H038 Health and welfare lasting power of attorneyin Huntington’s disease patients across the west midlands: an audit

<h3>Background</h3> Huntington’s disease (HD) is an autosomal dominant neurodegenerative disorder causing motor symptoms such as chorea and coordination loss, alongside psychiatric manifestations including personality changes, cognitive decline, and various mental health disorders. The Huntington’s Disease service, based at The Barberry under the Birmingham and Solihull Mental Health NHS Foundation Trust (BSMHFT), provides multidisciplinary support to address both physical and psychiatric symptoms. An essential aspect of HD care is establishing a Lasting Power of Attorney (LPA) for health and welfare, ensuring patients’ interests are represented as cognitive decline progresses. <h3>Aims</h3> 1. Assess whether the Huntington’s Disease service proactively discusses LPAs during outpatient reviews. 2. Evaluate the frequency and quality of discussions regarding LPA implementation before loss of capacity. Methodology: Reviewing notes of 339 HD patients at BSMHFT from May 2019 to May 2024, records were filtered using the term ‘LPA’ by any member of the multidisciplinary team (MDT). <h3>Results</h3> Only 6% of patients had active discussions about LPA for health and welfare before capacity was lost with 14% of patients having established an LPA. The majority (80%) had no evidence of LPA discussion. <h3>Conclusion</h3> The results reveal a significant gap in proactive discussions about LPA for health and welfare among HD patients. Despite its importance, only a small fraction of patients had such discussions or established LPAs. This highlights the need for robust strategies within the Huntington’s Disease service to ensure all patients are encouraged to consider and establish LPAs well before they lose capacity.