The Royal College of Surgeons has recently updated its good practice guidance on consent in light of the Montgomery judgment. Its main messages as regards the shift in balance towards recognising doctors as the clinical experts and patients as experts in being themselves are welcome, and clearly and crisply expressed. The explanation of the meaning and the role of capacity under the MCA 2005 is also succinct and to the point. However, as is so often the case, the treatment of Scotland and NI is problematic, failing to make sufficiently clear in relation to Scotland (in particular) that the legal framework is very different.