Advocacy in Focus

Advocacy Apprenticeships

2012-01-26T06:38:00.000-08:00

How do people feel about the idea of advocacy apprenticeships? Is it something that a4a should be exploring on behalf of the sector? Do we believe that young people have the potential to make good advocates? Let me have your views, either on this forum or by emailing me directly on rick@a4a.uk.net

Cardiff Council v Peggy Ross (2011)

2012-01-13T02:26:00.000-08:00

I will copy this extract verbatim from the excellent publication 'Brunswick's Healthcare Review' January edition, and let the reader make up their own mind about what this says about the approach of local authorities to the issue of capacity:

This case concerned an 82 year old woman with a diagnosis of dementia, who had decided with her partner of 20 years to go on a cruise ship holiday, something they had both done together on many previous occasions. Mrs Ross had moved to a care home a few months before the planned cruise following medical problems, but spent weekends with her partner Mr Davies at his home.

The local authority formed the view that Mrs Ross lacked capacity to decide to go on the cruise, and that it was not in her best interests. The critical issue from the local authority‘s perspective was that Mrs Ross was not able to appreciate the potential risks to her wellbeing of going on the cruise.

The court was required to make a decision at short notice and without oral evidence from expert witnesses on capacity. However, the judge felt that the decision in question was fairly straightforward – “It is a choice of whether to go on holiday or not, in familiar circumstances, with one’s companion of the past two decades‟ – and that despite the views of the social worker and a psychiatrist who had assessed Mrs Ross that she lacked capacity, there was insufficient evidence to rebut the presumption in favour of capacity.

The judge went on to hold that even if Mrs Ross lacked capacity, it was not contrary to her best interests to go on the holiday. The judge felt that the Council‘s approach to the best interests decision was too risk averse and failed to take proper account of the potential benefits to Mrs Ross: it “smacked of saying that her best interests were best served by taking every precaution to avoid any possible danger without carrying out the balancing exercise of considering the benefit to Mrs Ross of what, sadly, may be her last opportunity to enjoy such a holiday with Mr Davies. This led, in my view, to trying to find reasons why Mrs Ross should not go on this holiday rather than finding reasons why she should.‟

The judge was satisfied that Mr Davies would be able to care for Mrs Ross, as he did when she stayed with him at weekends, and was strongly influenced by the fact that this was likely to be her last cruise ship holiday.

The Council had put in place a DOLS authorisation to prevent Mrs Ross going on the holiday, and had then made an application to the court very shortly before the cruise was due to start. Although the issue was not fully argued or decided, the judge indicated that this was not the correct procedural route, and that an application should have been made to the court rather than the use of the DOLS regime.

Comment
This case provides another example of a tendency among local authorities to focus on risk prevention at the expense of emotional wellbeing. The opposite approach is often taken by the court, particularly in cases involving elderly people, who, even though they may have impaired capacity, would rather take the riskier option for care, residence or holidaying, rather than losing their remaining autonomy. It may be that judgments of this sort will persuade statutory bodies to take a broader view of best interests and to give proper weight to the wishes and feelings of the individual concerned, and to the need to promote emotional wellbeing as well as physical safety.

will you support our 100 words on advocacy campaign?

2012-01-06T05:36:00.000-08:00

Action for Advocacy (a4a) is calling upon advocates, advocacy services, charities, families and people who use services to sign up to support it’s ‘100 words on advocacy’ campaign. The campaign is designed to raise awareness of the need for and benefits of independent advocacy. We want Government to implement a ‘right to advocacy’ for all users of social care services, and compel local authorities to publish their plans for local advocacy provision.

If you or your organisation agrees with the statement below there are two ways you can show your support: Firstly, cut and paste the statement into any policy consultation responses, campaigns or press releases you are developing. Secondly, register your support below and help us to show Government just how strongly people feel about this issue.

1. STATEMENT: We/I fully support the Law Commission’s view that advocacy is ‘a vital component of achieving independent living and full citizenship for disabled people’[1]; and the EHRC’s proposal that everyone seeking care and support should be given access to advocacy, including in relation to human rights, non-discrimination and equality[2]. We/I call upon the Government to ensure that independent advocacy is widely and freely available to those who need it. This can be best achieved by implementing a ‘right to advocacy’ for those in need, and compelling local public authorities to specify their arrangements for assessing and meeting the advocacy needs of their communities.

[1] The Law Commission Report on Adult Social Care (Law com no 326) 2011

[2] From Safety Net to Springboard, Equality and Human Rights Commission, February 2009

You can sign up to this by pasting the following link into our web browser:
https://www.surveymonkey.com/s/KDGVJTJ

Patients Lose Out as 1 in 7 Psychiatric Wards Break the Law

2011-12-08T06:41:00.000-08:00

PRESS RELEASE: with immediate effect

Patients Lose Out as 1 in 7 Psychiatric Wards Break the Law

Action for Advocacy (a4a) has called on the Department of Health, PCTs and Mental Health Trusts to take action to address the failures in commissioning and implementation of the Independent Mental Health Advocacy (IMHA) service which have put patients’ rights at risk.

Despite being recognised as an important safeguard that supports patients to understand and exercise their legal rights, funding is not sufficient to meet demand and many ward staff do not tell patients about the service. 20,000 people are subject to the compulsory powers of the Mental Health Act at any one time, 16,000 as in-patients; 4,000 on community treatment orders (CTOs). a4a estimates that, at this very moment, at least 5000 people are being denied access to their statutory right to advocacy.

The Care Quality Commission report - Monitoring the Mental Health Act in 2010/11 shows a large scale failure in the Mental Health system. As the report states, “some staff who should have been fulfilling the detaining authority’s legal duty to explain the advocacy service to patients did not understand it, or even know of its existence.”

Despite having a legal right of access to Independent Mental Health Advocates (IMHAs) people on mental health wards are being routinely denied access to this service. The scale of the shortfall is shocking. Only 68% of wards have regular access to IMHA. 85% of wards were found to have access to IMHA on request, but even this generous interpretation means that legal rights are being ignored on more than 1 ward in 7.

Rick Henderson, Chief Executive of a4a says “The CQC report shows that in some areas, commissioning of the IMHA service demonstrates the worst kind of tokenism. These problems were highlighted by a4a in 2009 and have still not been addressed.”

The report shows that commissioning is inhibiting access to advocacy. Funding levels have left advocacy providers with insufficient resources to meet demand so that, for some people access to IMHA is theoretical. Access is particularly poor for people who are placed out of their local area and people on Community Treatment Orders (CTOs). Advocacy services which support people before they reach crisis point are having their funding cut in direct contradiction of commissioning guidance.

Martin Coyle, Deputy Chief Executive of a4a said, “The report confirms findings from a4a’s own experience and research. However it does not even take account of the failure of ward staff to make referrals to IMHA when people are unable to do so themselves. A whole category of people are being denied some important safeguards”.

The echoes some of the findings of a4a’s report Advocacy in a Cold Climate which shows a worrying trend in cuts to advocacy provision which could see tens of thousands of people at risk of abuse losing access to advocacy services.

Action for Advocacy’s Response to Caring for our Futures

2011-12-08T05:48:00.000-08:00

Action for Advocacy (a4a) is an organisation dedicated to ensuring a strong and equal voice for all citizens. a4a is the central point of information on independent advocacy in England and Wales. Our membership includes over 400 independent advocacy providers and we have built a reputation as the leading authority on the development of effective advocacy services.

Action for Advocacy shares many of the aspirations and recognises many of the problems highlighted in Caring for our Futures. This response will centre mainly on the area of Increased personalisation and choice, with particular regard to the role of independent advocacy in achieving this. However we strongly believe that achieving this aim would have a significant impact on the areas of Ensuring services are better integrated around people’s needs and Supporting greater prevention and early intervention.

Advocacy providers work with those people who find the current system unfair and confusing; those who need care most and may be at the greatest risk of neglect, abuse or poor services. Too often people have felt that they have no power over their care and that they are made to fit into the requirements of services or professionals. We agree that we need to put power back into the hands of the people who need care.

We entirely agree that people should “expect better standards of care .....[and] need to be protected from poor care, to have the support to choose the care that best meets their needs and to be able to speak out if there are problems. Current experience is that this is not possible in too many cases. We have seen in too many cases the experiences of those who have been abused and the belated calls for greater advocacy provision. Winterbourne View was simply one more example of a long line of failures in care. Even where safeguarding procedures are instigated, the focus falls to frequently on the abuse and not on the person affected. The independent nature of advocacy services can help ensure that the process serves the person, not vice versa.

We also agree that there is a need for greater access to information, advice and advocacy to support people in defining and controlling their care needs. “A Vision for Social Care” states that older people, people with learning disabilities, autism and those with complex needs disabled people may need more support in accessing personalised support. Further, it states that people in residential care homes should have the same entitlement to choice and control over care and support as anyone else. a4a wholeheartedly agrees. We believe that independent advocacy has a role to play in making choice and control a reality in these situations.
We therefore find the statement that “Councils should: …. focus on improving the range, quality and accessibility of information, advice and advocacy available for all in their communities – regardless of how their care is paid for – to support their social care choices” commendable.

Independent advocacy is clearly part of a spectrum of rights based services, but we believe there is a need for a more clearly defined role for advocacy. However the reality is that when information, advice and advocacy are talked of together, advocacy often becomes the poor relation. Too often, where advocacy has been funded as part of the information and advice spectrum, the proportion of funding for the advocacy component has made it appear like an afterthought. Even within A Vision of Social Care and Caring For Our Futures, advocacy appears and disappears within this rights based spectrum. This cannot be supportable for a service which delivers choice, control and safeguarding for the most vulnerable members of our society.
Advocacy is instrumental in creating a culture where the expectations of the Mental Capacity Act are realised; both through actively supporting the choice of individuals and being a catalyst to create cultures of dignity and respect in care settings. We welcome the recognition that advocacy “helps people express views and receive the services they want as a result”. We believe that advocacy also
• helps people to be confident of greater dignity in care
• provides an active and preventative safeguard against abuse and neglect
• leads to better information in care planning
• creates more cost effective care
• actively relocates power from the hands of professionals back into those of the service user
and
• provides a means by which people’s autonomy can be better realised in a culture that too often tries to manage risk out of people’s lives.

