England & Wales ONLY • Plain English • Scotland & Northern Ireland differ
This is general legal information, not legal advice.

Health & Welfare LPA — Guide (England & Wales)

Form LP1H • certificate provider • witnesses • signing order • life-sustaining treatment • OPG registration • ending an LPA
Quick summary: a health and welfare LPA lets you choose, in advance, who decides about your care and medical treatment — but it can only be used once you are unable to make those decisions yourself, and only after the Office of the Public Guardian has registered it.
This page covers form LP1H: what the LPA reaches, who can and cannot sign the certificate, the order the signatures must go in, what registration costs and takes, the life-sustaining treatment choice in section 5, and how an LPA ends.
Specialty: England & Wales health and welfare LPA guidance focused on the four things that actually stop an LPA working — the wrong certificate provider, the wrong signing order, an unregistered form, and a life-sustaining treatment box nobody read.
Whether you are planning ahead, helping a parent after a diagnosis, or you have just found out a signed LPA cannot be used yet, this page shows where the real problem is.
What AI Lawyer can do here (free plan)
  • Preparation pack — attorney choices, preferences, instructions and the section 5 decision, written down before you touch the official form.
  • Certificate provider check — who in your circle is actually eligible.
  • Signing-order plan — who signs what, in what order, witnessed by whom.
AI Lawyer cannot produce the LPA itself — that is only valid on the OPG’s own form. This is general legal information, not legal advice.
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Attorney choices
Certificate provider
Signing order
Registration delays
Best for people saying:
  • “Mum has been diagnosed and we need this sorted.”
  • “We signed it — why can’t the hospital accept it?”
  • “Who is allowed to be our certificate provider?”
  • “Do I tick Option A or Option B?”
  • “How long does registration actually take?”
  • “Should I do this, or apply for deputyship?”
You can start with one paragraph. We’ll ask only what’s needed.

How this guide helps

Three steps — clear, practical, risk-aware.
1) Decide before you touch the form
Who your attorneys are, whether they act jointly or jointly and severally, what preferences and instructions you want recorded, and Option A or Option B in section 5.
2) Check the people around the signing
The certificate provider and the witnesses have to be eligible. Most of the people a donor naturally asks are disqualified — better to find that out now than in eight weeks.
3) Sign in order, then register
A health and welfare LPA does nothing at all until the Office of the Public Guardian registers it. That is not a formality you can leave for later.

What it covers — and when it starts working

The biggest misunderstanding on this topic is timing.
GOV.UK describes two types of LPA. A health and welfare LPA covers your daily routine — washing, dressing, eating — your medical care, moving into a care home, and life-sustaining treatment. A property and financial affairs LPA is a separate document for money and property. Making one does not make the other.
The rule that catches families out: a health and welfare LPA can only be used when you are unable to make your own decisions. It gives your attorney no say while you still have capacity for the decision in question. A property and financial affairs LPA can be used while you still have capacity; this one cannot.
To make an LPA you must be 18 or over and have mental capacity when you make it. That is why “we’ll sort it if something happens” fails so often — by then the window has usually closed, and the only route left is a Court of Protection deputyship.

What “unable to make your own decisions” means

The Mental Capacity Act 2005 framework, as the NHS explains it.
  • Capacity is assumed unless proved otherwise.
  • Capacity is decision-specific. A person can lack capacity for some decisions and still have capacity for others. It is not a switch that flips once.
  • The four-part test. A person cannot make a decision if they cannot understand the relevant information, retain it long enough, use or weigh it, or communicate their decision in any way.
  • Best interests. Where a person lacks capacity, the decision must be made in their best interests — involving them as far as possible, considering their views and circumstances, avoiding discrimination, and consulting family, carers and appointed representatives.
A registered health and welfare LPA decides, in advance, who that consulted decision-maker will be.

