Five Interesting Facts About the Role of an IMCA
7th March 2023 / Posted by Family Welfare
An Independent Mental Capacity Advocate (IMCA) supports people to make important decisions about medical care and living arrangements if they are assessed not to have the mental capacity to make the decision themselves.
The IMCA has an important role to play in safeguarding people who are deprived of their liberty and have no family or friends to represent their wishes or challenge decisions made on their behalf. Their aim is to get the best outcome for someone who is unable to make a decision for themselves. They generally work on the instruction of a medical body or professional, or on behalf of a family member who lives far away.
The first thing you may not know about the role of an IMCA is this:
1) People referred under IMCA must have a capacity assessment before being detained
Under the Mental Capactiy Act, an IMCA can only be instructed once a capacity assessment has been completed. The capacity assessment looks at two key areas of capacity: impairment and decision-making.
When someone is assessed as having an impairment that prevents them from being able to make a decision about their care or accommodation (and there is no friend or family member to do it on their behalf), an independent advocate can be called in.
2) AN IMCA can access confidential patient health and medical records
Under the Mental Capacity Act, an IMCA has the right to review relevant records relating to the person concerned. This can include care plans, medical records, social services documentation, and care home logs if they live in residential care.
As they carry out their review, the independent advocate will speak to the people who know them best, including health and social care workers, doctors, clinicians, experts, and family members who cannot be present. The aim of their research is to understand the person’s preferences, needs and wishes so they can balance their best interests with professional recommendations.
3) An IMCA can ask for a second medical opinion
In serious medical cases, for example where doctors recommend surgery or intervention that may affect quality of life, the IMCA can request a second opinion. They also have the right to challenge decisions and the decision-making process where they feel it’s in the best interests of their client (see point 5).
4) In urgent cases, the IMCA can provide a verbal report
It’s standard practice for an IMCA to provide a written report summarising their findings and highlighting any information they feel the case decision maker should consider.
Where a decision needs to be made quickly, e.g. end-of-life care or life-changing surgery, it may not be possible for the IMCA to write up their report in time. In this instance the advocate would verbally share the views and wishes of the person affected by the decision with the decision-maker.
5) The IMCA can appeal a decision in the best interests of their client
Once the advocate has submitted their written report to the case decision-maker, they have a responsibility to read and consider all the information provided before they make their final decision.
An independent advocate is responsible for ensuring their client’s voice and views are always heard and prioritised. If the IMCA feels information in their report has been overlooked and/or the person’s best interests have not been upheld, they may launch an appeal against the decision on behalf of their client. Appeals can be made in all mental capacity advocacy cases, from living arrangements and care reviews to serious medical treatment decisions and end-of-life care.
How to instruct an IMCA
Our Family Welfare Advocacy team are experienced in listening to, respecting, and upholding the views of others. To learn more about the free service our Independent Mental Capacity Advocates provide across the Borough of Wigan, contact us on 01942 867888 or visit the IMCA page.