Advocacy services for adults with health and social care needs

Context

Advocacy helps to ensure that people's voices, wishes and preferences are heard, their rights are upheld and their needs are met, particularly when they have difficulty in speaking up for themselves or are concerned that they are not being heard.

An advocate helps someone with health and social care needs to express their needs and wishes, and to weigh up and take decisions about options available to them. Advocates can help people find services, make sure correct procedures are followed and challenge decisions made by councils, health services and other relevant health-based organisations. Advocacy helps protect human rights and plays a critical part in safeguarding. The advocate is there to represent the person's interests, which they can do by supporting them to speak, or by speaking on their behalf, including when the person is unable to instruct the advocate. (Adapted from the Think Local, Act Personal Care and Support Jargon Buster.)

This guideline covers advocacy delivered by a trained person whose sole engagement is to support the person and help ensure that their voice, needs and preferences are heard (referred to in law as 'independent advocacy'). Family members and friends play a vital role in the lives of people who draw on support, for example ensuring that the person's voice and concerns are heard. However, the focus of this guidance is on a trained person whose sole involvement is as an advocate.

Several Acts of Parliament specify the local authority's responsibility to ensure the provision of independent advocates and the situations in which they must make an advocate available. But many more people at certain points in their lives could benefit from access to the services of a trained advocate.

Little information is available about how many people access independent advocacy or how many independent advocates are currently operating. There is a widely held view that there is a shortage of advocates. The commissioning of advocacy services, their availability and the ongoing training and support of advocates varies significantly across the country, although the National Qualification in Independent Advocacy is widely recognised.

This guideline aims to help advocates and those who train and manage them, as well as those who commission their services and health and social care practitioners who interact with them, by setting out key aspects of service quality. It will also be of interest to people who use advocacy services and their families and carers.

This guideline is relevant to people who need advocacy regardless of their condition or life circumstance. For more specific guidance about conditions or circumstances where advocacy is likely to be helpful, see the NICE guidelines on decision making and mental capacity, people growing older with learning disabilities, people experiencing homelessness and safeguarding adults in care homes.