAs matter
It is a common misconception that Health & Welfare LPAs are only for older people.
Capacity can be affected by accident, stroke, serious illness, brain injury, dementia, mental health crisis or a degenerative condition.
If you lose capacity and there is no Health & Welfare LPA in place, your family and friends do not automatically have legal authority to make health and care decisions for you.
Professionals should consult people close to you where appropriate, but the final decision may sit with doctors, care providers, social services or the Court of Protection depending on the issue.
That can lead to delay, uncertainty and disagreement at a difficult time.
A Health & Welfare LPA helps make your wishes clearer and gives legal authority to the people you trust.
What if there is no Health & Welfare LPA?
If you have already lost capacity and there is no Health & Welfare LPA, it is usually too late to make one.
For some decisions, professionals may make best-interests decisions after consulting relevant people.
For serious disputes or major decisions, the Court of Protection may need to be involved.
A personal welfare deputyship may be possible in limited circumstances, but it is not a simple replacement for making an LPA in advance. It can be slower, more expensive and less certain than choosing your own attorneys while you still have capacity.
This is why putting a Health & Welfare LPA in place early is usually simpler and safer.
Cost and registration time
The OPG registration fee is currently £92 per LPA.
Fern Wills & LPAs’ professional fee is currently £250 per LPA.GOV.UK currently says registration usually takes 8 to 10 weeks if there are no mistakes in the application.
You may be able to apply for a fee reduction or exemption depending on income or benefits. The OPG form for this is LPA120.
Additional support, such as certificate-provider appointments, signing visits, professional witnessing, capacity records, certified copies or home visits, can be arranged separately where appropriate and agreed in advance.
How this works in real life
A disagreement about care
A parent’s health deteriorated and family members disagreed about whether home care or residential care was best. A Health & Welfare LPA would not remove every emotional difficulty, but it would identify who had legal authority to make the decision and what wishes should be considered.
Life-sustaining treatment
A client felt strongly about who should speak for them if they could not make a medical decision. The Health & Welfare LPA allowed them to choose whether their attorneys should have authority over life-sustaining treatment decisions.
Staying near family
A client wanted to make clear that, if care became necessary, they preferred to stay close to their sister and adult children. This was included as guidance so attorneys and professionals would know what mattered.
Keeping daily routines
For one client, personal routines such as pets, hair appointments, church, food preferences and familiar surroundings were important. These wishes were not just “nice extras”. They helped the attorneys understand what quality of life meant to that person.
Does a Health & Welfare LPA let my attorneys take over straight away?
No. It can only be used if you cannot make the relevant decision yourself at the time. While you have capacity for that decision, you remain in control.
Can I make only a Health & Welfare LPA?
Yes, but most people should consider both halves of LPA planning. A Health & Welfare LPA covers care and medical decisions. A Property & Financial Affairs LPA covers money, property, bills and practical financial matters.
Can my next of kin make health decisions without an LPA?
Not automatically. Being married, being a child, or being next of kin does not by itself give full legal authority to make health and welfare decisions. Professionals may consult family, but an LPA gives clearer legal authority.
Can attorneys decide about life-sustaining treatment?
Only if you choose to give them that authority in the LPA. This is a specific decision within the Health & Welfare LPA.
Can I include my care preferences?
Yes. You can include preferences and instructions. Preferences guide your attorneys. Instructions are binding if valid and workable. Good drafting matters because unclear or overly restrictive wording can cause problems.
Does this replace a Will?
No. A Health & Welfare LPA works during your lifetime. A Will deals with what happens after death. They do different jobs and usually work best as part of the same wider plan.
Can I make a Health & Welfare LPA after diagnosis of dementia?
Possibly, but only if you still have the mental capacity to understand and make the LPA. Capacity is decision-specific and should not be assumed either way. If there is any concern, a careful capacity record or specialist assessment may be needed.
What happens if my attorneys disagree?
This depends on how they are appointed and what the disagreement is about. Choosing the right attorneys and replacement attorneys is one of the most important parts of the planning. We will talk through practical risks before drafting.
Optional technical notes
Health & Welfare LPAs were introduced under the Mental Capacity Act 2005 and came into use in 2007.
The donor must be at least 18 and have mental capacity when making the LPA.
The LPA must be registered with the Office of the Public Guardian before use.
A Health & Welfare LPA can only be used when the donor lacks capacity for the relevant decision.
Mental capacity is decision-specific and time-specific. A person may have capacity for one decision but not another.
Next steps
A Health & Welfare LPA is about control, dignity and clarity.
It lets you choose who should speak for you if you cannot speak for yourself, and it helps reduce uncertainty for the people who care about you.
Most clients should consider it alongside the Property & Financial Affairs LPA so both halves of LPA planning are covered.
Contact Fern Wills & LPAs to discuss which LPA, or which combination of LPAs, suits your circumstances.
This article is general information only, not individual advice.
