What is a Health and Welfare LPA in the UK?

A Health and Welfare LPA (Lasting Power of Attorney) is a legal document you make while you have mental capacity that authorises a chosen attorney to make medical and care decisions on your behalf if you ever lose that capacity. Unlike the Property and Financial Affairs LPA, a Health and Welfare LPA can only be used when you lack capacity to make the specific decision yourself — your attorney cannot override your own choices while you retain capacity.

What decisions can a Health and Welfare attorney make?

A Health and Welfare attorney can decide: where you live (including which care home); your daily care routine (washing, dressing, eating, activities); medical treatment (consenting to or refusing procedures on your behalf); who has access to visit you; and — if you specifically authorise it in the LPA — whether to give or refuse life-sustaining treatment such as resuscitation or a feeding tube.

Can a Health and Welfare attorney refuse life-sustaining treatment?

Only if you specifically grant this power in the LPA. There is a dedicated tick-box on the OPG form: 'I give my attorney(s) authority to give or refuse consent to life-sustaining treatment.' If you do not tick this box, doctors must apply to the Court of Protection for guidance on life-sustaining treatment decisions. You can also make an Advance Decision to Refuse Treatment (ADRT) alongside your LPA to record specific treatment refusals.

When can a Health and Welfare attorney act?

A Health and Welfare attorney can only act when you lack mental capacity to make the specific decision in question (under the Mental Capacity Act 2005 test). This is stricter than the Property and Financial Affairs LPA, which — if you choose — can be used before capacity is lost. Capacity is assessed decision by decision: you may have capacity for some decisions but not others.

How much does a Health and Welfare LPA cost in the UK in 2026?

The OPG registration fee is £92 per LPA (increased from £82 in November 2025). If you make both LPA types together the total government fee is £184. If your income is under £12,000 per year, the fee is halved to £46 per LPA. There is no fee reduction for Universal Credit recipients from 2 February 2026. A solicitor charges an additional £250–£600+ in professional fees. WillSafe UK's LPA Guidance Pack (£25) helps you complete the official OPG forms without solicitor fees.

Do I need both an LPA and an Advance Decision (living will)?

They are complementary but serve different purposes. An Advance Decision to Refuse Treatment (ADRT, sometimes called a living will) is a legally binding written refusal of specific treatments — it does not need to be registered and cannot be overridden by an attorney. An LPA gives an attorney positive decision-making authority. Most people benefit from both: an ADRT for specific treatment refusals you feel strongly about, and an LPA for broader care and medical decision-making authority.

What happens if I lose capacity without a Health and Welfare LPA?

Without an LPA, your family cannot legally direct your medical care or care home placement — those decisions rest with healthcare and social care professionals under the Mental Capacity Act 2005 'best interests' framework. If your family disagrees with those decisions, they must apply to the Court of Protection, which is costly (£1,000+ in fees) and slow (months). A Health and Welfare LPA is the only way to guarantee that someone you choose has legal authority over your care.

Health and Welfare LPA UK (2026): What It Covers, How It Works & How to Set One Up

What is a Health and Welfare LPA?

A Health and Welfare Lasting Power of Attorney (HW LPA) is a legal document — registered with the Office of the Public Guardian (OPG) — that gives a person you choose (your "attorney") legal authority to make medical and care decisions on your behalf if you lose the mental capacity to make those decisions yourself.

The Mental Capacity Act 2005 governs when an attorney can act. Capacity is assessed decision-by-decision: you might have capacity to decide what you eat but not to consent to complex surgery. Your attorney steps in only for decisions where you currently lack capacity — they cannot override choices you make while you still have it.

This distinguishes the HW LPA from its companion document, the Property and Financial Affairs LPA (PF LPA): a PF LPA can be used while you still have capacity if you choose to allow it; an HW LPA cannot.

