CONSULTATION ON INDEPENDENT ADVOCACY – GUIDE FOR COMMISSIONERS

1. Introduction

1.1 The importance of advocacy

1.1.1 The Scottish Government recognises the important role that advocacy plays in enabling people to be involved in decisions which affect their lives. It helps them to express their views and wishes, to access information, to make informed choices and to have control over their care.

1.1.2 Advocacy:

• safeguards people who are vulnerable and discriminated against or whom services find difficult to serve
• empowers people who need a stronger voice by enabling them to express their own needs and make their own decisions
• enables people to gain access to information, explore and understand their options, and to make their views and wishes known
• speaks up on behalf of people who are unable to do so for themselves.

1.1.3 Advocacy has two main themes:

• Speaking up for and with people who are not being heard, helping them to express their views and make their own decisions and contributions
• Safeguarding individuals who are at risk.

1.1.4 Advocacy is a crucial element in achieving social justice. It is a way to ensure that everyone matters and everyone is heard - including people who are at risk of exclusion and people who have particular difficulties in making their views known. The importance of advocacy is reflected in a range of recent legislation and policy guidance. Further reference material is listed in Appendix 3.

1.1.5 Advocacy is part of everyday life. It is an ordinary activity. Many of us will at some point in our lives look to the support of someone we trust to help us speak up for ourselves to get our voice heard about decisions or actions that affect our lives. However, some people in society are much more likely than others to be treated unfairly, either because of other people's prejudice or because of their own vulnerability, or both.

1.1.6 Factors which put people at risk or make them vulnerable include age, physical frailty, gender, ethnic origin, sexual orientation, impairment (cognitive, psychological, motor, sensory), reputation, dislocation, abuse, family breakdown, caring and young caring responsibilities, and social isolation. Some people have to rely on powerful service systems for help with all aspects of their life - housing, personal assistance, decision-making, income, occupation, mobility. This can happen particularly when people have been immersed in the service system since childhood, and when they have no strong allies outside, institutions. Support services can affect every aspect of someone's life and can have long term consequences. For some people, their family is also part of the problem.

1.1.7 Individuals who rely on these service systems often have limited personal power and resources to argue their case. This is especially true for people who do not use words to communicate, for children and young people, for people who cannot read or write in the language of the system, for people who have a negative reputation within the system, for people who are physically frail and for people who are regarded as incapable of making decisions.

1.1.8 If these individuals do not have well-motivated and capable family and friends to speak up for them, they are at risk of not receiving the treatment they need. They may not have their own views, wishes and feelings taken into account properly, as is their right. They are also the least likely people to exercise their right to make a complaint. Even capable and positive family and friends may not be able to ensure that the individual's views are taken into account.

1.1.9 Individuals may also be unaware of their rights. The Charter of Patient Rights and Responsibilities launched on 1 October 2012 provides a summary of rights and responsibilities when using NHS services.

1.1.10 The Patient Advice and Support Service (PASS) was established in April 2012 to provide advice and support and will also raise awareness of patients' rights and signpost people to the support services available to them and this includes providing advice on the availability of advocacy. Further details about the service can be found at: http://www.cas.org.uk/patientadvice. NHS Boards have a responsibility to raise awareness of the support services available.