The calls for access to independent advocacy come from numerous sources outside the advocacy sector. A Vision for Adult Social Care (4.9) states that councils should, “focus on improving the range, quality and accessibility of information, advice and advocacy available for all in their communities”.

In its report “From Safetynet to Springboard”, the Equalities and Human Rights Commission called for the availability of independent advocacy outwith the personal budgets system to ensure that personalisation did not inadvertently widen health inequalities.

The Law Commission Report on Adult Social Care (Law com no 326) stated “Advocacy is, therefore, seen as a vital component of achieving independent living and full citizenship for disabled people” and made the recommendation that “The right to advocacy contained in the Disabled Persons (Services, Consultation and Representation) Act 1986 should be retained in the statute, with a power for the Secretary of State and Welsh Ministers to implement the right and modify it to bring it into line with modern understandings.” a4a wholeheartedly supports this view and urges Government to enforce this right to advocacy.

Action for Advocacy welcomes the widespread recognition of the importance of independent advocacy, but there is a discrepancy between rhetoric and people’s local reality. Our contact with advocacy providers makes it clear that the availability of independent advocacy is decreasing. This decrease is particularly dramatic in advocacy for which there is not a specific statutory requirement.

Our report “Advocacy in a Cold Climate” shows that funding is insufficient to cover the demand for advocacy. Statutory Mental Health and Mental Capacity Advocacy are being afforded limited protection from cuts - but even these services are struggling. 63 per cent of advocacy services say that they will be able to help fewer people in future. If this continues it will deny thousands of vulnerable people the right to a voice and to high quality care and support.

Somewhere between policy documents, national strategy and local implementation, access to independent advocacy is being lost. The Government's stated vision of 'nothing about me without me' will simply not be achieved without timely access to local independent advocacy. Action for Advocacy calls on the government to ensure that independent advocacy is a specific and separate area to be identified and reported on within Joint Strategic Needs Assessments. We believe this is the minimum requirement to ensure that there is local recognition of how many people need support from independent advocacy to make choice, voice and control a reality, and of scrutinizing the real level local provision.

A postcript to my previous blog....

2011-11-07T04:05:00.000-08:00

....about safeguarding adults at risk. New research just published by the NHS Information Centre shows that councils identified over 30,000 cases of abuse of vulnerable adults last year. That's around 200 cases per Local Authority. Can I respectfully suggest that EVERY advocacy service should be using these figures to lobby for specific funding to support victims of abuse in their local area?

2011-11-07T02:04:00.000-08:00

Last week I had the great privilege and pleasure to be speaking alongside Terry Bryan, the senior nurse who blew the whistle on the Winterbourne View abuse scandal. We were speaking at a Community Care Conference on Improving Outcomes for Adults at Risk, as part of a panel that also included Gary Fitzgerald, CEO of Action on Elder Abuse. Terry himself came across as a man of great integrity, who had been thrown into the spotlight rather reluctantly. His account of the events leading up to the Panorama expose was remarkable mainly for its exposure of a catalogue of missed opportunities. Approaching the BBC was a last resort, he said, and even then not actually his idea. Terry noted that there is a need for a stronger civil rights approach to the issue of adult abuse, and called for direct action against those individuals and authorities found to be perpetrators.

My point was that so much of the work being done in this field seems designed to 'mop up' after abuse has occurred, rather than to prevent abuse from happening in the first place. What is happening in the environment of these institutions that seems to breed the kind of complacency, callousness and unaccountability that results in poor treatment of the most vulnerable? I identified three key factors: the failure to adequately vet, train and supervise frontline care staff; the profit incentive of Big Businesses that puts margins before quality of care; and the inspection and regulation regime that fails to adequately listen to residents' voices. Gary added that in his view, the perpetrators of abuse were not evil, or indeed easy to spot. They were in fact 'ordinary' people whose sense of power and responsibility had been corrupted by a system that failed to hold them to account.

I maintain that if we are to make real progress on this issue we need to focus on prevention, not just management after the event. There needs to be an investment of resources targetted at the root causes of abuse, and not just in the Serious Case Reviews that allow certain professionals to bemoan 'we did all we could'. In the community, adult abuse is a tricky issue to tackle because it is often hidden and intertwined with complex family and other dynamics. In care homes and hospitals, in this day and age, abuse must and should be preventable.

For our part, we are pleased to announce that Skills for Care have recently awarded us a grant to develop new, tailored, free training for advocates focusing on their particular role in the safeguarding agenda. It's early days, but over the next few weeks we will be putting together a programme for the training that will be delivered free of charge in six locations across England. We hope that the training will create the space for advocates to reflect and build on the special role they play in both supporting victims of abuse and ensuring that the person is at the centre of the decision making process. More details will be posted on the a4a website soon so watch out for that.

AGM/Launch Venue

2011-09-12T03:41:00.000-07:00

For anyone travelling to our AGM/launch tomorrow (Tuesday 13th), it is being held at the offices of Irwin Mitchell LLP, 40 Holborn Viaduct London EC1N 2PZ. Nearest tube is Chancery Lane. Start 4.30 prompt, 6.30 finish. Refreshments provided. Hope to see you there.

It Pays to Collaborate

2011-09-06T06:28:00.000-07:00

I'm so proud to be launching our new joint publication, 'Stories of Collaboration in Advocacy' at next week's AGM on Tuesday afternoon. The report, produced in association with national development charity Locality, showcases 5 stories of joint working and partnership between independent advocacy organisations. We have featured stories from Devon, Cheshire, Lancashire, London and Hampshire and each tells an inspiring tale of how advocacy organisations worked together to improve access to advocacy for local people. The starting points for collaboration are all very different - some were to respond to gaps in provision, others were commissioner led, other still just involved 'common sense'. And the outcomes are similarly varied, although all the participants were able to identify lessons from the process.

It's great to think that even in these cash-strapped, competitive times, advocacy organisations are still able to make time for partnership, and that a sense of community still exists within the sector. It may be this sense of community that carries us through the next, difficult stage in our history.

'Stories of Collaboration in Advocacy' will be available in hard copy at the AGM and in PDF format as of 13th September. More details from our website. To book a place at the AGM email info@actionforadvocacy.org.uk

Abuse, Safeguarding and Advocacy Survey

2011-07-20T03:32:00.000-07:00

Recent exposés of systematic abuse in care homes and hospitals, exemplified by the Winterbourne View case, have brought the problem out into the public domain and raised serious questions about safeguarding. A4A wishes to explore Advocates' experience of abuse and safeguarding and the response of advocacy providers in order to inform our call for change to end this scandal. We are therefore conducting an on-line survey focused on the involvement, training and confidence of Advocates. We are seeking responses from individual paid or volunteer Advocates in England and Wales rather than someone completing it on behalf of an organisation.

It is of vital importance to us as the central point of information and policy work on independent advocacy. The survey will also inform our Advocacy and Financial Abuse Project, which aims to explore the role that independent advocacy can play in preventing financial abuse. We hope you can spare us a small amount of your time to help us to gather the evidence to back-up our work and your work. Please share this item and the link below with your colleagues and encourage them to respond. Closing date: 15th August.

To complete the survey cut and paste this link into your web browser:

http://actionforadvocacy-news.org.uk/F3V-H412-3GBHAS-6PJ91-1/c.aspx

Date for your Diaries

2011-07-18T06:28:00.000-07:00

Advance notice that our Annual General Meeting this year is on Tuesday 13th September, 4.30pm at our offices at The Oasis Centre in London. We will be taking the opportunity to launch two exciting new reports: the 'Advocacy in a Cold Climate' report which summarises the key findings from our sector-wide survey; and the 'Stories of Collaboration in Advocacy' report which showcases examples of best practice in collaboration between advocacy services.

A4A currently has over 650 members and it would be fantastic if as many of you as possible came along to the AGM. It's your way of showing your support for the work we do and a great networking opportunity as well. This year we will be proposing some significant changes to our constitution and it would be great to see a real mobilisation of members to support these changes. So please do email us at info@actionforadvocacy.org.uk to confirm your attendance!

It may only be one little word, but......

2011-07-04T06:13:00.000-07:00

.....it's a very important word! Nestled on page 44 of the just-published report 'Fairer Care Funding' (better known as the Dilnot Report) is the word 'advocacy'. It only appears once in the entire 82 page report, so it's worth quoting the sentence in its entirety. It says that local authorities should:

"work with trustworthy local voluntary, community-based organisations to provide support and advocacy services".

That's it, nothing else, no other mention, but even this tiny acknowledgement of the role of independent advocacy in supporting users of care services is a minor miracle. Up until this morning, Dilnot had steadfastly refused to refer to advocacy despite various protestations from us and many others. Although advice and information were acknowledged, it seemed that advocacy was set to remain the poor relation, the 'little secret' that nobody wanted to acknowledge. Those people who did manage to win this small concession from Dilnot should be very proud of themselves - you know who you are, and you should make it known that you worked hard to achieve this.

What does this mean for the advocacy sector? Well first and foremost, it means we can sit around the table with the big boys as the debate about funding for care continues. This is not an issue that will go away quickly, nor is it one (as Dilnot has discovered) with any easy answers. Any one of us could well find ourselves requiring residential or domiciliary care at some point in the future, so this is not some abstract issue that only affects other people. And as advocates we know that there is often a significant mismatch between the cost of care and its quality. So we need to take an active role in the ongoing debate, and this one small mention at least opens that door.

