A health and welfare LPA (lasting power of attorney) lets you appoint one or more people to make decisions about your care and medical treatment if you lose the mental capacity to make them yourself. It can cover where you live, your daily routine and, if you choose, life-sustaining treatment. This guide covers England and Wales.
What does a health and welfare LPA cover?
A health and welfare LPA gives your chosen attorneys legal authority to make personal care and medical decisions on your behalf once you can no longer make them yourself. It is one of two types of LPA in England and Wales, the other dealing with property and money (gov.uk, as at August 2026, subject to change). The decisions your attorneys can take include:
- Your daily routine, such as washing, dressing and what you eat.
- The medical care and treatment you receive.
- Where you live, including a move into residential or nursing care.
- Life-sustaining treatment, but only if you specifically give them that power when the LPA is made.
Your attorneys must always act in your best interests under the Mental Capacity Act 2005 and follow any wishes you have recorded.
When can a health and welfare LPA be used?
A health and welfare LPA can only be used once you have lost the mental capacity to make the particular decision at the time it is needed. Until then, you make your own care and medical choices, and your attorneys have no authority to step in (NHS, as at August 2026, subject to change).
This is the point most people misread: a property and financial affairs LPA can be used while you still have capacity, if you allow it, but a health and welfare LPA never can.
Health and welfare LPA versus a property and financial affairs LPA
The two LPAs cover different parts of your life and are separate legal documents, each registered on its own with its own £92 fee. A health and welfare LPA deals with care and medical decisions; a property and financial affairs LPA deals with money. Many people put both in place so the same trusted people can look after their care and their finances.
| Health and welfare LPA | Property and financial affairs LPA | |
|---|---|---|
| What it covers | Care, medical treatment, where you live, daily routine, life-sustaining treatment | Bank accounts, bills, pensions, benefits, buying and selling property |
| When it can be used | Only after you lose mental capacity | As soon as it is registered, if you allow it, even while you still have capacity |
| Who decides without it | Doctors or social services in your best interests, or a Court of Protection deputy | A deputy appointed by the Court of Protection |
| Registration fee | £92 | £92 |
Source: gov.uk lasting power of attorney and gov.uk registration guidance, as at August 2026, subject to change. See our fuller guide to the lasting power of attorney.
How do you set up a health and welfare LPA?
You make a health and welfare LPA while you still have mental capacity, then register it with the Office of the Public Guardian (OPG) before it can be used. You must be aged 18 or over, and it is worth allowing time for registration. The main steps are:
- Choose your attorneys. Pick one or more people you trust, and consider naming replacements.
- Decide on life-sustaining treatment. Choose whether your attorneys can make those decisions (Option A) or whether they are left to your doctors (Option B).
- Complete the form. Use the OPG's online LPA service or paper form LP1H.
- Get a certificate provider. An independent person confirms you understand the LPA and are not under pressure to make it.
- Sign and witness in order. You, the certificate provider and your attorneys sign in the correct sequence, each signature witnessed.
- Register with the OPG and pay the £92 fee. The LPA cannot be used until registration is complete.
Process summarised from gov.uk, make a lasting power of attorney, as at August 2026, subject to change.
How much does it cost and how long does it take?
It costs £92 to register with the OPG, and registration usually takes 8 to 10 weeks if the application is correct (gov.uk, as at August 2026, subject to change). It cannot be used until registration is complete.
| Item | Detail (August 2026) |
|---|---|
| Registration fee | £92 per LPA (£184 for both types) |
| Fee reduction | 50% off if your gross income is under £12,000 a year |
| Fee exemption | Possible if you receive certain means-tested benefits, such as Income Support |
| Time to register | Usually 8 to 10 weeks if there are no mistakes; the online service is generally quicker |
| Objection period | People notified of the LPA have 3 weeks to raise concerns with the OPG |
Source: gov.uk registration and fees, as at August 2026, subject to change.
Life-sustaining treatment and how it fits with a living will
When you make the LPA you choose whether your attorneys can consent to or refuse life-sustaining treatment. Option A gives them that power; Option B keeps those decisions with your medical team (gov.uk, as at August 2026, subject to change).
A health and welfare LPA is not the same as an advance decision (a living will), which records specific treatments you want to refuse. The order matters: an LPA giving an attorney power over life-sustaining treatment can override an earlier advance decision, while an advance decision made later can take precedence. Review the two together.
What happens if you don't have one?
If you lose capacity without one, no one automatically has legal authority to make care and treatment decisions for you, not even a spouse or adult child. Everyday care choices are then made by your doctors and social workers in your best interests under the Mental Capacity Act 2005 (NHS, as at August 2026, subject to change).
For bigger or ongoing decisions, a family member may have to apply to the Court of Protection to be appointed as a personal welfare deputy, which is slower and more costly than making an LPA in advance. A health and welfare LPA is part of wider estate planning, and often sits alongside a will and planning for care fees.
Frequently asked questions
Common questions on a health and welfare LPA cover when it can be used, what it costs, how long registration takes and how it sits alongside a living will. The short answers below are drawn from gov.uk and the NHS. For decisions about your own circumstances, it is best to take advice from a suitably qualified professional.
Can a health and welfare LPA be used while I still have capacity?
No. Unlike a property and financial affairs LPA, it can only be used once you have lost the mental capacity to make the particular decision. While you can still decide for yourself, your attorneys have no authority to act (NHS, as at August 2026, subject to change).
How much does a health and welfare LPA cost?
It costs £92 to register with the Office of the Public Guardian. You may get a 50% reduction if your gross income is under £12,000 a year, or an exemption if you receive certain means-tested benefits (gov.uk, as at August 2026, subject to change).
How long does it take to register?
Registration with the OPG usually takes 8 to 10 weeks if there are no mistakes, and includes a 3-week period during which anyone notified can raise concerns. The online service is generally quicker than paper. It cannot be used until registered, so start early (gov.uk, as at August 2026, subject to change).
Can my attorney refuse life-sustaining treatment?
Only if you gave them that power when you made the LPA, by choosing Option A on the form. If you chose Option B, those decisions stay with your medical team. Your attorney must always act in your best interests under the Mental Capacity Act 2005 (gov.uk, as at August 2026, subject to change).