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Independent Mental Capacity Advocacy (IMCA)

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What is an Independent Mental Capacity Advocate (IMCA)?

A group of people

When someone is assessed by a doctor or social worker as lacking mental capacity to make key decisions in their lives - perhaps because of mental illness, dementia, learning difficulties, a stroke or brain injury - they can have the help of a specialist Independent Mental Capacity Advocate (IMCA). This is a legal right for people over 16 who lack mental capacity and who do not have an appropriate family member or friend to represent their views.

When can an IMCA be instructed?

An IMCA can be instructed where there is a decision to be made regarding one of two specific issues:

  • Serious medical treatment
  • A change of accommodation.

Serious medical treatment applies where an NHS body proposes to provide, withdraw or withhold treatment.

Change of accommodation applies where an NHS body or Local Authority proposes a move for the person to hospital for more than 28 days or to alternative accommodation for more than 8 weeks.

In addition to the above, there is a duty to consider whether it would be of benefit for an IMCA to be instructed for the following issues:

  • Safeguarding Adults from Abuse
  • Care Reviews

Safeguarding Adults from Abuse applies where the NHS body or Local Authority have commenced Safeguarding procedures and the person lacks capacity regarding any of the protective measure being proposed. This is the only issue that the person can have family or friends appropriate and practical to consult and still have IMCA support.

Care Reviews applies where the NHS body or Local Authority have can instruct an IMCA to support and represent a person who lacks capacity when they have arranged accommodation for that person or they aim to review the arrangements as part of a care plan or otherwise. This issue can vary between Local Authority so further clarification can be obtain by calling our 0300 456 2370.

What is the role of an IMCA?

POhWER's IMCAs seek to ascertain the views and beliefs of the person referred to them and gather and evaluate all relevant information about that person. The advocate then writes a report to help decision-makers, like doctors, reach decisions which are in the best interests of the person concerned.

Sometimes the advocate will look at courses of action other than those suggested by the professionals and sometimes seek a second medical opinion.

An advocate has the right to challenge any decision made, informally if possible but otherwise through the relevant complaints procedure.

In this way an advocate can enable the individual to participate to some extent in decision-making.

What is the Court of Protection?

Ultimately the issue, if it is particularly serious, may go to the Court of Protection, which is a specialist court for all issues relating to people who lack capacity to make specific decisions. The court makes decisions and appoints deputies to act on behalf of people who are unable to make decisions about their personal health, finance or welfare.

Further information

IMCA in BSL Sign Language