Advocacy

An advocate is a person who represents your views and helps you have your say.

Sometimes, you a friend or family member may advocate for you informally (‘informal advocates‘). Professionals who are paid to act as an Advocate, as their job, are known as ‘Independent Advocates’.

Download the factsheet

Involve you in decisions

Knows your wishes

Independent Advocates

What do they do?

Help you understand health and care processes

An Independent Advocate could help you understand what to expect and support you.

Help you participate in health and care processes.

An Independent Advocate could help you to be involved in your adult social care assessment.

Make sure your views are heard

If the support you have is being reviewed and might change, an Advocate can help make sure decision makers know what impact it might have on you.

Help you understand your rights

An Independent Advocate can help you challenge the way you are being cared for under the Mental Health Act 1983 or Mental Capacity Act 2005.

Getting an Independent Advocate

Getting help from an Independent Advocate usually depends on whether you already have someone who can support you informally, such as a family member or a friend. Having informal support means having someone to advocate for you who is not already helping you in a professional capacity or on a paid basis (for example your GP or a care worker).

Many people prefer informal advocacy help from a family member or friend. If you have someone in mind who you might like to act as your informal advocate, you can discuss this with the healthcare professionals working with you.

If you don’t have anyone to help you informally, or you don’t have anyone that healthcare professionals can agree is suitable, there are different types of Independent Advocate that might help, depending on your situation. Sometimes the same Independent Advocate will be able to help you with more than one thing, across more than one type of advocacy.

Read about each type of Independent Advocate to find out how they might help you.

An IMHA can support you if:

You are detained under the Mental Health Act 1983 (even if on a leave of absence from the hospital), unless you are detained under certain short-term sections (4, 5, 135, and 136)
You are a conditionally discharged restricted patient
You are subject to guardianship
You are subject to a supervised community treatment order (CTO)
You are an informal patient, and being considered for section 57 or section 58A treatment.

An IMHA can support you even if you already have other people to support you informally. You can choose whether or not you have an IMHA.

You can read more about Mental Capacity Act advocacy in this factsheet (PDF, 446KB) .

An IMCA can support you if you can’t make certain decisions (you lack mental capacity) about your health or care. You could get help from an IMCA if:

An NHS organisation such as a hospital wants to give you serious medical treatment, or
An NHS organisation or a council wants to arrange accommodation for you (or change your accommodation) in a hospital or care home, and
- You will stay in hospital longer than 28 days, or
- You will stay in a care home longer than eight weeks.
You are being cared for in a way that amounts to a deprivation of your liberty, to keep you safe. In this situation, an IMCA could also help any family member or friend who is acting as your ‘Relevant Person’s Representative’ (RPR).

You can read more about the Mental Capacity Act 2005 on our MCA page.

Even if you don’t want to work with an IMCA, the law says one has to be appointed for you in some situations.

You can read more about Mental Capacity Act advocacy in this factsheet (PDF, 446KB) .

An Independent Care Act advocate can help you if you are likely to have ‘substantial difficulty’ with being involved in:

a social care assessment, in care planning or care reviews
a carers’ assessment, carers’ support planning or carers’ support plan reviews
with safeguarding processes.

‘Substantial difficulty’ means you can’t understand information relevant to the process, can’t retain that information, can’t use/ weigh the information, or communicate your views. Health/ care professionals will work with you to decide if you have ‘substantial difficulty’.

The Care Act calls someone who professionals agree is suitable to act for you informally an ‘appropriate person’. Although normally you are not eligible for an Independent Care Act Advocate unless you have no one to be your ‘appropriate person’, if there is a disagreement between health/ care professionals and someone who is acting or wants to act for you informally, it is often a good idea to appoint an Independent Advocate.

An Independent Complaint Advocate can help you through the health or adult social care complaints process, at any point in the process. This includes complaints about hospitals, GPs, mental health services, the ambulance service, community nursing services, or adult social care support, for example. The Independent Complaint Advocate can also help with complaints to the Ombudsman if you aren’t satisfied with the complaint outcome.

You can read more about the local complaints process on our share your health and care experiences page.

You can read more about advocacy in this factsheet (PDF, 446KB) .

A General Independent Advocate can help with anything that falls outside of the other areas, listed above. An Independent General Advocate’s role is to support you to be involved in any area of health or adult social care in which you might need help.

Do I need one?

…or if I do, which one I might need? What should I do?

If you think you might need an Independent Advocate, discuss this with your case worker or other professional working with you, so they can think about how best to help you. Your worker or other professional will make a decision about whether an Independent Advocate can help you, taking into account your wishes and feelings.

If you don’t have a case worker or you’re not sure how best to contact professionals that you’re working with, contact the Single Point of Access (SPA) on 01472 256 256.

Contact the local independent advocacy provider, Cloverleaf:

[email protected]

Phone

0303 303 0413

(calls are charged at local rate from a landline or mobile number)

Informal advocates

If you start out with an Independent Advocate, but then decide you would rather have someone you know to act as your informal advocate, talk to the healthcare professionals working with you. Professionals will take into account your wishes and feelings, but in some circumstances, they might decide it’s important for you to have an Independent Advocate. The professionals working with you will explain why.