Secondly, it shines a spotlight on the commissioning practices of local authorities which, as reported in this column previously, are often found wanting. I am really keen to finish work on drafting our 'Commissioners Charter' and get that out there, so this may well be the impetus for getting that finished.

Finally, there is hope that comes from a successful lobbying exercise -hope that, if we can win a concession here, we may be able to win them in other areas of Government policy.

Echoes of past horrors

2011-06-10T07:03:00.000-07:00

In 1982, whilst working as an assistant at Darenth Park Hospital, I witnessed a man with learning disabilities being goaded into attacking a member of staff, who then proceeded to restrain him - along with several other burly staff members - in the most humilating way possible. He was held down, stripped naked and frogmarched to a 'time out' padded cell where he was left for hours in an awful, distressed state. It was one of many such incidents that prompted me to give up my aspirations to go into nursing, and become an advocate.

Fast forward to 2011 and we have to endure the terrible sight of similar abuses at the hands of so-called carers, in the Panorama documentary on Winterbourne View, run by the Castlebeck Care company. 29 years on, and it seems that nothing has changed. When such scandals are exposed there is usually a media frenzy; fingers are pointed; blame is assigned (usually to a few individuals on the front line); enquiries are held and prove inconclusive; the public at large are interested for a few brief days and then everything goes back to normal. Until the next scandal hits the news stands in a few weeks or months time.

There is no doubt that Castlebeck Care should hang its collective head in shame. No doubt that the Care Quality Commission should do likewise. And the Government needs to take its share of the blame too, for encouraging a 'free market' in care services that means a profit making company can charge £3500 a WEEK for housing someone in what is basically a containment chamber, with little in the way of care, support or encouragement.

My particular interest is in the human, rather than systemic, aspects of the Winterbourne case. What compelled the staff to act towards residents in the way they did? What were the recruitment processes that led to the employment of such people? And are we talking about a few bad apples somehow worming their way into the job - or a culture where even the most caring of staff were corrupted into thinking that such appalling abuses were acceptable. Much has been written about the psychology of institutionalisation - both with staff and service users - but it seems to me that one of the key aspects of this case was that whenever anyone from the 'outside world' entered the service, they saw immediately what those inside it couldn't. It's a compelling argument for opening the doors of these closed institutions to a much wider group of external (and ideally independent) stakeholders. Inspectors, relatives, advocates, befrienders, advisors and volunteers should now be given a much stronger role in visiting such places and reporting back on their observations. There is no longer a justification for locked doors and closed systems. If we have to have such places at all (and I question their relevance in the 21st century) then external scrutinty must become the new watchwords. The problem with CQC inspectors is that they can become sanitised to poor practice: their threshold for what is deemed unacceptable is higher than most lay peoples'. This is where advocates come into their own, because they have an independent, non-compromised, person centred view of what's going on. I hope that one of the outomes of the current furore is that the need for and benefits of independent advocacy for people living in care settings of any kind is recognised by the wider world, policymakers included.

In 1982 the argument for institutions was that vulnerable people needed to be kept safe from sinister elements within society; cared for by expert staff in closed environments.

In 2011 my argument is that vulnerable people need to be kept safe from sinister staff working in closed environments; cared about by the rest of society.

A Request from the BBC....

2011-05-23T01:45:00.000-07:00

I've been asked to pass on this request from Julia Ross from BBC Radio 4, please do get in touch with her if you can help (and let me know how it goes):

Are you on Incapacity Benefit? Have you received a letter asking you to go for a reassessment to see if you can be moved onto Employment Support Allowance?
Or are you about to appeal against an earlier decision?

BBC Radio 4 is looking for volunteers to take part in a documentary programme about these assessments. We want to follow people through the process of assessments or appeals.

Please get in touch, by phone or email, if you have received your letter and would like to be involved.

Julia Ross 0207 973 6228 julia.ross@bbc.co.uk

Nearly conference time!

2011-04-15T05:49:00.000-07:00

Just over a month until the A4A juggernaut rolls into Brighton for our 2011 annual conference. The theme for this year is 'Fighting for Fairness' and the event takes place on the 25th and 26th May at the lovely Lansdowne Place Hotel in Old Steine (pronounced 'steen' so I'm told by people in the know).

We have a great line up of speakers and workshops plus all the usual conference accoutrements (exhibitions, debate, conference dinner and a well stocked bar). The debate looks especially interesting - the motion being 'this house believes that charging service users for advocacy, under any circumstances, will sound the death knell for our core values'. That promises to be a humdinger!

I'm also really hoping that we can have a good representation from local Brighton based advocacy organisations, watch this space for more information about that.

All in all it should be a great couple of days, and of course the Brighton seafront in May holds its own particular delights that delegates can explore for themselves during the conference 'downtime'. At the last count we have 65 delegates booked in, and the hotel has capacity for just over 100, so if you are thinking of coming I'd suggest you get in touch to reserve your place asap.

Professor Wolf Wolfensberger: 1934 – 2011

2011-03-22T09:27:00.000-07:00

I recently heard the sad news that Professor Wolf Wolfensberger passed away on 27th February 2011.

Those of you old enough to remember will know that Prof. Wolfensberger is widely credited as being the 'father' of modern advocacy as well as a tireless campaigner, researcher, teacher and writer. It was his vision, back in 1969, of a new model of 'Citizen Advocacy' that eventually made its way to the UK and sowed the seeds of advocacy as we now know it. His theories of 'normalisation', 'social role valorisation' and his work on evaluation systems such as PASS and PASSING influenced a generation of advocates, support staff and academics including myself.

Wolf was always a controversial figure and never minced his words. I had the pleasure of meeting him at a CAIT conference many moons ago and was impressed by both his logic and delivery. I couldn't pretend that I agreed with every word he said or wrote, but he was a huge influence on my life and will continue to be so. I'm sure you will join with me in mourning his passing.

From the USA

2011-03-18T02:48:00.000-07:00

I promised my good friend and advocacy 'guru' Michael Kendrick that I would help promote a couple of things he's involved with in the States.

The first is to raise awareness of the terrible plight of young people at a Boston school that uses electric shock as a treatment for children and adults with severe autism or emotional problems. You can read the story by pasting this link into your web browser: http://www.guardian.co.uk/society/2011/mar/12/electric-shock-school-matthew-israel

Secondly, Michael has asked me to plug an important international conference on agency transformation that is being held in conjunction with the international initiative on mental health leadership in San Francisco in September of 2011. This conference will focus largely on the disability sector and the challenges involved in transforming agencies so that they are better prepared to provide supports for person centered individual lifestyles. It is hoped that this conference, with its emphasis on linking people and agencies who are like minded, will eventually result in an ongoing national and international network to address these challenges. You can find out more by using this link: www.iimhl.com/iidl

A few years ago I was fortunate enough to attend a leadership programme in the US that Michael co-organised and can honestly say that it was a life changing experience - and actually proved to be cheaper than many of the leadership programmes offered in the UK! Plus I got to walk along Malibu Beach which is never a bad thing.....

Come to think of it - 2 day conference in San Fransisco in September?! See you there!

Beware 99p Umbrellas

2011-03-03T03:40:00.000-08:00

Picture the Scene.

I’m trapped inside Elephant and Castle shopping centre by a sudden and violent downpour. Have you ever been to Elephant and Castle shopping centre? It’s not a great place to be trapped.

And today of all days I’ve left the brolly indoors. The expensive, designer folds-down-to-almost-nothing umbrella that I bought especially for situations like this. I can see it now, in my mind’s eye, nestling smugly among the coats and hats in the downstairs cupboard, all ‘told you so’.

But in the here and now, in this Godforsaken shopping centre with the rain falling in sheets and a meeting I’m late for, decisive action is required. So I buy a 99p umbrella from the Pound Shop (they kept the change).

There will be those among you who, without needing to read further, will know what happened next. But for the uninitiated, the sequence goes like this: step out into rain; open brolly; brolly breaks into a hundred pieces; get soaked. And that entire sequence lasts about ten seconds. Of course being an advocate I immediately return to the shop to complain, only to hear the classic Pound Shop riposte of ‘what did you expect for 99p?’

They may have a point. What did I really expect? If one spends even a moment considering the cost of the raw materials – aluminium, canvas, plastic, and then factors in labour, shipping and profit margin, the futility of purchasing such an item becomes clear. Yet this shop and many others like it do a roaring trade in everything from brollies to cotton buds, screwdrivers to doggie treats. It seems some people don’t care about quality, only cost. Cheap equals good and the only people who really worry about quality are the ultra-rich and the snobbish.
When this mentality is applied more universally, and in particular in the context of ‘our’ services, then its potential consequences become more alarming. Then we are talking not just about getting wet, but about some very real dangers to health, wellbeing and even life. However this is exactly the approach that seems to be taken by many commissioners of health and social care services when contracting and tendering. We hear stories of 70, 90 or even 100% of tendering decisions being made on price alone. Quality and effectiveness are seen as afterthoughts, luxuries even. And the current Government is reinforcing this message through its cuts agenda, forcing local authorities into the ludicrous position of cutting back even further on services that in any civilised society would be perceived as essential.
Worse still, some provider agencies seem happy to go along with the delusion that they can provide quality services for peanuts. The act of winning contracts becomes an end in itself rather than a means to a greater goal. Corners are cut in pursuit of a lower unit cost, and it is staff and service users who bear the brunt of shortfalls.

