Oxford COMPASS (COMPetency ASSessment) is a new planned project to provide cognitive screening specifically aligned to Mental Capacity Assessments.

Assessment of mental capacity is a critical aspect of clinical practice, particularly for neurological patients. It provides the crucial judgement on patients’ ability to make informed decisions on a wide range of situations, from choosing treatment and discharge destination, to making financial decisions (e.g. selling a house), creating a power of attorney or making a will. Careful, well-informed capacity assessments are vital for ensuring the protection of peoples’ rights. In order to establish that a person lacks capacity, the law states that the person concerned must be unable to (i) understand information relevant to the decision, (ii) retain that information, (iii) use or weigh that information as part of the process of making the decision, or (iv) communicate the decision made.

In spite of clear legal guidance, mental capacity assessments are typically conducted in a short non-standardized interview and are highly variable in practice.  They often fail to align with legal standards of the MCA, are solely based on a subjective, qualitative interview and are poorly documented. 

We are therefore developing a standardised mental capacity assessment app, in line with legal standards, to improve the approach and documenting of this decision-making process, which has long-lasting and highly impactful consequences to patients’ rights to self-determination. This project brings together expertise in neuropsychological cognitive screening and in depth knowledge of mental capacity law with high level statistical methods and software engineering. 

The end goal is for this application (COMPASS, short for COMPetency ASSessment) to be brief (using adaptive testing methods), easy to use by health professionals and to provide them with a standardised and quantified graded mental capacity profile that will inform and guide situation specific capacity judgements.