The form, the certificate provider and the signing order

This is where most rejected applications go wrong.
The form is LP1H — “LPA for health and care decisions”. (LP1F is the financial one; LP3 notifies people; LP12 is the official guide; LPC are continuation sheets.) LP1H is used both to create the LPA and to apply to register it. There is no notarisation anywhere in this process — the safeguards are the certificate provider, witnessed signatures, and registration.
The certificate provider confirms you are making the LPA by choice and understand what you are doing. Certificate providers and witnesses must be 18 or over. These people cannot be your certificate provider: any attorney or replacement attorney; family members (spouse, children, parents, siblings, grandparents, grandchildren, in-laws, step-relatives); unmarried partners, boyfriends or girlfriends; business partners, employees or employers; and staff, managers or owners of a care home where you live.
Witnesses. Anyone aged 17 or under cannot witness, nor can an attorney or replacement attorney, nor an employee of a trust corporation that is an attorney. You cannot witness your own signature. Attorneys may witness each other — but an attorney cannot witness the donor signing.
Signing order is a validity requirement, not etiquette
(1) The donor signs, including section 5. (2) The donor’s witness signs. (3) The certificate provider signs. (4) The attorneys and replacement attorneys sign, each with their own witness. (5) Section 15 is signed to apply to register. Signed out of order, the Office of the Public Guardian will not register it and your attorneys will never be able to use it.

Section 5: the life-sustaining treatment choice

A real decision with two real outcomes — not a box to skim.
Option A
“I give my attorneys authority to give or refuse consent to life-sustaining treatment on my behalf.” Your attorneys can make that decision for you.
Option B
“I do not give my attorneys authority to give or refuse consent to life-sustaining treatment on my behalf.” Doctors make those decisions instead.
Many donors assume “health and welfare” automatically reaches life-sustaining treatment. It does not — section 5 decides it, and the donor must sign section 5 themselves. If what you want is to refuse a specific treatment yourself rather than appoint a decision-maker, that is a different document: an advance decision to refuse treatment. Where a person has both, we do not state which prevails — that turns on statutory wording we have not verified, and it is a question for a solicitor.

Registering with the Office of the Public Guardian

Until this is done, the document does nothing.
  • Registration is compulsory. GOV.UK is blunt: you must register your LPA or your attorney will not be able to make decisions for you.
  • Who applies. You can apply yourself while you are still able to make your own decisions, or an attorney can apply.
  • Cost. £92 per LPA on GOV.UK when we checked on 8 August 2026 — £184 for a health and welfare LPA and a property and financial affairs LPA together. Fees change; check GOV.UK before you pay.
  • Time. GOV.UK states it takes 8 to 10 weeks to register if there are no mistakes in the application.
  • Objections. People who are notified have 3 weeks from receiving the notification form to raise concerns with OPG.
  • If rejected for certain mistakes, OPG may let you correct it and apply again within 3 months for £46 (same date-check caveat).
Put those numbers together and the lesson is plain: an LPA signed during a crisis is about two months too late for that crisis. Make it while you are well.

Ending an LPA — and LPA now versus deputyship later

Revocation has its own capacity requirement. And one route is your choice; the other is a court’s.
Ending it deliberately: you must be able to make your own decisions when you end your LPA. Send OPG the original LPA plus a signed, witnessed written statement called a deed of revocation.
Ending it automatically: the LPA ends when the donor dies. An individual attorney’s appointment ends if that attorney loses mental capacity, divorces the donor or ends a civil partnership with them, is removed by the Court of Protection, or dies — though replacement attorneys, or attorneys appointed “jointly and severally”, can carry on. Bankruptcy and a Debt Relief Order end an appointment for property and financial affairs LPAs only, not for health and welfare.
No LPA, capacity already lost? The route is a deputyship application to the Court of Protection, which checks the application and issues a court order defining the deputy’s powers. The court will usually only appoint a personal welfare deputy where there is doubt about whether decisions will be made in the person’s best interests, or where someone needs to decide a specific issue over time; you cannot be a personal welfare deputy for someone under 16. GOV.UK puts it plainly: if the person already has an LPA or an enduring power of attorney, they do not usually need a deputy. Deputyship vs LPA explained →

