An LPA in healthcare refers to a Lasting Power of Attorney for health and welfare, a legal document that lets you appoint someone you trust to make medical and care decisions on your behalf if you lose the ability to make them yourself. It covers everything from day-to-day care choices to decisions about life-sustaining treatment. Without one in place, doctors and healthcare organizations may not even be able to discuss your medical situation with your family members.
How a Health and Welfare LPA Works
A health and welfare LPA names one or more people (called “attorneys”) to step in and make decisions about your medical treatment and personal care. This is separate from a property and financial affairs LPA, which deals with money and assets. You can set up one, the other, or both.
The critical distinction: a health and welfare LPA can only be used when you no longer have the mental capacity to make a particular decision yourself. A financial LPA, by contrast, can sometimes be used while you still have capacity. This means your health and welfare attorney has no power over your medical decisions as long as you can make them on your own. Their authority activates only when a healthcare professional determines you lack capacity for that specific decision.
What Decisions Your Attorney Can Make
Your attorney’s authority can be broad. It typically covers decisions about medical treatments, where you live (including whether you move into a care home), your daily care routine, and who has access to your medical records. The LPA form includes a specific section asking whether you give your attorney authority to accept or refuse life-sustaining treatment on your behalf. You must actively choose either yes or no and sign that section. If you select no, decisions about life-sustaining treatment would fall to your medical team instead.
This flexibility is one of the main advantages of an LPA over a living will (also called an advance decision). A living will only covers scenarios you’ve anticipated and written down in advance. An attorney, on the other hand, can respond to unexpected situations, speak up if there are disagreements about your care, and adapt to circumstances you couldn’t have predicted. Many people choose to have both: a living will that records specific wishes and an LPA that empowers someone to handle everything else.
Setting One Up
You can only create an LPA while you still have mental capacity. This is verified by a “certificate provider,” an independent person who meets with you privately to confirm you understand what you’re signing. Certificate providers fall into two categories: someone who has known you personally for at least two years, or a professional with relevant expertise such as a doctor, solicitor, or social worker.
The certificate provider will ask you open questions like “Can you explain what decisions your attorney could make for you?” and “Why did you choose these attorneys?” They’re looking for evidence that you can explain the key concepts in your own words and that nobody is pressuring you into the decision. Family members, anyone named as an attorney, business partners of the attorneys, and care home staff where you live are all legally excluded from acting as certificate providers to prevent conflicts of interest.
Once completed, the LPA must be registered with the Office of the Public Guardian (OPG) before it can be used. Registration costs £82 per LPA application, rising to £92 for applications received from 17 November 2025. Fee exemptions or reductions are available based on financial circumstances. Since you need separate LPAs for health and financial matters, registering both means paying the fee twice.
How Healthcare Staff Verify an LPA
When your attorney needs to make decisions on your behalf, hospital or GP staff may want to confirm the LPA is legitimate. NHS and local authority staff can submit a request to search the OPG’s registers using an official form (OPG100) sent from an accredited email address such as one ending in @nhs.uk. For urgent situations, staff can email the OPG directly for faster confirmation. It’s a good idea to give your GP surgery a copy of the registered LPA so it’s already on file before any emergency arises.
LPA vs. Other Legal Documents
People sometimes confuse an LPA with a living will or advance decision. They serve different purposes. A living will is a written record of specific treatments you would or wouldn’t want, particularly around end-of-life care, pain management, and organ donation. It speaks for you in the exact scenarios you’ve described, but it can’t cover every possibility. An LPA gives a real person the authority to make judgments on your behalf in real time, including situations you never anticipated.
If you have both documents and they conflict, the more recently signed one generally takes priority. But an LPA that specifically includes authority over life-sustaining treatment will usually override an earlier advance decision on the same topic, because the attorney can weigh current medical circumstances that you couldn’t have foreseen when you wrote the advance decision.
Why Timing Matters
The most common mistake with LPAs is waiting too long. You cannot create one after you’ve lost mental capacity. For conditions like dementia, this means the window to set one up closes as the disease progresses. If no LPA exists and you become unable to make decisions, your family may need to apply to the Court of Protection to be appointed as a deputy, a process that is significantly more expensive, slower, and more restrictive than registering an LPA in advance.
For caregivers, having a registered health and welfare LPA is particularly important. It is the only way to ensure the person you’re caring for receives the treatment they want and doesn’t receive treatment they don’t want. Without valid documentation that includes current privacy authorization language, medical providers are often legally unable to share information with anyone other than the patient, even close family members.
Differences Across the UK
The LPA system described here applies in England and Wales. Scotland uses a different legal framework called a “welfare power of attorney,” which operates under separate legislation and has its own registration process. Northern Ireland has its own distinct rules as well. If you or the person you’re caring for lives in a different part of the UK from where the LPA was registered, cross-border recognition can get complicated, so it’s worth checking whether additional steps are needed.