Advocacy — Getting Help to Be Heard

An advocate helps a person to:

• Understand information and the choices available.
• Express their views, wishes and feelings.
• Prepare for and attend meetings.
• Ask questions and get clear explanations.
• Challenge a decision appropriately.
• Make a complaint or an appeal.
• Take part in assessments, care planning, reviews and safeguarding processes.

Independent advocates are normally separate from the organisation making the decision, so they are not speaking for the council, hospital or care provider.

An advocate does not:

• Make decisions for the person.
• Tell the person which choice to make.
• Automatically provide legal advice or legal representation.
• Replace a solicitor, social worker, healthcare professional, interpreter or paid care worker.
• Guarantee that the person will get the outcome they want.
• Speak over the person when they can express their own views.

It helps to know the difference between these kinds of help:

• Advocacy — support to understand, take part and be heard in a decision that affects you.
• Advice — information about your options and rights, usually from a specialist adviser.
• Representation — someone formally acting for you, such as a solicitor at a tribunal or in court.
• Interpretation — converting spoken or signed language accurately, including British Sign Language.
• Emotional support — listening and reassurance, such as a helpline or a befriending service.

People often ask for an advocate when they are dealing with:

• A council care-needs assessment.
• Care and support planning.
• A hospital discharge or a decision about treatment.
• Mental-health treatment.
• A decision about moving into a care home.
• A safeguarding enquiry.
• Housing difficulties.
• Decisions connected with disability.
• Children in care, and young people leaving care.
• A complaint about an NHS or social-care service.
• Information that is difficult to understand or hard to remember.
• Communication difficulties, disability, illness, distress or a learning disability that makes taking part harder.

Advocacy rights and arrangements are not the same across the United Kingdom. England, Scotland, Wales and Northern Ireland each have their own law and services, so a rule that applies in one nation may not apply in another.

The main forms of advocacy set out in law or official guidance include:

• Care Act advocacy in England.
• Independent Mental Health Advocates, usually called IMHAs.
• Independent Mental Capacity Advocates, usually called IMCAs.
• NHS complaints advocacy.
• Advocacy connected with social-care assessments, care planning, reviews and safeguarding.
• Advocacy for children and young people in care or involved with children’s services.

Whether someone qualifies depends on their circumstances and on the law that applies where they live. If advocacy is refused, it is reasonable to ask the council, hospital, care provider or professional for a written explanation of the decision and the reasons for it.

Under the Care Act 2014, a local authority may have to arrange an independent advocate when a person would have substantial difficulty taking part in particular care and support processes and there is no appropriate person available to support their involvement.

Substantial difficulty can include problems with:

• Understanding relevant information.
• Remembering information.
• Using or weighing information in order to decide.
• Communicating views, wishes or feelings.

This does not mean that everyone dealing with social care automatically qualifies. The council considers the person’s situation and whether someone suitable is already able to help them take part.

NHS complaints advocacy in England is a separate service from Care Act advocacy. People can ask their local council which organisation provides NHS complaints advocacy in their area.

Read the NHS guide to advocates →

Scotland has its own advocacy rights and legislation. Under Scottish mental-health law, people with a mental disorder — which can include mental illness, dementia, a learning disability or a personality disorder — have a right of access to independent advocacy.

Independent advocacy in Scotland may also help people understand their rights, express their views, raise concerns and take part when their support is reviewed or changed.

The Scottish Independent Advocacy Alliance does not provide advocacy itself. Its “Find an Advocate” service lists independent advocacy organisations by council area and by subject, including which groups each organisation can support.

Find an advocate in Scotland →

Read official Scottish advocacy information →

We have not shown a national advocacy telephone number for Scotland, because we could not confirm a current published number on the official website at the time of checking. Please use the “Find an Advocate” search for local contact details.

Wales operates under Welsh legislation, including the Social Services and Well-being (Wales) Act 2014 and its statutory code of practice on advocacy.

Local authorities in Wales must consider whether a person needs advocacy in order to take part fully in decisions about their care and support, and must think about what would help that person be involved.