Independence is also sacrificed in the quest for lower costs. The ability of organisations to lobby and campaign; to undertake outreach work to marginalised communities; to employ and nurture disabled staff and volunteers; or to invest in longer term developments; all suffer when there’s no margin built in to contracts.
For the past few years Action for Advocacy has built a platform on developing tools that enable advocacy schemes to demonstrate their quality and impact. To a large extent we have succeeded, but in the light of an emerging Pound Shop mentality, maybe we are missing a trick. It’s not the advocacy schemes that need to address quality, it’s the commissioners. If they continue to award tenders on cost alone, then sooner or later the sector will reach a point below which it cannot go without endangering the people we serve. And at that very point (maybe we’ve already reached it?) someone will come along and go below, that’s just in the nature of things. Can we prevent this potentially catastrophic decline? I hope so, and to me the key seems to be intervening directly in commissioning practice, taking the fight to commissioners and reminding them in the strongest terms that money isn’t everything. Wish us luck, because that must be the most unpopular message of all at this time. But we cannot sit back and do nothing. If you are aware of poor commissioning practice in your area, we want to hear about it.

an interesting piece from A4A's ex-Chair

2011-02-16T01:33:00.001-08:00

http://www.guardianpublic.co.uk/more-advocacy-professionals-needed-under-nhs-reforms

It's not often I'm lost for words but....

2011-01-25T04:02:00.000-08:00

http://www.bbc.co.uk/news/uk-northern-ireland-12264415

Happy New Year?

2011-01-04T02:28:00.000-08:00

It's always a drag coming back to work after the long festive break. Coming up to London this morning for the first day back, there was a palpable sense of doom and gloom amongst my fellow commuters. Was this caused by the 12.5% increase in rail fares? Or the massive double hike in fuel prices? the VAT increase? The rise in beer prices? Or are people simply dowbeat at the thought of having to lose those few extra pounds that seem to pile on over Xmas?

Whatever the cause, there's no doubting that 2011 has got off to a disappointing start. It will be a tough year for most people, and none more so than those employed within the public sector. We heard about the cuts in 2010, this year we'll start to feel them. And there's no reason to suspect that the advocacy sector will be immune from the 'pain'. That's a given - but how we react and respond to this new climate is still up to us.

So if as a sector we are going to make a collective New Year resolution, let it be this: let's try really hard to be positive, to be 'glass half full' people, to commit to seeing advocacy as a community of like minded activists who are prepared to stand up and be counted. Petty internal squabbles are SO 2010!! This year should be about unity, collaboration, partnership, radicalism, innovation, opportunity.

We'll do our bit - I trust you'll do yours.

Happy new year!

Liberating the NHS: Legislative framework and next steps

2010-12-21T03:53:00.000-08:00

A Briefing for Action for Advocacy members drafted by Phil Jew, A4A's Head of Policy

The Coalition Government’s paper, Liberating the NHS: Legislative framework and next steps, published on 15 December 2011, sets out how it plans to implement Health Service reforms. The reforms were announced in the consultation paper Equity and excellence: Liberating the NHS, released in July 2010, which attracted 6000 responses. Action for Advocacy responded to the consultation.
The reforms cover putting patients first in health services, improving outcomes (rather than focusing on process targets), new GP commissioning arrangements, democracy, accountability and regulation. The paper is part of a series on NHS reform. A further paper setting out a new NHS outcomes framework will be released in early 2011. The Government will introduce a Health & Social Care Bill in 2011 that will pave the way for the reforms.

Key developments for Advocates

HealthWatch (HW): This new ‘consumer champion’ will be created. It will involve the transformation of Local Involvement Networks (LINks) into local HW bodies. These will be funded by local authorities with enhanced funding available. They will be supported by HW England (itself part of the Care Quality Commission). HealthWatch will be established by April 2012. Local HW will be able to escalate issues and complaints to HW England.
Local HW will have a role in NHS complaints advocacy but will not necessarily provide it. The Government has listened to opposition to proposals that local HW should be the provider of advocacy services. Local authorities may therefore commission local HW or another organisation to deliver complaints advocacy. They will be given funding to procure advocacy, advice and information services but the amount will not be prescribed. The change from the Independent Complaints Advocacy Service (ICAS) arrangements to local authority commissioned services has been pushed back and will now take place in 2013. Current ICAS contracts are likely to be extended for a further year.
Local HW will have a role in ensuring all views and particularly those of socially marginalised and vulnerable people are heard in NHS commissioning processes. It is therefore important that Advocates exert some influence on local HW, bringing their unique insight into experiences of health care.
Responsibility for commissioning Independent Mental Health Advocacy will pass, as expected from Primary Care Trusts to local authorities from 2012. This will be separate from the NHS complaints advocacy services that local authorities will commission. The role of supervisory body regarding hospitals under the Mental Capacity Act deprivation of liberty safeguards will also pass from PCTs to Local authorities.
The Department of Health will publish a transition plan for local authority commissioning of advocacy in early 2011.
Independent Mental Capacity Act services are not mentioned in the paper.
Personal Health Budgets will be piloted. An evaluation will report in October 2012. The Bill will include the power to extend direct payments for health care nationally if the pilot is successful and Parliament approves.
Patients will be given control over their health records to enable them to be more involved in decisions about their treatment or care.
The new NHS outcomes framework will include several ‘domains’ including:
• Ensuring people have a positive experience of care and treatment and
• Caring for people in a safe environment and protecting them from avoidable harm
The outcome framework will underpin commissioning by GP consortia and will be translated into a commissioning outcomes framework and form part of commissioning guidance. Advocates have a key role to play in achieving such outcomes. We will need to influence development of the framework and guidance by the NHS Commissioning Board.
As widely reported in the news, GP commissioning will happen. The Government will press ahead with pathfinder pilots before the Bill is passed, with GP consortia in place by April 2012 and having statutory responsibility for commissioning health services from 2013. The paper contains considerable information about how this will work. It does state that it is ...important for GP consortia pathfinders to develop their understanding of local communities by working closely with groups that represent and involve local patients – for example, current LINks organisations and HealthWatch pathfinders – as they consider how best to ensure patients and the public are involved and engaged in commissioning 2.70
Advocates have a key role here and should build influence with GP consortia at an early stage.

The paper also announces a new duty to secure continuous quality improvement in the effectiveness, safety and broader experience of treatment and care. Again, Advocates can make a big contribution to continuous improvement.

Listen to patients, Speak up for change

2010-12-03T03:35:00.000-08:00

The extract below is taken from the website of the Patients Association. We whould all get behind their campaign to highlight poor practice in the care of older people by the NHS. I have written to their Chief Executive to pledge our support and raise awareness of the role that independent advocacy can play in supporting people in these kinds of situations:

Today the patients association publishes Listen to patients, Speak up for change, a collection of 17 firsthand accounts of hospital care of older patients from across the NHS. The stories highlight serious failings in standards of nursing care, poor communication with relatives and an ineffective complaints handling system.

A follow up to last year’s Patients not numbers, People not statistics it’s publication marks the launch of a fundraising drive (supported by the Daily Mail) for the Patients Association Helpline as we try to deliver a more active support service. We are seeking to raise £100,000.

Patients Association President Claire Rayner, who passed away earlier this year, wrote the foreword for last years report and her son Jay Rayner writes the foreword this year in memory of Claire. Commenting on the launch of the report her husband, Des Rayner, said

“Let the haunting begin”

in reference to Claire’s famous last words ("Tell David Cameron that if he screws up my beloved NHS I'll come back and bloody haunt him!").

Chief Executive Katherine Murphy said:

'Surely the essentials of nursing care are what every patient deserves and should get? The NHS should get this right all of the time. Lack of help with eating and drinking. Lack of help with personal hygiene. Lack of help with toileting needs. It is clear from the stories we hear on our Helpline that too many patients are being badly let down. It’s a scandal and it’s outrageous that has been persisting for years. Families are left with a life sentence of grief, with no lessons learnt and the same failings continuing.'

‘The fact this problem hasn’t been properly addressed before is a sad indictment of our society. If we continue to ignore the problem, then many millions of us will end up in a similar position in the years to come. We will regret not having spoken out. Every single one of us needs to say enough is enough.’

‘The people who wrote these stories were not asking for the earth. They just wanted their relatives to be cared for, to have their basic needs met, for staff to show their loved ones kindness and compassion. I think we’d all want that if we were in their shoes.’

'The NHS has tried to bring back matron, but is hasn't worked. That absolute commitment to patient care seems to get sidelined by targets, finances and bureaucracy. What we need is a matron who can ignore all of that. They can tell Trust managers, ‘forget your strategic framework and middle manager initiatives, it is meaningless if patients are not getting the vital nursing care they are entitled to.'

'We've been told for years that the NHS is listening to patients, but where is the proof? Complaints are not being listened to. That is a fundamental thing that needs to be put right. The whole complaints system needs to be reviewed urgently starting with surveys for complainants so we can find out where the really poor performers are.'

'Patients and carers need to be able to call on a real advocate when they complain, someone to fight their corner.'

‘When we published our report in 2009 we were inundated and ever since we have heard story after story after story. Our calls are going up and with the help of the Daily Mail readers we will try to make sure everyone who contacts us gets the help they need.’

Kieran Mullan from the Patients Association supported the story tellers during the difficult process of producing their accounts and commented:

'Their grief is palpable. Many of them feel guilty that the system disempowered them so thoroughly. Taking part in the report reminds them they are not alone, that it was not their fault. It is the system they were up against that is at fault.'

'It is vital that other people show the courage these people have shown because unless people speak out the problems will continue. It was a privilege to help them do this. We can't publish everyone's story, but everyone's story helps us to shout from the roof tops as loud as we possibly can.'

'When I took the stories and showed them to Claire last year she was upset and then she was angry. We know she would have been even more angry that these things are still happening. We should all be angry. This is our NHS run by our Government. The NHS exists to meet our needs and the needs of our families and friends. We shouldn't tolerate such abysmal failings. Our story tellers are speaking out. They are saying enough is enough. We all need to get behind them.’

