Core Revision
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The Ethics, Law & Safeguarding Guide
Eleven interactive chapters on the medico-legal half of the AKT — capacity, consent, confidentiality, safeguarding and the Mental Health Act. Written by practising NHS GPs, checked against primary sources, and free to everyone.
Ethics and law is the part of the AKT people leave until last and then regret. It is also the most learnable: the rules are written down, the thresholds are exact, and the questions turn on a small number of distinctions that come up again and again — Gillick or Fraser, consider or suspect, must or may, MHA or MCA.
This guide works through all of them. Every chapter has an interactive decision tool built round a real clinical scenario, self-test questions you can reveal, and the exam traps set out explicitly. Nothing is gated and nothing needs an account.
Why this guide is different right now. On 2 June 2026 the Supreme Court held that Cheshire West was wrongly decided and abolished the “acid test” for deprivation of liberty. Most UK ethics revision material still teaches the old test. Chapter 3 covers what actually replaced it. We have also updated for the Mental Health Act 2025 (enacted, largely not yet in force), Working Together 2026, the Crime and Policing Act 2026 reporting duty, and the 2025–26 notifiable disease list — chickenpox is now notifiable in England.
Capacity and consent
The gateway to everything else. Who can decide, who decides when they cannot, and what happens when care becomes confinement.
Mental capacity: the two-stage test
The five principles, the diagnostic and functional tests, and why capacity is never a whole-person label.
Best interests, ADRTs and LPAs
The order of priority, the section 4 checklist, and the two things a deputy can never do.
Deprivation of liberty in 2026
The acid test is gone. What the multifactorial test asks, and why consent without capacity is now possible.
Children, Gillick and Fraser
Three ages, two tests people confuse, and exactly who holds parental responsibility.
Confidentiality and disclosure
The duty, its limits, and the difference between a disclosure the law compels and one it merely permits.
Confidentiality: two systems
Common law and UK GDPR, implied consent for direct care, records access, and confidentiality after death.
Must, may, must not
Notifiable diseases, FGM, the DVLA ladder, gunshot and knife wounds, and the public-interest threshold.
Safeguarding
Children, adults and domestic abuse — the thresholds, the timescales, and when you act without consent.
Child safeguarding
Consider versus suspect, the section 47 threshold, the timescales, and what mandatory reporting will and will not do.
Adult safeguarding
The section 42 three-part test, ten categories, six principles, and what to do when a capacitous adult says no.
Domestic abuse and coercive control
The statutory definition, non-fatal strangulation, MARAC thresholds, and why screening is not recommended.
Mental health and professional standards
The sections you have to know cold, and the professional duties that sit behind every consultation.
The Mental Health Act
Every section as four numbers, the s117 rules, consent to treatment, and where the 2025 reforms have got to.
Ethics, GMP 2024 and candour
Montgomery and Bolam, the four domains, the candour thresholds, complaints, negligence and death certification.
The one-page cheat sheet
Every number, threshold and timescale in the guide, on a single page. Print it.
How to use this guide
- If you have a month: one chapter every two or three days, in order. Do the interactive tool before you read the section it sits in — getting it wrong first makes the explanation stick.
- If you have a week: chapters 1, 4, 6, 7 and 10 carry the most marks, then the cheat sheet.
- If you have a night: the cheat sheet, then every “exam trap” box in the guide.
A note on scope. This guide is written for the RCGP AKT and is England-focused, with the main Scottish, Welsh and Northern Irish differences flagged where they matter. If you are sitting the MSRA, PLAB 1 or the UKMLA, everything here is relevant — the same law applies. If the MSRA is your exam, pair it with the Professional Dilemmas Reasoner — where this law turns into exam technique, with ranking and choose-three dilemmas marked on the near-miss principle NHS England describes. Also free and open.
The AKT Statistics Guide does the same job for medical statistics — 16 chapters with videos and self-tests, plus a cheat sheet, also free and open. Between them they cover the two topics that most reliably decide an AKT result.
Who wrote it
Core Revision is written by practising NHS GPs. This guide was checked against primary sources — legislation.gov.uk, the GMC, GOV.UK, NICE and the UK Supreme Court — in August 2026, and every chapter carries its sources and a review date. Law changes: always follow current local policy and your defence organisation’s advice in a real case.
Written and checked by NHS GPs. Last reviewed 24 August 2026. UK law and guidance change — always follow current local policy and your defence organisation’s advice in a real case.
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