TLA v Chelsea and Westminster Hospital NHS Foundation Trust

Litigation capacity is issue- and time-specific. The court must identify the decisions and information relevant to the particular proceedings, assess functional ability first, and consider impairment of mind or brain only if functional inability is shown. Capacity is presumed and is displaced only on the balance of probabilities. Strong views, lack of objectivity, persistent complaints and decisions regarded as unwise do not themselves establish incapacity. A litigant need not analyse information more finely than a person of full capacity. Diagnosis and perceived harm from litigation cannot replace proof of functional inability under the Mental Capacity Act 2005.

The claimant, acting without legal representation, brought a High Court claim alleging breaches of confidentiality and other statutory or policy rights by the defendant hospital trust. He alleged psychiatric and psychological injury and sought damages exceeding £350,000.

The claim was stayed after an expert instructed on causation, condition and prognosis expressed the opinion that the claimant lacked litigation capacity. Further experts disagreed. The defendant adopted a neutral position. The central issue was whether the claimant could understand, retain, use or weigh relevant information and communicate decisions in these proceedings, and whether any inability was caused by an impairment or disturbance of mind or brain.

1. Outcome. The court determined that the claimant had litigation capacity. The presumption of capacity had not been rebutted. Having resolved the functional stage in the claimant’s favour, the court did not determine the competing diagnostic evidence.

2. Legal framework. The capacity inquiry was quasi-inquisitorial and required the court to interrogate the available evidence, including the claimant’s own evidence. Under the Mental Capacity Act 2005, capacity is presumed and a person is not incapable merely because a decision is unwise. Capacity is issue- and time-specific. The court adopted the functional-before-diagnostic sequence in A Local Authority v JB [2021] UKSC 52. The diagnostic question arises only if functional inability is established.

3. Functional assessment. The court identified the relevant litigation decisions as including mediation, settlement, trial, procedural steps and whether to instruct a lawyer. Relevant information included the strengths and weaknesses of the claim and defence, likely outcomes, costs, risks and the consequences of settlement or trial. The first question was whether the claimant could understand the issues requiring decision, applying Masterson-Lister v Brutton Co [2002] EWCA Civ 1889. The court then considered understanding, retention, use or weighing of information, and communication.

4. Application. The claimant identified competing considerations, explained the weight he attached to them and addressed the advantages and disadvantages of representation, mediation and trial. His strong views, lack of objectivity and persistent complaints did not establish incapacity. Consistently with Macpherson v Sunderland City Council [2025] EWCOP 18 (T3), difficulty for the court to manage and decisions regarded as unwise were not synonymous with inability to make decisions.

5. Expert evidence. Dr Bradbury’s opinion was substantially undermined because she began with diagnosis and assessed functional decision-making through that diagnosis. Her view that pursuing the litigation was harmful or unwise could not substitute for proof of functional inability. Dr Fisher’s evidence was given little weight because of the structure of her reports and the absence of oral evidence. Dr Chelidoni’s functional-first assessment, supported by specific examples, was persuasive.

This was a first-instance determination of litigation capacity. The claim had been stayed by an order of Master Sullivan dated 3 July 2025 pending the decision; no appeal history is stated.