What a Health and Welfare LPA covers

Six main areas fall within a Health and Welfare LPA:

Where you live

Which care home, nursing home, or whether to remain at home — including emergency placements

Daily care & routine

Washing, dressing, eating, activities, social arrangements, and hobbies

Medical treatment

Consenting to or refusing operations, medication, therapy, and procedures on your behalf

Visitors & contact

Who is allowed to visit you and under what circumstances — including refusing contact

Mental health treatment

Medication, therapy, and care arrangements for mental health conditions (voluntary only; the Mental Health Act has its own framework)

Life-sustaining treatment

Resuscitation, feeding tubes, ventilation — only if you specifically grant this power in the LPA

Life-sustaining treatment: opt-in required

Your attorney can only make life-sustaining treatment decisions (resuscitation, feeding tubes, ventilation) if you tick the specific authorisation box on the OPG form. Without it, doctors must apply to the Court of Protection for guidance, which causes serious delays at the most critical moment.

Health and Welfare LPA vs Property and Financial Affairs LPA

The two LPA types cover entirely different aspects of your life. Most people need both.

Feature	Health & Welfare LPA	Property & Financial LPA
Covers	Medical treatment, care, daily life	Bank accounts, property, bills, tax
When attorney can act	Only when you lack capacity	Can be used while you still have capacity
Covers life-sustaining treatment	Yes — if specifically authorised	No
Can override your wishes	No — capacity is assessed each decision	Only when you lack capacity for finances
OPG registration fee (2026)	£92	£92
Registered with	Office of the Public Guardian	Office of the Public Guardian
Used alongside	ADRT / living will	Will
Do you need both?	Yes — they cover different life stages	Yes — they cover different life stages

Health and Welfare LPA vs Advance Decision (ADRT)

An Advance Decision to Refuse Treatment (ADRT) — sometimes called a living will — is a legally binding written refusal of specific treatments. It does not need to be registered and takes precedence over an attorney's decision even if you have made an LPA.

An LPA gives your attorney positive decision-making authority across a broad range of situations. An ADRT binds doctors to a specific refusal of a specific treatment, regardless of what your attorney says.

The two documents work together: use an ADRT for treatment refusals you feel strongly about (e.g., "I do not want to be resuscitated if I have advanced dementia"), and an LPA to give your attorney broader authority for care and day-to-day medical decisions.

How to set up a Health and Welfare LPA: 7 steps

The process is identical to the Property and Financial Affairs LPA — both use the same OPG online service.

1
Choose your attorney
Pick someone you trust absolutely — they will make medical decisions on your behalf. You can name one attorney or up to four, acting jointly (all must agree) or jointly and severally (any can act alone).
2
Choose a replacement attorney
Your primary attorney may predecease you or lose capacity themselves. A named replacement steps in automatically.
3
Decide on life-sustaining treatment
Tick the authorisation box if you want your attorney to make life-sustaining treatment decisions. This is the most important decision in an HW LPA.
4
Add preferences and instructions
Include guidance for your attorney — for example, religious or cultural preferences about medical treatment, care home preferences, or dietary requirements.
5
Notify people (optional)
You can name 'people to notify' who must be told when the LPA is being registered — a safeguard against misuse.
6
Sign and witness
You, your attorney(s), and a certificate provider (an independent person who confirms you have capacity and are acting freely) must all sign the form. Your signature must be witnessed.
7
Register with the OPG
Submit online at gov.uk/lasting-power-of-attorney with the £92 fee. Processing takes approximately 20 weeks in 2026.

You cannot make an LPA after losing capacity

The Mental Capacity Act requires that you have capacity at the time you make and sign an LPA. If you have already lost capacity, the only route to appointing someone is a Court of Protection deputyship — which costs £1,000+ in fees and takes 6–12 months. Make your LPA now, while you can.

