What is a mental capacity assessment?

A mental capacity assessment is a structured evaluation of a person’s ability to make a specific decision at a specific time, in line with the Mental Capacity Act 2005. It considers whether there is an impairment of mind or brain and whether the person can understand, retain, use or weigh relevant information and communicate a decision.

When is a mental capacity assessment needed?

A mental capacity assessment may be needed when there are concerns about someone’s ability to make important decisions, for example when creating a Lasting Power of Attorney, making or amending a will, completing Court of Protection forms or when cognitive or mental health problems may affect legal or financial decision-making.

What types of medico-legal reports do you provide?

We provide expert mental capacity assessments for Lasting Power of Attorney, testamentary capacity and Court of Protection (COP3) applications, as well as independent medical reports for Home Office immigration cases involving cognitive impairment, mental health vulnerabilities and the impact of deportation on individuals and families.

Who carries out the mental capacity assessments?

All assessments are carried out by Dr Soumit Singhai, a highly experienced Consultant in Cognitive and Neuropsychiatric Medicine. He has extensive experience working with law firms, barristers and the Home Office, and his reports are known for being clear, balanced and legally robust.

Can assessments be done at home or remotely?

Yes. Assessments can be arranged at our Harley Street clinic, in the person’s home or remotely by video where appropriate. We will discuss the most suitable format based on the individual’s needs, health, location and the requirements of the instructing solicitor or court.

How can law firms or families arrange an expert report?

Law firms, families and individuals can contact the clinic by telephone or email to outline their requirements. We will review the referral, confirm the scope of the report, arrange an assessment appointment and provide a clear timescale for completion of the medico-legal report.

Same Day Diagnostic Pathway | Memory and Brain Clinic London

Our Approach

At Memory and Brain Clinic London, our approach is built around a single integrated clinical pathway: the Same Day Diagnostic Pathway.

This pathway incorporates four integrated layers of assessment — structural, cognitive, functional where clinically appropriate, and molecular or biomarker evaluation — designed to ensure that cognitive symptoms are assessed with depth, coherence, and clinical responsibility.

Same day diagnosis refers to same day clinical synthesis and decision making. Information from clinical history, collateral reports, examination, cognitive assessment, and investigations is brought together by the named consultant on the same day to reach a diagnostic conclusion, explain it clearly, and outline next steps.

The pathway is structured to support integration rather than fragmentation. Diagnostic responsibility remains with the consultant throughout.

What Happens During the Day

The Same Day Diagnostic Pathway follows a structured sequence of assessment:

Review of prior medical records and relevant correspondence
Detailed clinical history
Collateral information from a family member or companion where appropriate
Focused neurological and general examination, including assessment for movement or Parkinsonian features where relevant
Structured cognitive assessment
Structural imaging where safe and appropriate
Blood based investigation including biomarker assessment
Same day clinical synthesis, explanation, and management planning

The aim is not simply to complete investigations, but to interpret them together within a single, coherent clinical dataset.

Structural Assessment

Structural assessment evaluates the physical integrity of the brain, including patterns of shrinkage, vascular change, and other anatomical findings that may explain cognitive symptoms. Structural assessment helps determine whether cognitive symptoms reflect neurodegeneration, vascular change, or non structural causes.

In most cases, high resolution 3 Tesla MRI forms part of the diagnostic assessment, provided it is clinically appropriate and safe. Advanced structural imaging allows detailed evaluation of brain volume, regional patterns of change, and the presence of small vessel disease or other vascular burden. Imaging is not undertaken where contraindicated, and the decision to proceed is based on individual clinical judgement.

Structural findings are interpreted within the full clinical context. Imaging supports diagnosis, but does not replace clinical reasoning. The purpose of structural assessment within the Same Day Diagnostic Pathway is to provide anatomical clarity that informs overall diagnostic synthesis.

Cognitive Assessment

Cognitive assessment forms a central part of the Same Day Diagnostic Pathway. In most patients, structured cognitive testing is undertaken to evaluate key domains including memory, attention, language, executive function, and visuospatial ability. The ACE III Addenbrooke’s

Cognitive Examination is commonly used as part of this structured evaluation.
Cognitive assessment is conducted directly by the consultant. Observing how a person approaches tasks, responds to challenge, and reflects on their own performance provides additional diagnostic information beyond the numerical score alone. Performance patterns are interpreted alongside clinical history, day to day functioning, and collateral information from family members. This allows differentiation between normal ageing, mild cognitive impairment, and established neurodegenerative disease.

Where clinically indicated, additional or more detailed cognitive profiling may be arranged to explore specific domains in greater depth. Screening for anxiety, depression, or other mood related factors is also undertaken where relevant, as these can significantly influence cognitive performance and may contribute to presenting symptoms.