On the plans for the Helpline, Michael Watson Helpline Manager said

‘We want the resources to help more individuals to make their voices heard locally. Whether that be writing letters to Trusts and MPs, putting them in touch with local patient groups, getting them expert advice. Anything we can do to help. At the moment we are limited to sign posting, helping people to help themselves. The need is just so great that we are determined to do more and we hope people can support us and donate to the appeal.’

Croeso i Cymru!

2010-11-19T02:25:00.000-08:00

Recently returned from speaking at an advocacy AGM/seminar in North Wales, Caernarfon to be precise. It was great to spend time in a different country and hear about how advocacy is alive and well even in far-flung parts. It was also very heartening to see that A4A's reach extends that far - 2 of the 3 organisations that formed the IMHA partnership I visited have the QPM. And there was a real sense of collective ownership of things like the Charter, Quality Standards and Manifesto. It sounds coy, but it was nice to feel useful.

There were also some commissioners at the event, and they went away with a copy of Lost in Translation tucked under their arms. The commissioners were candid about the prospects for the future - cost will continue to play a major part in tendering decisions, but schemes can help themselves by embracing outcomes and evidence-based practice. In future nobody will fund a service that doesn't make an impact - or can't prove it.

I still think it's a shame that A4A doesn't have a stronger physical presence in Wales - we lost our funding some years ago - and it's not far short of a scandal that the Welsh Assembly Government doesn't fund any second tier support for the advocacy sector over there. Hopefully this anomaly can be rectified over the coming months and years. In the meantime as long as the hotels are comfy and the welcome is warm, A4A will be happy to pop over as and when we are needed.

Action for Advocacy response to Local Democratic Legitimacy in Health

2010-10-12T02:49:00.000-07:00

Action for Advocacy (A4A) is the resource and support agency for independent advocacy organisations in England and Wales, with over 550 members.

In the interests of time we have chosen to limit our response to Question 2 of the consultation document.

Q2 Should local HealthWatch take on the wider role outlined in paragraph
17, with responsibility for complaints advocacy and supporting
individuals to exercise choice and control?

The independent advocacy sector in England has a wealth of experience built up over 25 years in supporting people to have a real voice, choice and control over their own lives. We estimate there to be around 650 independent advocacy providers in England alone. These organisations are mainly registered charities and vary in size and scope, although the vast majority sign up to the Advocacy Charter, Code of Practice and Quality Standards for Advocacy Schemes (all produced by A4A). It is essential that this legacy and track record in providing high quality local advocacy is not undermined by the new Healthwatch proposals. On the contrary, we need to be making the most efficient use of existing advocacy resources. This means forging constructive partnerships between local Healthwatch and local advocacy organisations – a role that could be undertaken jointly between Healthwatch England and Action for Advocacy. It is vital that Healthwatch works alongside existing provision rather than trying to duplicate it.

We accept that the introduction of Healthwatch means that the existing Independent Complaints Advocacy Services (ICAS) will need to change. Our view is that the integration of complaints advocacy into local independent advocacy provision would make good use of existing advocacy infrastructure and ensure better local legitimacy. There have been concerns expressed in the past about the lack of local knowledge and accountability of ICAS services – a move towards integration of complaints advocacy functions alongside other advocacy functions would seem to us to be the best way forward. The issue would then be how to transfer resources currently tied up in the NHS down to local providers – either via local authorities or via Healthwatch itself. We would be more than happy to explore options regarding this issue.

We would also like to flag up our concerns regarding the role of Healthwatch to support the views of people deemed to lack the capacity to make choices. It is vital that Healthwatch has due regard for the well established IMCA (Independent Mental Capacity Advocacy) services that exist up and down the country. These services provide specialist advocacy support to people who lack capacity to make key life decisions. A great deal of expertise and professional reputation has been built up over the 3 years that the IMCA service has been operating and it will be important to recognize this. In addition, there is a wealth of knowledge and expertise across the advocacy sector regarding what is known as ‘non-instructed advocacy’ (NIA).

In summary we feel it would be wrong to suggest that Healthwatch could or should be a provider of advocacy in any form. Instead, work should be undertaken to forge constructive local links between Healthwatch and local independent advocacy organisations. Those local organisations should be supported via Healthwatch and the commissioning local authorities to provide the full range of advocacy services to local people, including complaints advocacy and non-instructed advocacy to those within the community who lack capacity to make key choices.

Nationally, we would suggest that there will be significant benefits to very close working links between Healthwatch England and Action for Advocacy.

Rick Henderson
Chief Executive
Action for Advocacy

Action for Advocacy’s Response to Equity and Excellence: Liberating the NHS

2010-10-06T06:17:00.000-07:00

Action for Advocacy can see much to celebrate and support in “Equity and Excellence: Liberating the NHS”. Coming at a time of severe financial constraint it is understandable that there is much concern amongst people about how they may be affected by any forthcoming changes to the NHS. In this context, the stated commitment to equity and equality is a hopeful indicator of the aims of the reforms and something that must not be lost in the journey from policy to implementation.
Many of the aspirations and principles of the paper echo the fundamental ethos of advocacy; that people are the experts on their life, that people should have a choice on the fundamental nature of care - not merely a choice of provider, that services should be designed around the person and not vice versa, that discrimination is unacceptable, that substandard treatment will be identified and that is not tolerated. Most strikingly of all, to see a government publication adopting the self-advocacy rallying cry of “nothing about us without us” shows a continued move towards a society where all members can take responsibility for their own lives and choices.
Action for Advocacy welcomes this tone in the paper. We support the commitments to putting patients first, making sure that care is personalised to individual need, to ensuring that need and background do not present barriers to accessing the benefits of service redesign and to strengthening patient voice.
The paper highlights that in some cases the NHS is poor at being responsive to the patients it serves – a statement that reflects the reason that many people come to independent advocacy providers. Individuals often feel the need to be supported to challenge health professionals; sometimes to ensure that the care is designed to meet their needs rather than those of the service, at other times to tackle discrimination and inequitable access to care. This need for support tends to be more pronounced amongst those with longstanding or complex conditions, particularly those which are associated with stigma. In these cases, independent advocacy has been one of the engines of transformation in the way that services are delivered to individuals, providing support and confidence to individuals to participate in designing their own care and challenging those who would deny patients fundamental choice and control. Shared decision making must be the way forward for all NHS services.
The aspiration to give people support and freedom to live the life they choose with dignity is unarguably positive. However, for many people dignity can be compromised by service centred delivery. Services in which where people are too afraid to challenge inappropriate or substandard care do not provide good health outcomes. Empowering individuals to speak up and to make decisions is a necessary requirement for this aspiration to be realised in the medium to long term. Increasing patient voice in this regard may enable people to become empowered regulators of their own care.

We are heartened to read that choice is not seen in relation merely to the time and place of appointments but is defined in the paper as, “a more fundamental control of the circumstances of the treatment and care you receive”. Access to information will define people’s ability to gain autonomy in care decisions. We therefore welcome the provision to provide assistance to those who are less able to access online health information. However, whilst access to information is necessary it is not sufficient to ensure that people can take control of their own lives. For this to happen people must be able to speak up and confident that others will listen. If these decisions are to allow people to look beyond the scope of existing service provision it will require the support of people from outside the “pure” health sector. This is the area in which independent advocacy services have developed expertise over the last 30 years. We urge the government to make use of these hard won resources to ensure that the NHS is responsive to the differing needs of a wide range of empowered individuals.
We welcome the recommendation that patients are to hold their own notes as an important step forward in empowering people and making available the information which defines which choices they may be able to make. Whilst noting that this will start with GP records and extend to health records held by all providers we would urge that there is explicit guidance that people with mental health problems are not unfairly excluded from this provision.
We will respond in more detail to the arrangements around Health Watch in the consultation specific to Local Democratic Legitimacy in Health, and our response will focus on how to ensure commissioning of health advocacy makes best use of all available resources for independent advocacy. However it is important to note that the provision of complaints advocacy will not be sufficient to realise the vision of a transformed NHS.
The Equalities Impact Assessment notes that there is unequal access to and take-up of healthcare, stating further that, “Addressing these inequalities will lead to greater efficiencies in the healthcare system as well as promoting and supporting a fairer society”. Simply put, people are more likely to access services that reflect their need, more likely to stick to plans that they have designed and such plans are more likely to work. Ensuring patients are able to co-design their care will be a fundamental challenge to meet if we are to realise the vision of empowered and independent patients. Finding a means to access the voices and experiences of previously excluded groups of people will be essential if long standing inequalities are addressed in future commissioning arrangements. Both challenges must be met if resources are to be best used.

The Equalities Impact Assessment rightly cautions that “A high quality, safe service is no good to someone who needs it but cannot access it, or who does not want to use it because it is insensitive to their needs”. This is a salutary warning when put in the context of the experience of advocacy service users. Numerous advocacy organisations tell us of the difficulties they have in getting access to GP care for some of their clients. Methods of delivery of many services have been inappropriate to the needs of individuals wishing to access them. Exaggerated focus on one aspect of a person’s life has often led to services which ignore the rest of their needs. These are all instances of people being disbarred from access to high quality healthcare which is appropriate to them. In times of tough decisions it is likely that those less able to challenge will suffer disproportionately in access to care and in the commissioning and design of services. We welcome the onus which the Equalities Impact Assessment places on GP commissioning consortia to promote equalities and ensure equality of access. We suggest that engagement with voluntary sector organisations may help consortia to meet this obligation.

To ensure that the transformation of the NHS is one that fundamentally gives power back to individuals is an immensely positive aspiration. We believe that patient centred planning and decision making will lead not only to greater satisfaction but also to more appropriate services and better health outcomes. Implementation of the programme will need to carefully consider how it will address imbalances of power, information and ability to control the decisions affecting our own lives. We believe that independent advocacy could have an important role in facilitating this change.