Choosing your Health and Welfare attorney

For health and welfare decisions, your attorney must be someone who:

Understands and respects your values and treatment wishes
Will advocate firmly on your behalf with medical professionals
Can handle emotionally difficult decisions under pressure
Is likely to be available when needed (geographic proximity matters for care homes)
Is aged 18 or over and has mental capacity themselves
Is not bankrupt (bankrupts cannot be financial LPA attorneys but CAN be HW LPA attorneys)

Your attorney cannot be a paid care worker unless they are your spouse, civil partner, or close family member. A professional such as a solicitor or social worker can act if you wish.

Frequently asked questions

What is a Health and Welfare LPA in the UK?: A Health and Welfare LPA (Lasting Power of Attorney) is a legal document you make while you have mental capacity that authorises a chosen attorney to make medical and care decisions on your behalf if you ever lose that capacity. Unlike the Property and Financial Affairs LPA, a Health and Welfare LPA can only be used when you lack capacity to make the specific decision yourself — your attorney cannot override your own choices while you retain capacity.
What decisions can a Health and Welfare attorney make?: A Health and Welfare attorney can decide: where you live (including which care home); your daily care routine (washing, dressing, eating, activities); medical treatment (consenting to or refusing procedures on your behalf); who has access to visit you; and — if you specifically authorise it in the LPA — whether to give or refuse life-sustaining treatment such as resuscitation or a feeding tube.
Can a Health and Welfare attorney refuse life-sustaining treatment?: Only if you specifically grant this power in the LPA. There is a dedicated tick-box on the OPG form: 'I give my attorney(s) authority to give or refuse consent to life-sustaining treatment.' If you do not tick this box, doctors must apply to the Court of Protection for guidance on life-sustaining treatment decisions. You can also make an Advance Decision to Refuse Treatment (ADRT) alongside your LPA to record specific treatment refusals.
When can a Health and Welfare attorney act?: A Health and Welfare attorney can only act when you lack mental capacity to make the specific decision in question (under the Mental Capacity Act 2005 test). This is stricter than the Property and Financial Affairs LPA, which — if you choose — can be used before capacity is lost. Capacity is assessed decision by decision: you may have capacity for some decisions but not others.
How much does a Health and Welfare LPA cost in the UK in 2026?: The OPG registration fee is £92 per LPA (increased from £82 in November 2025). If you make both LPA types together the total government fee is £184. If your income is under £12,000 per year, the fee is halved to £46 per LPA. There is no fee reduction for Universal Credit recipients from 2 February 2026. A solicitor charges an additional £250–£600+ in professional fees. WillSafe UK's LPA Guidance Pack (£25) helps you complete the official OPG forms without solicitor fees.
Do I need both an LPA and an Advance Decision (living will)?: They are complementary but serve different purposes. An Advance Decision to Refuse Treatment (ADRT, sometimes called a living will) is a legally binding written refusal of specific treatments — it does not need to be registered and cannot be overridden by an attorney. An LPA gives an attorney positive decision-making authority. Most people benefit from both: an ADRT for specific treatment refusals you feel strongly about, and an LPA for broader care and medical decision-making authority.
What happens if I lose capacity without a Health and Welfare LPA?: Without an LPA, your family cannot legally direct your medical care or care home placement — those decisions rest with healthcare and social care professionals under the Mental Capacity Act 2005 'best interests' framework. If your family disagrees with those decisions, they must apply to the Court of Protection, which is costly (£1,000+ in fees) and slow (months). A Health and Welfare LPA is the only way to guarantee that someone you choose has legal authority over your care.

Set up your LPA with the WillSafe UK LPA Guidance Pack

Our LPA Guidance Pack (£25) walks you through both the Health and Welfare and Property and Financial Affairs LPA forms — official OPG process, step by step, without solicitor fees.

Get the LPA Guidance Pack — £25 Essentials Bundle (Will + LPA) — £50

Related guides

This article is for general information only and does not constitute legal advice. WillSafe UK is not a firm of solicitors. Laws described apply to England and Wales only. Always consult a qualified solicitor for advice specific to your circumstances.