The purpose of cognitive assessment within the Same Day Diagnostic Pathway is not simply to measure performance, but to understand the pattern and context of change. Findings are integrated with structural and other clinical information to inform the overall diagnostic synthesis.

Functional Assessment Where Clinically Appropriate

In some cases, additional functional imaging may be considered within the Same Day Diagnostic Pathway to provide further diagnostic clarification.

Functional imaging techniques evaluate how the brain is working rather than its structure alone. These may include metabolic imaging such as FDG PET, dopaminergic imaging such as DAT scan in suspected Parkinsonian or Lewy body syndromes, or amyloid imaging where clinically appropriate.

Functional assessment is considered in complex or atypical presentations, where structural imaging does not fully explain symptoms, or where early diagnostic clarification is important. These investigations are not undertaken routinely. The decision to proceed is based on individual clinical judgement.

Where indicated, functional imaging is arranged and its findings are integrated into the diagnostic process. The Same Day Diagnostic Pathway refers to same day clinical synthesis. Additional investigations, when required, are incorporated into ongoing consultant led care.

Molecular or Biomarker Assessment

Molecular and biomarker assessment forms part of the Same Day Diagnostic Pathway and includes blood based investigations that support diagnostic clarity at a biological level.

A comprehensive cognitive blood panel is undertaken as part of the diagnostic assessment to identify potentially reversible or contributing causes of cognitive symptoms. This includes assessment of thyroid function, vitamin B12 and folate levels, metabolic markers, vascular risk factors, and other systemic indicators that may influence brain health.

In addition, the Alzheimer’s biomarker blood test P217 is undertaken as part of the blood evaluation. This biomarker provides information that may support or refine the diagnosis of Alzheimer’s disease pathology when interpreted in full clinical context.

The purpose of the P217 biomarker test within the Same Day Diagnostic Pathway is to optimise and add precision to diagnostic accuracy, while maintaining clinical judgement as the central decision making tool. Biomarker findings are integrated with structural imaging, cognitive assessment, clinical history, and examination to inform coherent diagnostic synthesis.

How Investigations Are Selected

The Same Day Diagnostic Pathway is built around a structured approach incorporating four integrated layers of assessment, applied consistently within consultant led care. This includes detailed clinical evaluation, cognitive assessment, structural imaging where safe and appropriate, and blood based investigation including biomarker assessment.

Within this structured multi layer approach, clinical judgement determines whether further clarification is required. Additional investigations, such as functional imaging, are considered only where they are likely to provide meaningful diagnostic value.

The pathway is structured, but designed to adapt to the needs of the individual patient. Each component serves a defined diagnostic purpose. All findings are interpreted together within the same clinical dataset, under the responsibility of the named consultant specialist, ensuring coherent same day diagnostic synthesis.

Consultant Led Clinical Responsibility

The Same Day Diagnostic Pathway is led and delivered by a named consultant specialist with expertise in memory and cognitive disorders. Diagnostic responsibility is not delegated. Clinical assessment, interpretation of findings, and same day synthesis are undertaken under the direct supervision of the consultant who knows the patient’s history from beginning to end.

Continuity is integral to the pathway. The same consultant integrates structural imaging, cognitive performance, biomarker results, clinical history, and examination findings into a coherent, accurate diagnostic conclusion.

This ensures that integration occurs within the full clinical context rather than in isolation.

The outcome of the consultation is a clear explanation of findings, a defined diagnostic position or working diagnosis where appropriate, and a structured plan for next steps. Written documentation is provided, and correspondence is sent to the GP with patient consent as part of ongoing care.

Clarity and a way forward are achieved through thoughtful and careful synthesis and coherent integration, not volume of testing.

Named Consultant Lead

The Same Day Diagnostic Pathway is delivered by Dr Soumit Singhai FRCP, Consultant Geriatrician.

He leads the assessment, integrates all findings, and retains full clinical responsibility for diagnostic conclusions and next steps.

Communication and Next Steps

Patients receive a structured written summary following the consultation. With patient consent, correspondence is sent to the GP to support continuity of care.

Where further investigation or follow up is required, this is arranged within ongoing consultant led management.

About the Author

Dr Soumit Singhai FRCP is a Consultant Geriatrician with specialist expertise in cognitive disorders and dementia. He is the Founder and Clinical Lead of Memory & Brain Clinic London and has been a consultant since 2009. His clinical practice focuses exclusively on the diagnosis and management of memory disorders.

Contact

If you are concerned about cognitive symptoms such as memory or thinking, for yourself or for somebody you care about, you are welcome to get in touch to discuss further by telephone.