Martin Coyle,
Deputy Chief Executive, Action for Advocacy
5th October 2010

Knowing you Matter

2010-09-22T06:08:00.000-07:00

Review

‘Knowing you Matter’ DVD

F4C Media www.frameworks4change.co.uk

“We are living longer. Many of us will need care. How do we want that care to be?”
This film was commissioned and funded by East Sussex County Council and made by F4C films, a subsidiary of Andy Bradley’s well-known Frameworks for Change organisation.
The film sets out to explore some powerful issues to do with ageing, care and dignity. As the older population grows, many of us are forced to confront our own fears about ageing, and consider the kind of care arrangements we would want for ourselves in the future. It is no secret that many care homes fall far short of the standards that we would set for ourselves – but what can be done about it? The film is designed to be watched by care staff, older people themselves, advocates and family members. It challenges care workers to reflect on their own practice and adopt a more person-centred approach. As Andy Bradley himself says, “We’ve lost the point of care – which is to care”.

Unsurprisingly the most powerful parts of the film are those vignettes of older people themselves. The interviewees show a remarkable insight into both their own needs, and the ‘bigger picture’ issues of low pay, understaffing and poor status amongst care staff. There is a quiet dignity in the way people recount the highs and lows of their own lives and relationships leading up to being in care. It becomes clear that a partnership between carer and cared-for based on mutual respect and trust is a cornerstone of any genuinely caring relationship.

If there are any criticisms, aside from the film being maybe 5 minutes too long, it is that the voices of care staff – so central to this process – are missing. It would have been nice to hear their side of the story. But there is plenty here for them to reflect on. In particular, striking a balance between providing physical care, and taking time to talk and listen to the person.

Without a doubt, this is one of the most powerful, thought provoking films about ageing and care that I have ever seen. I defy anyone not to be moved by the life stories, and by Andy’s sensitive and stimulating commentary. Together with the accompanying training pack, ‘Knowing you Matter’ might just stimulate the revolution in care that is long overdue.

it's not all IKEA and Stieg Larsson...

2010-09-16T06:41:00.000-07:00

Just spent a wonderful morning in the company of 5 advocates and service users who are over from Sweden on a fact finding tour of London. Over there they have a system of state funded Personal Ombudsmen (POs) who are somewhere between advocates and care brokers. They were especially interested in peer advocacy and the role that ex-mental health service users might play in delivering effective advocacy. They were leaving me to go and visit Advocate for Mental Health and HUBB (thanks guys), two advocacy schemes that work hard to achieve high levels of user involvement.

My visitors were very interested to hear about the IMHA and IMCA developments, and were impressed with the work that's been done on the advocacy qualification and the QPM quality mark. They took away gooide bags full of A4A materials and it caused me to reflect on the fact that we really have come a long way in this country over the past few years. I think it's fair to say that the UK is now leading the way internationally when it comes to advocacy. Let's hope this new Government doesn't undermine all our good work.

Rest assured I've offered to pop over to Stockholm if I'm ever needed to give a presentation.....

Big Society (3)

2010-07-20T03:16:00.000-07:00

Thought I'd test out some of the new Big Society ideas. So I went to WH Smiths, grabbed an armful of books, told the cashier I wanted 'more for less' and offered her a pound.

She just looked blankly at me.

So I suggested that if they made half their employees redundant and used volunteers to staff the shop instead, they could pass on those savings to 'the community' (i.e. me).

More blank looks I'm afraid.

I'm not sure this Big Society thing is going to catch on.....

Advocacy manifesto now ready to launch!

2010-07-08T02:48:00.001-07:00

After a great deal of time and effort, the new Advocacy Manifesto is back from the printers and ready to launch. To give its full title, 'A manifesto for advocacy services in England and Wales' is the culmination of a process that started with a national conference in March, followed by a lengthy drafting process, and online consultation, and a further redraft and redesign (thanks Mark).

The result is a very readable, attractive A5 document that sets out a platform for lobbying and campaigning at both local and national levels. The manifesto is divided into 6 sections: access and diversity; funding; safeguarding; volunteering; training and support; and personalisation. In each section we spell out the key issues and our beliefs/expectations for the future. All of thos expectations are, I believe, entirely reasonable. We are not demanding world peace - although that would be nice - rather, we are asking that advocacy be afforded the respect and resources it deserves.

Big thanks to all those individuals and networks who were involved in the development of the manifesto. It was very much a joint effort and is jointly owned by all the contributors: A4A, OPAAL, DAN, GAIN, British Deaf Association, Age Cymru Elder Abuse Project, Advonet, and Newcastle Advocacy Centre. And thanks also to ACUK for providing a space for discussing and debating the issues.

We have printed 5000 copies of the manifesto to make sure there's enough to go round. We are also working on a PDF version for people to post up on their websites. We'll be sending out copies to advocacy providers in the next couple of weeks. We will also be working on a mailing list of 'powerful people' including ministers, MPs and QUANGOs who we want to receive a copy.

This is a great demonstration of how the advocacy sector has come on in leaps and bounds in the past decade, and gives us a solid platform from which to lobby for greater recognition and resources.

Big Society (2)

2010-06-23T02:05:00.000-07:00

Following on from my previous post, I have come across an excellent publication by the New Economics Foundation (NEF) called 'Ten Big Questions About the Big Society' (thanks Martin). Having read through this, I think I'm becoming a bit clearer about a) what the Big Society (BS) actually means and b) what role independent advocacy might play in it. NEF states that:

"The Government hopes the 'Big Society' will help to replace 'big government', to mend 'our broken society' and help to cut the size of the public deficit. Getting people at local level to take more responsibility and do more to help themselves and their neighbours is seen as an alternative to action taken by state institutions and public services. Poverty, unemployment and inequalities are signs of social breakdown and these, according to the Prime Minister, are best addressed by shifting power, control and responsibility from the central state to families and communities. Increasing the volume of voluntary action is seen as a way to cut public spending."

Ok so that's clear enough - although as NEF point out, Big Society is big on rhetoric and low on detail.

Thinking about the role that independent advocacy might play in this context, it is helpful to break down the BS aims and take them one at a time:

1) Empowering local people - advocacy does this in so many ways: firstly advocacy empowers people to speak for themselves and self-advocate wherever possible. It has the effect of equipping people with knowledge about how systems work, and the confidence to get things done. Advocacy encourages professionals to work in person-centred ways, and supports positive risk-taking.

2) Promoting neighbourliness - advocacy does this by actively recruiting volunteer advocates and providing them with the training and support needed to be effective advocates for local vulnerable people. In this way, advocacy skills up the community to advocate for each other. It also increases the likelihood that contact between professionals and lay-advocates (ie friends, family and neighbours) is constructive and calm.

3) Moving from centralised, state interventions towards local solutions - advocacy services are, in the main, fiercely and proudly local. They are integrated into local communities and know how things work on a day to day level in our villages, towns and cities. Advocacy engages with people at their level, and wherever they happen to be. In this way, advocacy supports local enterprise and local solutions to local problems.

4) Addressing inequalities and shifting power - advocacy does this by empowering individuals and communities. Advocacy services are part of the wider voluntary sector but also part of a national advocacy sector, represented by organisations such as Action for Advocacy, that lobbies for social justice and human rights for all. Advocacy speaks for those least able to speak for themselves and in so doing, raises awareness that such people exist within society and can contribute to society.

5) Reducing public spending - so much money is wasted by the state on inappropriate and ineffective public services. Although the personalisation agenda raises the prospect of a revolution in the way services operate, there is resistance and inertia at the level of those professionals charged with implementing it. Advocacy can help to ensure that service responses to peoples' needs are person centred, appropriate and timely, thus avoiding waste and keeping costs down.

So in summary, I believe that there is a compelling case for greater investment in both advocacy services and advocacy training as part of the Big Society agenda. A modest investment by the Coalition Government will reap big dividends. I will be taking this message loudly and clearly to Government over the coming months - I hope you will too.

The NEF report referred to can be viewed at
http://www.neweconomics.org/sites/neweconomics.org/files/Ten_Big_Questions_about_the_Big_Society.pdf

Big Society

2010-05-24T07:33:00.000-07:00

If somebody has worked out what the 'Big Society' means for advocacy services could they please let me know? Otherwise I'll have to work it out for myself.....and concrete information about what it means, in any context, seems to be thin on the ground.

I'll keep you posted.

A Contradiction in Terms Surely?!

2010-05-18T05:48:00.000-07:00

Just had an invite to attend a very interesting looking training course. It was a one day course entitled 'Lobbying on a Shoestring'.....I really fancied it until I saw the price. Hope you're sitting down. It was £575 plus VAT!!! that's right - for a course designed to help groups with hardly any funding to get their message across to Government.

A contradiction in terms, surely.

Oh Prime Minister, So Much To Answer For

2010-04-29T05:25:00.000-07:00

Gordon Brown is in the process of learning one of the most important lessons in public life, which is this: just because you think it, doesn't necessarily mean you should say it. His off the record remarks about a member of the public being 'a bigot' will no doubt haunt him for some time to come. The Press are quick to seize on these kinds of gaffes,and most of the papers are currently running articles about similar mistakes made by other politicians and public figures.It seems nowadays there is no such thing as 'off the record'. Couple this with the current obsession with tweeting or Facebooking every last detail of what we are doing, thinking or watching, and the old adage 'think first, speak second' takes on a whole new significance.

It's easy, almost natural, to react instinctively when challenged or faced with a sticky situation. A persons's first reaction is usually their most honest, the one that most closely resembles their world view. But rarely is that first reaction the most diplomatic, nor will it be the one for which we wish to be remembered. This is because in public life, diplomacy, tact and strategy are just as important as honesty.The balance between saying what you think and saying what is most likey to achieve your desired outcome is a tricky one to get right. Some people are just blunt. But bluntness is hardly an attractive quality in a public figure (I'm thinking about Prescott et al here). What's acceptable in the pub after a few pints is rarely so on a conference platform. Or in a blog or email for that matter.

