Advocacy : The problem with not having any national data

I never thought I would look back at the DH database which captured information about every IMCA referral and think ‘ooooh, the halcyon days, we never had it so good’. But we did. We took the database for granted and moaned and groaned about the time it took to input the information. For those new to advocacy asking ‘what’s the DH database?’, this was a national recording system, managed by the then Department of Health, which required every IMCA to answer 40 questions including the number of hours spent on each ‘case’, the referrer, the condition and communication the person had, equalities information, outcomes from the IMCA involvement and so on.

The information that was subsequently analysed led to an annual report published by the DH which told us about the state of IMCA. We could tell how many referrals were made by each local authority and it gave us insight into trends experienced by people affected by the Mental Capacity Act. We could see massive gaps in referrals for Serious Medical Treatment for instance and we could see the difference in the number of IMCAs being instructed within DoLS processes across the different regions. It was great.

The database and reporting ended around 2014 and we have had absolutely no data since then about how many people get an advocate – let alone commentary about its quality or impact.

Yet since this date we have witnessed a number of significant developments which has increased the number of people being eligible for statutory advocacy:

• Cheshire West increased IMCA referrals tenfold overnight.
• The introduction of advocacy within Care Act processes in England meant an additional 130, 000 people would access statutory advocacy. Yes, you did read that right. 130, 000 people across England.
• Calls within the Mental Health Act review for advocacy to become an opt out service (instead of opt in) will mean more people receiving IMHA support
• The introduction of advocacy within the Social Services and Wellbeing Act in Wales
• The extension of the IMCA role within the forthcoming LPS system

The problem is, at the moment, we just do not know how many people are getting access to an advocate nationally, which areas are the worst (and best) at making advocacy accessible, if there are groups of people who are less likely to get an advocate and how advocacy is funded, delivered and monitored across the country. Sure, your individual service may collect and monitor this but this is not published anywhere for others to see (most likely due to concerns about commercial sensitivity).

The lack of published data matters because the sector generally feels under-resourced, under-funded and under-supported by commissioners which means people who should be, are not getting access to quality advocacy support. But without any data to back this up, we have no evidence that the numbers of people nationally entitled to advocacy are actually receiving one.

Lets think about Care Act Advocacy. We know that the impact assessment estimated that 7% of people going through an assessment would use advocacy. When Community Care published a freedom of information (FOI) request in 2016 the actual figure sat at just below 2%. We don’t know what the figures are in 2019, but our gut tells us we have not seen a three fold increase in Care Act referrals to hit the anticipated 7% figure.

Lets think about IMCA. We completed a FOI last year asking local authorities to tell us how many times an IMCA was instructed (including within DoLS). The information we received painted a picture of absolute inconsistency across the country: one Local Authority instructed an IMCA in 2 DoLS authorisations. This represented just 0.17% of people going through a DoLS authorisation. At the opposite end of the scale another Authority arranged advocacy for 70% of people who were subject to DoLS processes – a whopping 1000+ people. How can there be such a huge variation in the availability of a statutory service across local authorities – and how can Government not be monitoring this?

I worry that the lack of any national data and a complete lack of scrutiny from Government means that Local Authorities, feeling the burn of austerity, cannot afford advocacy and silently fail to discharge their duties.

Its time we pushed for the collection of national data which is published, analysed and acted upon. Without this, I fear advocacy will continue to be the under-resourced proverbial thorn for Local Authorities and no-one will even notice.

Kate Mercer, Blackbelt Advocacy