Telephone: 0207 062 7248

Other services

What Defines a Gold-Standard Private Memory Clinic in London What Does Same-Day Diagnosis Really Mean in a Private Memory Clinic?Why Clinician-Led Care Matters in Complex Memory Assessment How to Choose the Best Private Memory Clinic in London Cognitive Assessment 3 Tesla MRI in the Assessment of Memory Disorders Alzheimer Biomarker Blood Test (P-tau217)Brain Resilience Advanced Functional Brain Imaging Alzheimer’s Blood Tests in Clinical Context Consultant-Led Diagnostic Synthesis Diagnostic Authority in Dementia | Consultant Led In Person Assessment London The Integrity of True Same-Day Diagnosis What Is a Private Memory Clinic?What Happens at a Private Memory Clinic Appointment?

What our patients and colleagues say...

Dr Singhai is a very approachable, empathetic and proactive consultant who has been caring for my husband since June 2025. The diagnosis was Mild Cognitive Impairment and Dr Singhai has been constantly monitoring my husband with a holistic approach to treating the condition which, in my view, is showing positive signs. Under Dr Singhai's care in the past nine months I can honestly say that I haven't seen any further decline in my husband's condition. It is very refreshing to meet a consultant who is prepared to consider a holistic approach and not jump immediately towards medication. Dr Singhai, in our view, is at the cutting edge of an alternative approach to the fight against Alzheimer's Disease and my husband and I are both incredibly grateful to be one of his patients.

Verified Google Review 31/03/2026

After months of waiting and delays with the NHS, we opted to see Dr Singai in order to understand why my mother was experiencing memory loss. The whole process was efficient and completed in one afternoon, MRI, bloods etc and a final consultation with Dr Singai to assess cognitive capability and to discuss symptoms. Overall a very thorough process, and we walked away not only with a diagnosis and treatment plan but feeling we had a path forwards to help my mother with an understanding of her condition. This has been a very positive experience, one which both me and my sister in the US could be involved and share our experience. We would highly recommend the service provided by Dr Singai, the service is professional, efficient and you will get answers.

Verified Google Review 24/03/2026

I did very thorough research on my mother’s behalf, and there is no question that Dr Soumit Singhai is at the absolute top of his field in memory and cognitive disorders. From our very first consultation, he was warm, empathetic, and highly approachable. He explained complex diagnoses in a way we could clearly understand, taking time to go through each step and each medication with care and clarity. Most importantly, he put my mother completely at ease and gained her trust. He respected her independence while offering practical, thoughtful guidance that both she and our family felt confident following. Since starting treatment, my mother repeatedly tells me how much better she is feeling, which has been incredibly reassuring for all of us. I would not hesitate for a moment to recommend Dr Singhai to anyone seeking expert, compassionate care for memory or neurological concerns.

Verified Google Review 24/03/2026

I was very impressed with the first class experience I had when taking my partner along to the various clinics. They were all professional and understanding and I would not hesitate to recommend this service .

Verified Google Review 24/03/2026

We attended the clinic during what can only be described as one of the darkest times in our lives. My dad was experiencing frightening delusions and confusion, including believing he had two houses and that his wife of over 50 years had somehow been cloned. After searching everywhere for help and getting nowhere, we finally came across the Memory and Brain Clinic London. From the moment I first made contact with Larry, I felt that someone genuinely cared. We were able to get an appointment quickly, and Larry made all the arrangements as easy as possible, removing as much stress from the situation as he could. During the appointment, Dr. Soumit Singhai made my dad feel completely at ease. He was calm, patient, and incredibly understanding. He allowed my dad to explain how he was feeling and listened carefully to us as a family. For the first time, someone clearly explained the MRI results in detail so that we could truly understand what was happening. Once all the tests had been carried out, we were given a clear explanation of the diagnosis and how medication might help. Although the news confirmed what we had feared, it was still a huge relief to finally know what we are dealing with and to have a plan of action. For the first time in a long while, our family can see a small light at the end of the tunnel. We know there is a long road ahead, but the care, clarity, and support we received made this the best money we could have spent. Having everything assessed and explained within three hours was invaluable.

Verified Google Review 24/03/2026

Dr Singhai's calm and sympathetic manner put my Dad, who was very unwell and scared, at ease. Both my Dad and I felt listened to. Within just over 2 weeks from arranging the initial appointment, Dad had a diagnosis and was on medication. This was gamechanging. With Dr Singhai's support my Dad still enjoys a good quality of life and is happy. Recently, Dr Singhai's care prevented Dad from being admitted to A&E. We are very grateful. In addition, appointments at the One Hospital Hatfield are very low stress. His secretary is also very efficient and helpful.

Verified Google Review 17/03/2026

My partner was diagnosed with Alzheimer’s 5 years ago! At that time we sought the services of Dr Soumit Singhai, as I wanted to give him the best chance of stabilising this awful disease! Needless to say, apart from very short term memory loss, he is very much enjoying his life today! The medication he has been given over the period, I believe has helped immensely!