Advocacy Definitions and Trends
Patrick Wood Training and Consultancy E: pwtc@btopenworld.com M: 07841 024667
Š 2015 Patrick Wood Patrick Wood Training and Consultancy Email: pwtc@btopenworld.com Blog: https://patrickwoodtc.wordpress.com/ Twitter: https://twitter.com/pwtc_wood Mobile: 07841 024667
Contents What advocacy is
1
Historical summary
2
What happens now
4
Different types of advocacy
5
Definitions of different types of advocacy Self-advocacy
7
Group advocacy
7
Peer advocacy
7
Citizen advocacy
8
Professional advocacy
8
Non-instructed advocacy
8
Advocacy principles and standards Co-production
10
Equality and Diversity
10
About Patrick Wood Training and Consultancy
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ADVOCACY DEFINITIONS AND TRENDS
What advocacy is Advocacy supports people to:
Make changes and take control of their lives
Be valued and included in their communities
Be listened to and understood
It involves taking action that enables people to:
Express their views and wishes
Secure their rights
Have their interests represented
Access information and services
Explore choices and options
Advocates do this through:
Establishing open, trusting relationships with advocacy partners
Finding out what advocacy partners want from their relationships with advocates
Identifying goals and outcomes from the advocacy process
Gathering information on behalf of their advocacy partners
Representing advocacy partners' views, wishes and concerns to health and social care professionals and other people
Reviewing progress and redefining goals as necessary
Advocacy promotes equality, social justice and social inclusion. It aims to make things happen in the most direct and empowering ways possible and it recognises that selfadvocacy, whereby people speak out and act on their own behalf, is the most empowering form of advocacy.
Advocates are independent of services and represent their partners' interests as if they were their own. Independent advocacy should be available to everyone who needs it, regardless of their age, gender or cultural background.
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Historical summary The overall trend in advocacy has seen a change from activity promoted by service user activists and concerned citizens towards an expert model of advocacy provided by advocates who are not necessarily directly affected by the issues faced by the people they support. This trend has resulted in a move away from advocacy projects that support a single client group towards larger organisations that provide generic support alongside statutory forms of advocacy like Independent Mental Capacity Advocacy (IMCA) and Independent Mental Health Advocacy (IMHA) that have been introduced since 2006.
The first formal advocacy scheme in the UK was set up in 1981 and the initial development of advocacy projects can be linked to the move to community care throughout the 1980s that was formalised by the NHS and Community Care Act 1990. Although there were a number of advocacy projects providing support for older people and people with physical disabilities in the later 1980s/early 1990s, the majority of advocacy projects at this time were concerned with supporting people with learning difficulties or personal experience of mental health problems, and these projects stressed the importance of linking one to one support with group self-advocacy provided by patients' councils and service user groups.
In 1994, the user-led UK Advocacy Network (UKAN) produced 'Advocacy: A Code of Practice' as part of the government appointed Mental Health Task Force. This was the first document to outline principles and good practice in mental health advocacy and proved influential in the development of local advocacy groups, including non-mental health specific groups, throughout the rest of the decade.
In 2002, Di Barnes and Toby Brandon of the University of Durham produced 'Independent Specialist Advocacy in England and Wales: Recommendations for Good Practice' as part of a study commissioned by the Department of Health. They proposed a model of professional advocacy provided by paid advocates, which should be tightly focused on individual, rather than group advocacy. This report provides the foundation for the development of the models of statutory advocacy that were developed in its wake.
Also in 2002, Action for Advocacy (A4A) launched its Advocacy Charter to inform advocacy Page | 2 Patrick Wood Training and Consultancy
ADVOCACY DEFINITIONS AND TRENDS
practice and training, raise awareness of the value of advocacy and promote quality assurance. In 2006, A4A produced 'Quality Standards for Advocacy Schemes' based on the Advocacy Charter and in 2008 it developed a Quality Performance Mark as a tool for providers of independent advocacy to show their commitment and ability to provide high quality advocacy services. Following the demise of A4A in 2013, a third edition of the Advocacy Quality Performance Mark was launched by the National Development Team for Inclusion in April 2014.
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ADVOCACY DEFINITIONS AND TRENDS
What happens now Current advocacy provision consists of statutory advocacy, community advocacy (which refers to all advocacy that is not statutory advocacy) and self-advocacy.
Statutory advocacy consists of IMCA, IMHA, independent advocacy under the Care Act and NHS Complaints Advocacy. Although children do not have the right to access an advocate whenever they need one, the Children's Act 2004 establishes children's rights to participate in decisions regarding their care, which has informed the development of a number of advocacy projects providing advocacy to enable children to exercise these rights.
