Knowledge of role of Independent Mental Capacity Advocate can be improved

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The Independent Mental Capacity Act Advocacy (IMCA) service was established in 2007 following concerns expressed during the implementation of the Act that there was a need to provide extra support in the Act for the most vulnerable people.

The purpose of the service is to help those vulnerable people who lack capacity facing decisions made by the NHS and Local Authorities about serious medical treatment and changes of residence.

The researchers in this study set out to discover to what extent care managers in understood the role of the Independent Mental Capacity Advocate (IMCA) service, and to identify what differences there were between this newly created statutory service IMCA and the existing general advocacy services.

22 participants from three community teams took part: all but one had attended training on the Mental Capacity Act (2005).

Using a series of scenarios, the researchers asked the participants to answer questions relating to the most appropriate response to the scenarios and which would be the most appropriate professional to contact and what the role of that professional would be.

They found that the responses showed quite a poor understanding of the issues with less than 50% of respondents giving the correct responses with substantially less than 50% getting the right answer when relating to the need for an IMCA referral. Worryingly, half of the respondents did not identify the function of advocacy as representing client’s views with a number suggesting that the IMCA had decision making powers. None of the respondents identified the statutory requirement to involve an IMCA in decisions relating to serious medical treatment.

The authors conclude that given all but one of the participants had attended training, that in order to achieve a better working knowledge of the Act, a different approach to training and supporting staff might be required.

Knowledge of Advocacy Options within Services for People with Learning Disabilities, Martins, C et al., in Journal of Applied Research in Intellectual Disabilities, 24: 274–279

Booklet explaining the IMCA service from the Office of the Public Guardian

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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