The Scottish Government is planning to introduce a National Care Service (NCS) with the intention of improving community health and social care support in Scotland. As part of the plans, the Government recently met with people and organisations who need or deliver community health and social care support in ‘co-design’ sessions. These co-design sessions took place all over Scotland from Stranraer to Shetland, in both rural (mainland and island) areas as well as town and urban areas. The Government recently published their findings from these sessions. The ‘making sure my voice is heard’ strand of the co-design process features Independent Advocacy.
The Government said that they ‘want to have a standard approach to Independent Advocacy support planning: we want to improve the way people can access support’. (This refers to how people access existing services, not provision for an expansion of Independent Advocacy services.)
Independent Advocacy what is working well
From these sessions the Government found that ‘across the sessions, people generally agreed that using an independent advocate helps people feel supported to challenge decisions about their care, although some highlighted that experiences of advocacy services can be mixed.’
In terms of what is working well they also found that:
- advocacy is particularly important for those who cannot use their voice or have additional communication support needs;
- there is good advocacy support for complaining about the NHS;
- where someone is in conflict with one body or service, independent advocacy often resolves the issue;
- it is important that advocacy is independent. (With some people saying that the Scottish Independent Advocacy Alliance (SIAA)’s definition of an ‘independent’ advocacy service or advocate explains this well.)
What is not working well
People included views on what is not working well in Independent Advocacy provision in their responses. There are a number of concerns about access, with people saying that there is a lack of information available about what Independent Advocacy is and how it can be accessed. There is not enough information about how it can help, and it can be more difficult to access in rural or island communities.
People also had concerns about true independence. For example they said that in small communities advocacy workers may know the issue from both sides as the population is so small. People also thought that ‘care professionals, rather than independent advocates, should be talking to people about their care support options. The primary role of independent advocates should be to help people claim their rights’. Some people expressed concern about a lack of scrutiny around the quality of support provided by Independent Advocacy services.
How Independent Advocacy can be improved
People who attended also shared ideas of how the NCS might improve Independent Advocacy provision. Many of these were about improving the information that is available and improving awareness of and access to Independent Advocacy.
Other suggestions were:
- recognising there are local differences and local needs;
- having advocacy services for carers, who may have a different view or needs to those of the person receiving care;
- independent advocacy services should be funded sustainably and there should be funding for specific issues;
- advocates should be trained and knowledgeable on the issue at hand;
- recognising the difference between person-centred and person-led advocacy. Person-led approaches are preferable, as the emphasis is on decisions being made by the person accessing care support;
- building on existing services and practices by gathering information about what advocacy services are out there and what is working well.
The Government plans to use the full feedback that they received to ‘develop further co-design work with people and organisations over the next 18 months, as we move towards the final decisions about the design of the National Care Service’.