Independent advocacy under the Care Act is the most recent form of statutory advocacy, requiring local authorities to arrange for independent advocates to be available to represent and support people who are judged to have substantial difficulties to be involved in assessment and the preparation and review of care and support plans.
Guidance on the relevant sections of the Act and Regulations clearly describe local authorities' responsibilities to provide this form of advocacy, including:
Issues to consider in determining if an individual would experience substantial difficulty in engaging with the care and support process
Circumstances in which an advocate must be provided
The role of the advocate providing independent advocacy under the Care Act
How independent advocates are to carry out their functions
It is recognised that independent advocacy under the Care Act is similar in many ways to IMCA and that many people who qualify for IMCA in relation to care planning and review will also qualify for independent advocacy under the Care Act.
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ADVOCACY DEFINITIONS AND TRENDS
Different types of advocacy There are a number of different types of community advocacy, which have developed as a consequence of advocacy's roots in the service user and citizen activist movements and the later trend towards professionalisation.
The main types are:
Self-advocacy
Group advocacy
Peer advocacy
Citizen advocacy
Professional advocacy
Non-instructed advocacy
Self-advocacy, group advocacy and peer advocacy support individuals and groups of people with similar experiences to maximise their involvement in their own care and support. They are often linked and included in the remit of groups that also seek to bring about changes in the way health and social care services operate.
Professional advocacy operates in a wide range of different settings and supports people with different kinds of experience, although the role of the professional advocate in providing support remains the same or similar.
Non-instructed advocacy is a later development. It is a specialised form of advocacy that requires the advocate to work in a particular way to ensure that they represent the needs and wishes of their partner as accurately as possible.
There is a danger that the proliferation of different forms of advocacy might result in a system that is confusing for prospective advocacy partners and other stakeholders, provides no guarantee of quality, is administratively inefficient, and does not provide best value for money.
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Commissioners can mitigate these dangers by supporting a whole systems approach to advocacy, which involves a single point of contact in a local authority area linking directly to a small number of providers who can provide all of the different forms of advocacy mentioned above.
The advantages of adopting a whole systems approach to advocacy include:
Improved continuity of advocacy provision to meet the changing needs of advocacy partners
Easier to guarantee quality and consistency of provision
Increased ability to identify and respond to gaps in provision
Savings in time and money
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Definitions of different types of advocacy Self-advocacy Self-advocacy refers to an individual's ability to effectively communicate his or her own interests, desires, needs and rights. It recognises that people are experts by experience and involves them in speaking out for themselves about the things that are important to them. It means that people are able to ask for what they want and need and to tell others about their thoughts and feelings.
The goal of self-advocacy is for people to decide what they want and to carry out plans to help them to get it. Self-advocacy differs from other forms of advocacy in that the individual self-assesses a situation or problem and then speaks for his or her own needs. The ultimate aim of all forms of advocacy should be to support people to self-advocate as far as they are able to.
Group advocacy Group advocacy involves people with shared experiences, positions or values coming together in groups to talk and listen to each other and speak up collectively about issues that are important to them. Self-advocacy groups aim to influence public opinion, policy and service provision. They vary considerably in size, influence and motive. Representatives of local self-advocacy groups are often included on planning committees and involved in the commissioning and monitoring of health and social care services.
Peer advocacy Peer advocacy refers to one to one support provided by advocates with a similar disability or experience to their partner. It is often provided by trained and supported volunteers as part of a co-ordinated project. Peer advocacy schemes argue that they are particularly well placed to empathise with the needs of advocacy partners, to approach them as their equals and to feel strongly and fight hard about their issues.
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Citizen advocacy Citizen advocacy aims to involve people in their local community by enabling them to have a voice and to make decisions about the things that affect their lives. Citizen advocacy partnerships are long term, not time limited, and last for as long as the citizen advocate and advocacy partner want them to. Citizen advocates are ordinary members of the local community. They are unpaid and they usually operate with support from a co-ordinated scheme.
Professional advocacy Professional advocacy is usually provided by paid independent advocates who support their partners to represent their views during times of major change or crisis. It is issue based and the advocate may only need to work with their partner for a short time. Professional advocacy is generally a form of instructed advocacy, in which the advocate is clearly instructed by their partner and works to their agenda.
Non-instructed advocacy Non-instructed advocacy differs from all of the other types of community advocacy in that it is requested by health and social care professionals rather than advocacy partners themselves. It aims to support decision making by ensuring that due regard is paid to people's rights and preferences.
