Best interests and the least restrictive option

When someone lacks capacity for a specific decision and the decision must still be made, it should be made in their best interests. This does not mean choosing what is quickest, easiest for staff, or preferred by a family member.

What best interests involves

• Encourage the person's participation: involve them as far as they are able, even if they cannot make the final decision.
• Consider all relevant circumstances: focus on the factors that matter for this specific decision.
• Take account of wishes, feelings, beliefs, and values: both past and present views can be relevant.
• Consult others where appropriate: carers, relatives, attorneys, deputies, and professionals may provide important information.
• Avoid discrimination: do not form assumptions based on age, appearance, diagnosis, behaviour, or lifestyle.
• Ask whether capacity may return: if the person might decide later, consider delaying the decision when it is safe to do so.

Least restrictive option in pharmacy

The law requires choosing the option that interferes least with the person's rights and freedoms while still meeting the need. In pharmacy this might mean offering treatment in a quieter area, using a simpler or less intrusive method of explanation or supply, or delaying a non-urgent decision until the person can participate more effectively.

Pharmacy teams do not normally authorise wider restrictions on liberty. If a situation raises safeguarding, restraint, or deprivation of liberty concerns, it must be escalated through the appropriate clinical and care pathways.

What the decision-maker should record and consider

Best interests is about the person, not what is most convenient for the service. The least restrictive option should always be considered, but it must still meet the real need.