Terms used in this guideline

This section defines terms that have been used in a particular way for this guideline. For other definitions, see the NICE glossary and the Think Local, Act Personal Care and Support Jargon Buster.

Anti-oppressive practice

The phrase describes a critical examination of the impact of power, inequality and oppression on people. This could include examining an organisational structure while taking into account the wider social, cultural and political context. Anti-oppressive practice seeks to lessen the exclusion of certain social groups from social equality, rights and social justice.

Anti-oppressive practice may include:

  • recognising the barriers that people might face, such as personal, cultural or structural barriers

  • recognising a person's place in a structure or culture and how this might affect other people

  • working to understand people's experience of oppression

  • recognising people's attributes and contribution

  • empowering people to realise their rights.

Cultural competence

Cultural competence is the ability to understand and respond to a person's particular religious, cultural or language needs and experiences.

Digital platforms

This describes digital spaces where communication can occur, or information can be exchanged, securely. This could include some social media.

Health inequalities

Systematic, unfair and avoidable differences in health across the population and between different groups within society. They arise because of the conditions in which we are born, grow, live, work and age. These conditions influence our opportunities for good mental and physical health.


The interconnection of social categorisations such as age, disability, gender reassignment, pregnancy and maternity, marriage or civil partnership, race, religion or belief, sex and sexual orientation and other characteristics or experiences listed in box 2, creating unique overlapping and interdependent systems of discrimination or disadvantage.

Non-instructed advocacy

When a person cannot communicate their views or wishes in a way that can be understood by other people, then advocates may use recognised approaches to ensure that what may matter most to the person is represented. Advocates will need to take additional steps to determine as far as possible what the person's likely wishes, feelings and desired outcomes are likely to be, to best represent the person. The advocate's role in non-instructed advocacy may include: upholding the person's rights; making sure that their likely concerns are recognised and responded to; ensuring access to support; and encouraging decisions to be taken based on what is important for the person, and challenging any that appear not to be. A person's ability to communicate what is important to them might fluctuate and advocates may move between using non-instructed advocacy and using instructed advocacy.


Opt-out is when a person is automatically referred to the advocacy service unless they opt out of the referral. The opt-out system is designed to ensure that people who are eligible for advocacy are made aware of independent mental health advocacy services and have the opportunity to access them. An opt-out measure may overcome barriers to access.

Peer advocacy

Peer advocates have lived experience and can support others with a similar disability or experience.

Reflective practice

A process for staff to:

  • reflect on previous practice

  • talk about why they made the decisions they made, and why they acted or behaved in particular ways

  • talk about their emotional responses to their actions and the actions of others

  • engage in continuous learning.

Reflective practice may also provide insight into personal values and beliefs, and help staff understand how these influence action and decision making.


The action of representing oneself or one's views or interests. This may be with respect to the care and support that people receive or the way that services are organised locally.

Structural inequalities

The phrase refers to the inequalities that are systemically rooted in the normal operations of social institutions, in which different categories of people may not be seen as having equal status. This can result in the marginalisation of, or discrimination against, certain categories of people and manifest itself in areas such as unequal access to healthcare, housing or education.


The Care Act 2014 defines 'wellbeing' as a broad concept, relating to the following areas in particular:

  • personal dignity (including treatment of the individual with respect)

  • physical and mental health and emotional wellbeing

  • protection from abuse and neglect

  • control by the individual over day-to-day life (including over care and support provided and the way it is provided)

  • participation in work, education, training or recreation

  • social and economic wellbeing

  • domestic, family and personal

  • suitability of living accommodation

  • the individual's contribution to society.

  • National Institute for Health and Care Excellence (NICE)