In a recent turn of events, the Supreme Court has granted permission to Epsom and St Helier University Hospitals NHS Trust to appeal against the Court of Appeal’s decision in the Townsend case, handed down in March 2026.
The case concerns the distinction between clinical decision-making and best interests decision-making in medical treatment cases, with important implications for commissioners and providers of healthcare and social care services.
In its judgment in Townsend v Epsom and St Helier, the Court of Appeal decided that any decision about the medical treatment of a mentally incapacitated adult, including the withdrawal of life-sustaining treatment, must be taken in the patient’s best interests. As a result, clinicians are not permitted to make unilateral decisions to refuse treatment where there is a dispute; instead, such cases must be referred to the Court of Protection, which is responsible for determining the patient’s best interests.
The Townsend family has cross-appealed and it is likely that others will follow to ensure that the Supreme Court’s approach is fully informed by the clinical realities of the impact this decision could have.
The Supreme Court hearing date has not yet been fixed. We will keep readers updated as soon as further details are available.
By way of reminder, you can read the key points from the Court of Appeal’s March decision here: Medical treatment cases: No carve out for ‘clinical decisions’ says Court of Appeal.
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