What does NOT apply outside England & Wales

Read this before you use any of the above anywhere else.
  • Scotland. Scotland has a continuing power of attorney (financial, usable as soon as it is registered) and a separate welfare power of attorney (only exercisable after loss of capacity); the two can be combined. It is registered with the Office of the Public Guardian (Scotland), and the document must be certified by a solicitor or a medical practitioner who has interviewed the granter first. Form LP1H, the certificate provider rules, the £92 fee, the 8–10 week timescale and the 3-week objection window are England & Wales only.
  • Northern Ireland. Northern Ireland uses an Enduring Power of Attorney, which continues after mental incapacity and covers property and affairs; nidirect’s guidance describes no health-and-welfare equivalent. It is registered with the Office of Care and Protection at the High Court. There is no LP1H and no health and welfare LPA in Northern Ireland.
  • Republic of Ireland, USA, Australia, Canada. None of this applies. The US equivalent is a medical power of attorney or healthcare proxy, and it is state law — see the US guide at the foot of this page.
Create your health & welfare LPA preparation pack free with AI Lawyer
Your Free Legal Starter plan is free forever and includes 1 document build and 25 legal & business questions. Answer a few plain-English questions and AI Lawyer drafts your health & welfare LPA preparation pack — then download it and have it checked before you rely on it.
Free Legal Starter • £0 forever • 1 document build • 25 Q&A • Login required
Demo document — shows exactly what the free build produces.
A generated draft is a starting point, not legal advice. Have it reviewed before you sign, send or file it.
Important: a preparation pack is not an LPA. An LPA is only valid on the Office of the Public Guardian’s own form LP1H, and only usable once OPG has registered it. The pack gets your decisions straight so the official form is filled in once, correctly.

Long FAQ (health & welfare LPA, England & Wales)

Tap to expand.
1) Can my attorney use it while I am still capable?
No. GOV.UK is explicit: a health and welfare LPA can only be used when you are unable to make your own decisions. That is the main difference from a property and financial affairs LPA.
2) We signed it last week. Can the hospital act on it now?
Not until OPG has registered it, which takes 8 to 10 weeks if there are no mistakes. A signed but unregistered LPA gives your attorney no authority at all.
3) Can my daughter be the certificate provider?
No. Children, spouses, parents, siblings, grandparents, grandchildren, in-laws and step-relatives are all excluded, as are unmarried partners, business partners, employees and employers, any attorney or replacement attorney, and staff, managers or owners of a care home where you live.
4) Does the order of signatures really matter?
Yes, and it is fatal. Donor, then the donor’s witness, then the certificate provider, then the attorneys with their own witnesses, then section 15. Signed out of order, OPG will not register it and your attorneys will not be able to use it.
5) What does it cost to register?
£92 per LPA on GOV.UK when we checked on 8 August 2026, so £184 for both types. If OPG rejects it for certain mistakes it may let you correct and reapply within 3 months for £46. Fees change — confirm on GOV.UK before paying.
6) Do I need a notary or a solicitor?
Notarisation is not part of the England & Wales LPA process at all — the safeguards are the certificate provider, witnessed signatures and OPG registration. A solicitor is not required either, though many people use one where the family situation is complex or contested.
7) What is the difference between Option A and Option B?
Option A gives your attorneys authority to give or refuse consent to life-sustaining treatment. Option B withholds it, and doctors make those decisions instead. You must choose one, and you must sign section 5 yourself.
8) Can someone object to registration?
People who are notified have 3 weeks from receiving the notification form to raise concerns with OPG. We do not name a specific objection form here because we have not verified the form references.
9) How do I cancel an LPA I no longer want?
You must be able to make your own decisions at the time. Send OPG the original LPA plus a signed and witnessed written statement called a deed of revocation.
10) Is this the same in Scotland or Northern Ireland?
No. Scotland uses continuing and welfare powers of attorney registered with OPG Scotland and certified by a solicitor or medical practitioner. Northern Ireland uses an Enduring Power of Attorney covering property and affairs, registered with the Office of Care and Protection. Nothing on this page transfers.
11) Can AI Lawyer create the LPA itself?
No, and no online tool can. An LPA is only valid on the OPG’s own form and only usable once registered. What AI Lawyer produces is a preparation pack — your attorney choices, preferences, instructions and section 5 decision, written down so the official form is completed once, correctly.
12) Can I speak to a lawyer confidentially first?
Yes. If capacity is already in doubt, the family disagrees, or life-sustaining treatment is a live issue, take advice from a solicitor in England or Wales before you sign anything.

 

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This is general legal information, not legal advice.