An informal advocate should be someone that you feel comfortable with having to help you. They are usually a family member or friend. Someone who is paid to help you, such as a GP, care at home or supported living worker, cannot be your informal advocate.

An ‘appropriate person’ is the phrase that is sometimes used in law to mean someone that you choose to help you, and that healthcare professionals agree is suitable to help you.

Healthcare professionals must feel confident that anyone helping you informally is willing and able to speak up for you, and help you to take part in health and care processes such as an assessment or care plan. An informal advocate will need to be able to put you first – to make sure that it is your voice, your feelings, and your opinions that are heard, rather than their own.

If someone starts out in this role for you but changes their mind (or you change your mind about having them help you in this way), you may still be entitled to help from an Independent Advocate.

Healthcare professionals have a duty to appoint an Independent Advocate for you in some circumstances. Where this duty applies, healthcare professionals must agree that any person who might act as your informal advocate is suitable, willing and able to help you. If professionals don’t agree, they will explain why they think it is important for you to have an Independent Advocate for support. You can still choose to include people who are important to you, even if they are not acting as your informal advocate. It can be a lot to ask of a family member or friend, to act as your informal advocate.

For example, professionals might be worried that the person won’t do what’s best for you, won’t be able to separate their own opinions and feelings from yours or make sure that your opinions and feelings are the centre of all discussions. Healthcare professionals also know that the system they work in can be very confusing. Someone might be willing to act as your informal advocate, but not understand enough about the health and care processes they’re trying to help you with, or not have the confidence to ask the questions about those processes that will make sure your voice is heard. There might also be practical difficulties for someone you’d like to act as your informal advocate, for example, they have a busy job which means they are not free often enough to help you, or they may just live too far away.

If healthcare professionals decide there is no one suitable to act for you informally and you need advocacy help, they will arrange an Independent Advocate for you.

Talk to the professionals working with you about who you would like to help you. The starting point is that you can choose anyone you like to help you with health and care processes, but there are some limits.

You must be:

Willing to help the person is this way (helping in this way can only be with your agreement)
Available often enough to help the person in this way (how often you need to help will depend on what help the person you’re acting for needs)
Practically able to offer the help the person needs (depending on how the person you’re acting for is being helped, you might need to be physically near enough, or able to be near enough, to attend an assessment (for example) during working hours)
Able to help the person to join in with the health and care processes that are relevant to them, such as a safeguarding investigation (this could mean asking questions for the person, or sharing information with them in a way that they are better able to understand)
Able to put the person’s wishes and feelings across, rather than your own (this means trying to make sure the person’s voice is heard)
Able to avoid any conflict of interests between what you want and what the person might want for themselves (this means putting the person first, even if you might disagree with them or have an opinion which is different from theirs).

Healthcare professionals have a duty to appoint an Independent Advocate for a person with needs, in some circumstances. Where this duty applies, health/ care professionals must agree that any person who might act as an informal advocate is suitable, willing and able to help. If professionals don’t agree, they will explain why. If the person with needs wants to include you they can, even if they are not acting as their informal advocate.

Sometimes Cloverleaf offers advocacy skills training to help people who may want to act as an informal advocate. Check the Cloverleaf website to see if there is anything available in your area: Cloverleaf Advocacy.

Local advocacy services

In North East Lincolnshire, the types of advocacy listed on this page are provided by Cloverleaf Advocacy. Together, the local Council and the local NHS (the Integrated Care Board or ICB) have a contract with Cloverleaf for advocacy services in North East Lincolnshire. There are other advocacy providers in other areas of the country, but in North East Lincolnshire, the Council and ICB have bought these services from Cloverleaf for the benefit of local people.

If you want to know more about who Cloverleaf are and what they do, visit their website: Cloverleaf Advocacy (cloverleaf-advocacy.co.uk) or telephone them on 0303 303 0413.

Cloverleaf can also help you if you would like information about advocacy in other formats, such as easy read.

Advocacy help for carers

In North East Lincolnshire, carers aged 18+ who look after a family member, friend or neighbour can access any of the support provided by the Carers’ Support Service for free, which includes advocacy support for carers, in matters relating to health, social care, benefits and housing. Support may also be available to help carers talk to their employer if they feel their employer is not supportive of their caring role.

Often carers experience challenges that relate to the care and support of the person or people they care for. In those circumstances, depending on your individual situation, the Carers’ Support Service may work with you, alongside the advocacy service supporting those you care for, to ensure everyone’s needs are taken into account.

Carers must be registered with the Carers’ Support Service to get help, and can refer themselves to the Carers’ Support Service at:

[email protected]

Phone

01472 242277

Write to

1 Town Hall Square, Grimsby, DN31 1HY

Online

www.carerssupportcentre.com

Useful links

Social Care Handbook – Focus
Independent advocacy – Indepentage
Care and support statutory guidance – GOV.UK – Chapter 7
Mental Capacity Act Code of Practice – GOV.UK – Chapter 10