There are four recognised approaches to non-instructed advocacy and non-instructed advocacy providers should endeavour to integrate them all when providing support:
Rights Based Approach – we all have certain fundamental human rights that can be defined and measured.
Person-Centred Approach – based on the development of long term, trusting and mutually respectful relationships between advocates and advocacy partners.
Watching Brief Approach – placing the advocacy partner at the centre of thinking about the best way to support them.
Witness – Observer Approach – in which the advocate observes or witnesses the way in which their advocacy partner leads his or her life.
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It is important to remember that an individual's capacity to be involved in decision making or to instruct an advocate might fluctuate. This possibility provides a further argument in favour of a whole systems approach to advocacy, which maximises the chances of continuity of support for advocacy partners.
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Advocacy principles and standards Co-production Quality advocacy services are person-centred and developed using a co-production approach that aims to maximise the participation of people who use services and carers. Co-production means delivering services based on an equal and reciprocal relationship between service users, carers and professionals and results in the provision of support that meets the needs of advocacy partners.
Equality and Diversity Advocacy projects should be able to meet the needs of diverse local populations. They should be respectful of advocacy partners' cultural, religious and spiritual needs and ensure that advocates receive training to enable them to understand the issues that impact on the communities they serve.
Advocacy projects can maximise the diversity of their staff team and ability to provide culturally appropriate services through:
Employing part-time or sessional workers
Providing opportunities for volunteers from diverse communities
Developing links with specialist advocacy workers
Developing partnerships with community based organisations that can provide appropriate advocacy support
The following key advocacy principles were defined and promoted by A4A and provide the foundation for the Advocacy Quality Performance Mark currently administered by the National Development Team for Inclusion:
Clarity of Purpose – Advocacy projects should have clearly stated aims and objectives, which are clearly expressed to advocacy partners, service providers and other stakeholders.
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Independence – Advocacy projects should be independent from service providers and free from conflicts of interest.
Putting People First – Advocates should ensure that the needs, interests and wishes of advocacy partners direct their work. Advocates should be non-judgemental and respectful of advocacy partners.
Empowerment – Advocacy projects should support self-advocacy. Advocacy partners and other service users should be involved in the management of projects.
Equal Opportunities – Advocacy projects should recognise the need to be proactive in tackling all forms of inequality, discrimination and social exclusion.
Accessibility – Advocacy should be provided free of charge and advocacy projects should ensure that they are accessible to everyone from the communities they serve.
Accountability – Advocacy projects should develop effective systems for monitoring and evaluating their work.
Confidentiality – Advocacy projects should have a written confidentiality policy, stating the circumstances in which information about an advocacy partner might be shared with other people outside of the project, and advocacy partners should be informed of this policy before they start to work with an advocate.
Complaints – Advocacy projects should have a written policy explaining how to make complaints or give feedback about the project or individual advocates.
Supporting Advocates – Advocacy projects should ensure that advocates are trained and supported in their role and provided with opportunities to develop their skills and experience.
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About Patrick Wood Training and Consultancy Patrick Wood has been involved with advocacy since the early 1990s. He has worked as a mental health advocate in Sheffield, Barnsley and Rotherham.
He was commissioned by the Social Care Institute for Excellence (SCIE) to write ‘Ten Top Tips for Commissioners: Commissioning Independent Mental Health Advocacy (IMHA) Services in England’ (SCIE, March 2015) http://www.scie.org.uk/independent-mentalhealth-advocacy/measuring-effectiveness-and-commissioning/10-top-tips.asp and contributed to the SCIE resource on Commissioning Independent Advocacy under the Care Act (SCIE, October 2014, updated March 2015) http://www.scie.org.uk/care-act2014/advocacy-services/commissioning-independent-advocacy/
As Training and Development Officer for the UK Advocacy Network from 1995 – 2006, Patrick produced a range of advocacy related publications, including:
•
Advocacy Today and Tomorrow: The UK Advocacy Network Training Tool
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Standards for Advocacy in Mental Health
•
A Clear Voice, A Clear Vision: The Advocacy Reader
Patrick Wood Training and Consultancy can provide advocacy training tailored to the needs of your organisation for as little as £400 a day. For further information, contact:
Patrick Wood Training and Consultancy Email: pwtc@btopenworld.com Blog: https://patrickwoodtc.wordpress.com/ Twitter: https://twitter.com/pwtc_wood Mobile: 07841 024667
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