There are also arrangements for advocacy for children and young people, and in some situations for parents involved with statutory children’s services. Not every parent automatically qualifies — eligibility depends on the circumstances and the rules that apply.

Read the Welsh advocacy code of practice →

Advocacy for children and young people in Wales →

Llais — independent voice for health and social care in Wales →

Northern Ireland has separate health, social-care, mental-health and capacity arrangements. The Care Act 2014 does not apply in Northern Ireland.

Depending on the problem, the right starting point is usually the person’s Health and Social Care Trust, the Patient and Client Council, or an independent advice service such as Advice NI.

Find your Health and Social Care Trust →

Patient and Client Council →

Advice NI →

How to complain about health and social care in NI →

• An IMHA is specially trained to help certain people affected by mental-health legislation.
• They can explain rights, treatment, restrictions and the choices available.
• They may attend meetings and help the person raise concerns.
• Who qualifies for an IMHA differs across the four UK nations.
• An IMHA is not a solicitor and does not replace legal representation.

Read Mind’s guide to advocacy →

• An IMCA supports certain people who lack capacity to make a particular important decision.
• Mental capacity is decision-specific. It must never be assumed to be absent simply because someone is disabled, has a diagnosis, or makes a choice that others think is unwise.
• An IMCA may be required for certain serious medical-treatment or long-term accommodation decisions when there is nobody appropriate to consult.
• IMCA arrangements differ across the United Kingdom.

GOV.UK — Independent Mental Capacity Advocates →

NHS — the Mental Capacity Act explained →

Advocacy may be available to help someone understand and use the NHS complaints process. An advocate can help organise concerns, prepare letters, attend meetings and understand the response.

An advocate does not investigate the complaint and does not decide its outcome. That is the job of the organisation being complained about, and afterwards the relevant ombudsman.

• England — ask your local council which organisation provides NHS complaints advocacy in your area. How to complain to the NHS (NHS).
• Scotland — use the Scottish Independent Advocacy Alliance search to find local independent advocacy. Find an Advocate (SIAA).
• Wales — Llais supports people raising concerns about NHS Wales and social care.
• Northern Ireland — the Patient and Client Council supports people making complaints about health and social care.

Children in care, care leavers and some young people receiving children’s services may have rights to advocacy, so that their views are heard in decisions about where they live, their care and their plans.

Coram Voice provides advocacy for children and young people within its stated eligibility, which is focused on children in care, people leaving care, and young people who have or need a social worker. It is not a general helpline for every child, so please check the current service description before contacting it.

Check Coram Voice advocacy for young people →

We have not published Coram Voice telephone or text numbers here, because we could not confirm them on its current website pages at the time of checking. Its up-to-date contact details are shown on its own site.

SEND, ALN and ASN support in education →

1. Ask the council, NHS service, hospital, care provider or social worker whether advocacy is available.
2. Explain what makes it difficult to take part without support.
3. Ask whether there is a legal entitlement to an advocate in this situation.
4. Ask for the name and contact details of the local advocacy provider.
5. Ask for a written explanation if the request is refused.
6. Contact an independent advocacy organisation directly where it accepts self-referrals.
7. Check whether the service covers the person’s postcode and type of problem.

Find your local council →

• Do you cover my area?
• Do you help with this particular type of problem?
• Is the service free?
• Can I refer myself?
• How long is the waiting list?
• Can the advocate attend meetings?
• Can you communicate by email, text, telephone or video call?
• Can you provide information in an accessible format?
• Is the service independent from the organisation making the decision?
• What information will you keep, and when might confidentiality have to be broken?

• Write down the main decision or problem in one or two sentences.
• List the outcome you want.
• Keep important letters, emails and reference numbers together.
• Record dates, names and what was said.
• Ask for information in an accessible format, such as large print, easy read or email.
• Request reasonable adjustments when you need them.
• Ask whether the advocate can attend with you.
• Ask for decisions and the reasons for them in writing.
• Do not send original documents unless you are specifically asked to.