Brown is now describing himself as a 'penitent sinner' and the Press reaction is that the apology is even more cringeworthy than the original comment. I tend to agree. There's a lesson for all of us here. A few moments contemplation before opening one's mouth (or putting pen to paper) can save an awful lot of misery. Let Brown take his punishment so that we don't have to.

Manifesto first draft now ready for consultation

2010-04-23T01:57:00.000-07:00

Yes after much blood, sweat and tears, the first draft of the Advocacy Manifesto is ready to go out for consultation. The plan is to get it up on the A4A website on Monday, with a link to an online survey so that people can feed in their comments on the draft. The timescale will need to be tight if the manifesto is to be relevant for the Election....I'm hoping that some of the other networks will also be able to get this up on their sites in time. Once we've got a final draft it will be proofed, printed and distributed widely. I'm not expecting that we'll please everyone (this is advocacy after all!) but I do think it reads very well and that our demands/requests are reasonable and achievable.

2010-04-23T01:51:00.001-07:00

the new jobs I mentioned in a previous post should be advertised in next Wednesday's Guardian Society.

New Server

2010-04-12T02:16:00.000-07:00

we've just had a new server installed to make life easier for those A4A staff who are not based in London....it means that everyone can have access to the database which hopefully will pay dividends in the future. But in the meantime please bear with us if there are problems, there are bound to be a few teething troubles,let's hope there aren't too many!

I Like It When Things Work Out

2010-04-06T08:56:00.000-07:00

Just returned from a short break to discover that we were successful with BOTH our bids to the Department of Health's Third Sector Investment Programme (the old Section 64). One is to establish a support project for IMHA providers nationally, and the other is a joint project with Action on Elder Abuse exploring the range of advocacy approaches to supporting people in finance abuse and money management situations. Both exciting, new, 3 year projects which will contribute significantly to the evidence base in support of advocacy.

We'll be advertising both posts towards the end of the month - keep your eyes peeled......

sometimes I just get so........

2010-03-12T07:38:00.000-08:00

(I was recently contacted by a researcher who had written an article claiming that advocates could not represent vulnerable people - they were recommending that a new workforce of 'independent guardians' were appointed. I have reprinted my response below).

"Of course I completely disagree with your assertion that advocates cannot represent people....that is our lifeblood, it is in our DNA. Advocates bring a wonderful (possibly unique) combination of independence, loyalty to the service user, empathy, an in-depth knowledge of the system, a non-judgmental outlook, tenacity, negotiation skills and an ability to devote time to people who are always being rushed - from assessment to assessment, case conference to case conference, from one shift pattern to another. Advocates also bring a wealth of personal and professional experience to their roles - many advocates have experience of using or working in services. But advocates are very much rooted in the voluntary sector - these are not burned-out or retired profssionals, now looking to earn an extra few quid by purporting to be independent when really their loyalty to the 'old ways' is so ingrained as to render them eternally part of the system. It is these very people who worked in the services that disempowered, victimised and often abused people in the first place.

Advocates bring a fresh outlook to old, institutional problems. They see 'outside the box' and because of their non-judgmental nature, enable service users to do the same. This allows people who have been led to believe there are only limited options (limited by resources more often than not) the wonderful opportunity to say what they really want, what they really feel about what is happening to them. The key to this is the advocate's relationship with the service user, often developed over time and always at the service user's pace. Advocacy does not involve some complex, bureacratic 'assessment' in order to define eligibility, and for that reason is extremely accessible even to those service users whose past experiences have rendered them suspicious and cynical.

In cases where the client lacks capacity, then the model of 'non-instructed' advocacy comes into its own. Even here, the advocate goes way beyond what any designated guardian might do (as per your article). The advocate resists passing judgment on the person - there is no 'best interests' requirement - and instead tries to get to know the person, spending time with them and observing them in a range of settings, trying to find out who they are, what they like and dislike, and constantly searching for any opportunity to communicate. The advocate also questions the status quo, the decision making processes used by services that so often disempower rather than empower, restrict choice rather than enable it. The non-instructed advocate also brings a human rights based approach, ensuring that those immutable rights that citizens do have are upheld. If there is a need for representation, formal or otherwise, the advocate provides it. But where possible, more localised, informal solutions are preferred. Not forcing services against their will to do something, but helping them to see why they should, in the hope that others may be treated more favourably in future.

Yes, the IMCA and IMHA roles are more tightly prescribed, with tighter reporting requirements and certain boundaries beyond which the advocate should not stray, but even in these circumstances, the IMCA/IMHA does not give up, they simply refer the person to their more generic advocacy colleagues, who are happy to pick up the baton.

So you can see - there is nothing wrong with advocacy, beyond a chronic underfunding and a woeful lack of appreciation amongst certain professional groups. What is needed is not an 'alternative' service (eg guardians) but a concerted effort to get behind advocacy, promote it, support it, fund it."

'Towards race equality in advocacy services: people with learning disabilities from black and minority ethnic communities'.

2010-03-04T07:28:00.000-08:00

It is difficult to know where to start in my criticism of this document which was recently published by the Race Equality Foundation.

But I will start by asking why my own organisation was not consulted in the development of this document, nor is listed under the 'resources' section. Action for Advocacy (A4A) is THE national umbrella body for advocacy services in England and Wales and is the primary source of information on advocacy issues. We also have a number of BME-specific projects within our portofolio. The two advocacy organisations that are listed in that section - NAN and ARX - are either no longer operational (NAN) or have lost the funding for their BME work (ARX).

Secondly, no reference is made to the work that IS being done to ensure people from BME communities have access to culturally appropriate advocacy support - I will not go into all of this here but suffice it to say that the authors clearly have not done their research before making sweeping generalisations about the failure of advocacy services to address issues of race and culture in their service delivery.

The most amazing thing to me about this report is that it doesn't appear to include any real recommendations about the way forward, either for advocacy providers, funders or policymakers. The closest it gets to a recommendation is suggesting that advocacy services need to 'redouble their efforts' to reach and advocate for people with learning disabilities from BME communities. There is no reference whatsoever to the fact that, whilst many advocacy services are striving to provide more accessible services, it is the lack of funding that prevents them from doing so. A valuable opportunity to lobby for more funding for advocacy has therefore been lost.

This report is potentially damaging. People who read this without a real understanding of the dynamics of advocacy and the current dire financial position of many advocacy organisations (as a result of Government underinvestment) may well reach the conclusion that advocacy services are doing nothing to promote the voices of this client group. This would be a completely wrong conclusion.

I am sorry to have to be so critical of a piece of work that could have been hugely useful, to advocacy services and people with learning disabilities alike. It is hard to imagine why the researchers did not contact A4A for advice before putting pen to paper.

Where will our future inspiration come from?

2010-02-24T05:37:00.000-08:00

I have just had the misfortune to stumble across a disturbing publication by the name of 'The Theological Voice of Wolf Wolfensberger' (Haworth Pastoral Press 2001). Those of you with long memories will know that Wolfensberger is widely credited with 'inventing' advocacy back in the late 1960s, and is certainly one of the most published authors on the subject worldwide. He is also a controversial character: his writing on normalisation and social role valorisation has often been criticised by disabled people themselves and others within the sector. In the above mentioned book however, he appears to take a step too far for even me, a devout Wolfensberger fan. He seems to be arguing that disabled people (he uses the awful phrase 'retarded') are - brace yourseves - 'carrying a prophetic message from God'. He lists 10 ways in which 'retarded' people may be prophetic. I cannot bring myself to reproduce his points here, but as an example, he seems to suggest that people with communication difficulties may be 'speaking in tongues'....

I sincerely hope that I have completely misread his work - and if that is the case then I apologise profusely - but I have a nagging doubt that I've read it right.

Reflecting on this, I started to wonder about our current position in the UK advocacy sector. Where do we get our inspiration, passion, drive and theoretical backdrop? Who are our gurus? What do we read, watch, listen to in order to see the future for ourselves and the people we support? Or do we no longer feel the need for such radical investigation, now that we are part of the 'mainstream'? Ultimately I am led to question my own, and A4A's role, in providing, if not inspiration, then certainly an internally critical safe space to discuss the successes, and failings of the current sector.

What do YOU think?

'Rights with Meaning' highlights threats to advocacy independence

2010-02-08T05:14:00.000-08:00

The Baring Foundation has published 'Rights with Meaning', a report on the work of its Strengthening the Voluntary Sector programme in 2008. It focuses on the independence of advice and advocacy charities. A4A was a major contributor to this project. See Third Sector news item at http://www.thirdsector.co.uk/news/980893/, or download the report (pdf, 184KB) from http://www.baringfoundation.org.uk/RightswithMeaning.pdf.

Best and worst decisions

2010-02-08T05:07:00.000-08:00

I've got a small piece in Community Care magazine this week entitled 'the best and worst decisions I've ever made'....it's hidden away halfway through, but if you do get that esteemed publication, have a look and let me know what you think.

A KIND OF MAGIC?

2010-01-20T02:31:00.000-08:00

(this piece was written for the recent OPAAL newsletter, www.opaal.org.uk)

I watched fixated as TV magician Derren Brown predicted the lottery results some weeks ago, and for a few minutes was convinced I was witnessing something magical. However, we live in an internet age and it wasn’t long before ‘ordinary’ members of the public were posting solutions to his trick on the Web (see YouTube for example). The whole experience proved that Lincoln was right when he said ‘you can fool all of the people some of the time....’.

So is that what we, the advocacy sector are doing? Tricking people (public and politicians alike) into believing that advocacy is needed, wanted, indispensible? Are we really the ‘thin line’ between those who have no voice, and those who try but so often fail to provide State-led solutions to peoples’ needs? Do we inhabit a special, almost sacred place on the spectrum between what should happen for people who need support to live good lives, and what actually does? Or is it all smoke and mirrors, an attempt to project a professional aura onto something as natural and inevitable as eating, sleeping, breathing? Critics of advocacy have mocked our assertion that advocacy is unique; arguing that each and everyone who is involved in the life of a vulnerable person has a responsibility to advocate for that person. Advocacy, they say, is an act not a service, so why does it need funding, training, ‘professionalising’?

For those of us who live and breathe advocacy, of course, these and similar arguments have been fought, won and fought again ad nauseum. To an extent, the policy debate has been won. The Mental Capacity Act and Mental Health Act have enshrined in legislation the ‘right’ to advocacy, albeit only for certain ultra-vulnerable individuals. If we (the advocacy sector) cannot use these vital precedents to lobby for an extension of this right to other vulnerable groups then more fool us. Of course there are strings attached to these forms of statutory advocacy, but again these should not be overly constrictive if managed with skill and tenacity. What IMCA and IMHA have done for advocacy is to raise its profile, inject much-needed resources, and give it a reason to examine its processes and infrastructure in a way that has never before occurred.

There have been winners and losers in this process. A great many contracts have gone to larger, out-of-town providers, for reasons best known to commissioners. Some smaller schemes have formed partnerships or consortia in order to compete, whilst other still have opted out of the ‘bidding frenzy’ and are content to focus on their core purpose, with all the associated risks of staying small. However, the additional demands for greater scrutiny and accountability required by commissioners have been felt sector-wide, regardless of whether or not IMCA/IMHA is part of the portfolio. A lot of Action for Advocacy’s recent work has been directly focused on this issue, from the Quality Performance Mark (QPM) to the Independent Advocacy Qualification (IAQ) to the Code of Practice for Advocates. In raising standards, we hoped to address many of those concerns expressed by funders that ultimately seemed like excuses for not funding our schemes. In raising awareness, we hoped to challenge the apparent ignorance (whether real or perceived) that prevented advocacy from appearing in so much central Government policy and guidance. And in raising our own profile, we hoped to provide leadership and give voice to the concerns, views and aspirations of advocates and advocacy schemes themselves.

The economic crisis has been slow to affect the advocacy sector, but it will. Predictions of massive public sector spending cuts, and the prospect of an unpredictable Cameron Government, mean that once again we may find ourselves fighting for survival. Heaven forbid that we are labelled as part of the ‘Quangos and bureaucrats’ culture that the Tories are so eager to destroy. There may be tough times ahead for all those who are perceived as intermediaries or ‘surplus to requirements’. And the personalisation agenda raises the prospect of a rebranding of Social Work to look much more like the stuff that we (advocates) currently do. So to survive this tricky next half-decade, we need to get back to basics, assert our uniqueness and independence, and make sure we have a set of guiding principles that are fit for purpose in the 2010s. My 7 point plan, outlined below, offers an agenda for future discussions within and outside of the advocacy sector:

1) Review our Core Values. These are most succinctly stated in the A4A Advocacy Charter – but this document is now 7 years old, and a review is overdue.
2) Do the Research. There are still too many unanswered questions in advocacy – especially about outcomes and impact, methods and costs. These need to be addressed if we are to compete in a crowded and cash-strapped marketplace.
3) Shout Louder. As a sector we do not devote sufficient time and resources to celebrating our successes, voicing our concerns and raising our public profile. This includes embracing new technologies and focusing on the advocacy ‘brand’.
4) Embrace Personalisation. It’s the Next Big Thing, yet we are currently holding back from offering to be part of the solution which hopefully will see many thousands of people liberated from the tyranny of State service solutions.
5) Unite to End Fake Competition. The commissioners have had their way for too long, and the sector has been decimated by unnecessary competitive tendering at the local level. It is time to move beyond this current state and to find creative solutions to the problems of not enough resources, too many providers.
6) Put the Quality Issue to Bed. Now is not the time to shy away from engaging with initiatives such as the QPM and the Qualification. Better to invest in these measures of quality and expertise now, so we can move on from the debate in future years.
7) Reconnect with Communities. In the end, what matters is what happens in the lives of people. We should seek integration into our communities, become part of the very fabric of them, because that way we can never be removed from them at the whim of funders or politicians. If we can connect with the places where people live and spend their time, we may just be able to secure a positive future for them and us. Isn’t that what we all want?

If you only read one book this year.....

2010-01-20T02:20:00.001-08:00

....then make it 'The Secret Scripture' by Sebastian Barry. The book tells the story of the relationship between a 100 year old woman, living in a mental institution in Ireland, and her psychiatrist, who is responsible for assessing her for a return to 'the community'. As the psychiatrist attempts to piece together her history from scraps of ancient records and a handful of 'difficult' conversations, so Roseanne Clear(the 100 year old in question) is secretly writing her memoirs. These she hides under the floorboards of her room, believing her story to fantastical that nobody would take her seriously. The book serves as a poignant reminder of the role that institutions have played in the lives of so many people, both staff and so-called 'patients'. And the twist at the end is mindblowing.....

I'd love to hear what you think of the book, you can comment easily below.

Season's Greetings!

2009-12-23T01:49:00.000-08:00

Here's wishing everyone a very merry Christmas and a Happy New Year. We will be closed from today until Monday 4th January 2010, when we shall return to work refreshed and fighting fit.....

How do we educate commissioners about advocacy?

2009-12-14T02:42:00.000-08:00

This is a question that we spend a lot of time thinking about at A4A - and I'm sure you do too! The nature of current funding structures in England and Wales means that PCT and local authority commissioners have a disproportionate level of influence over what we do as an independent advocacy sector. I say disproportionate because my experience (and that of countless others) is that in fact commissioners have a very poor understanding of what advocacy is; what it does; and the impact of our work on individuals and communities. The main concerns that advocates express to us are:
* That local commissioners think advocacy is 'just another service' like home care, day care etc and don't appreciate the uniqueness of our role
* That commissioners are only interested in outputs (ie numbers of people seen etc.)rather than outcomes
* That IMCA and IMHA commissioning, by the very fact of its statutory nature, is having a negative effect on the commissioning of more generic, community based advocacy models.

To this list of issues I would add one that is especially problematic for us at A4A - and that is the lack of an accurate database of advocacy commissioners. This makes it very difficult for us to engage with commissioners nationally because we simply don't know who they are. Earlier this year we wanted to invite commissioners to a seminar looking at IMHA commissioning, but even our joint attempts with the Department of Health failed to reach sufficient numbers of PCT commissioners to make the event viable.

Until this issue is resolved, it will be up to local advocacy schemes (who presumably have a relationship with their own commissioners) to pass on information about national developments and the work of A4A and others. The benefit to local schemes is that they can set their local work in a national context, and hopefully educate their commissioner about the 'big, wide world' of advocacy that exists beyond their borders. So many commissioners are currently reviewing their funding of advocacy services that it would be advantageous that they do this from a position of awareness rather than ignorance. It would also be very interesting to know whether they are receiving, and reading, the commissioning guidance around things like IMCA and IMHA that has been produced by the Department of Health, or whether in fact a more hands-on approach is required.

I'd love to hear your views about local commissioning. You can post a comment easily below.

Psst! Wanna go to a conference?!

2009-12-07T06:07:00.000-08:00

Plans are now well underway for the big advocacy conference to take place on 15th and 16th March 2010 in Birmingham. The conference, Shaping The Vision will be an action-focused event aimed at producing a vision for advocacy in the next decade. The manifesto created via the event will be used to negotiate with the new Government and define a positive agenda for advocacy going forward. The conference is being organised by a consortium of agencies including A4A, OPAAL, the Dementia Advocacy Network, GAIN, Advonet and others.

The event will allow advocates to have their say about topics such as:

Access to Advocacy
Personalisation
Safeguarding
Non-Instructed Advocacy
Human Rights
IMCA & IMHA

....and much, much more!

This really is a must attend event for anyone with something to say about the future of our sector. The main conference day is the 16th, but there will also be an optional pre-conference event on the 15th, with dinner and accommodation available and plenty of networking opportunities.

Cost with accomodation/dinner is £149 and the day rate (16th March) only is £99. We are currently in discussions to be able to offer bursaries to smaller schemes, to ensure their active involvement in shaping the future of advocacy services.

It would be great to see a really good turnout at the conference. I am sure that there are lots of financial pressures on advocacy schemes at the moment, but we are hoping that people can see the potential of such an event to really shape a pre-election manifesto for the sector. See you there? You can book via our website www.actionforadvocacy.org.uk

Third Sector Investment Fund

2009-12-07T06:00:00.000-08:00

The announcements have now been made about which bids have gone through to the second stage of the Department of Health's Third Sector Investment Fund (still known affectionately as 'Section 64' in some quarters). We've got a couple of bids through, and following various delays the deadline for second stage applications is 18th January 2010, so bang goes any chance of a quiet December!

Good luck to all those advocacy schemes out there that are also through, and are now wading through the new, hi-tech online forms, so get ready....on your marks, get set, GO!

ODI Advocacy Report – Inconclusive

2009-12-04T02:29:00.000-08:00

The eagerly anticipated report on advocacy for disabled people was launched recently by the Office for Disability Issues. The report, ‘Access to Independent Advocacy: and evidence review’ focused on evidence to support the case for advocacy for disabled people in four specific situations: transition; when the children of disabled parents are subject to safeguarding procedures; when entry to residential care is a possibility; and when disabled people are victims or alleged perpetrators of anti-social behaviour.

Unsurprisingly (to advocates anyway) the review concludes that there is ‘a limited evidence base’ about the need for and benefits of advocacy in these very specific situations. Well, yes, that’s because for the past 20 years it has been almost impossible to obtain any funding for advocacy research beyond basic ‘mapping’ or ‘literature reviews’. In fact, there have been so many of these that people are now doing literature reviews of literature reviews! But real research has been thin on the ground. Aside from one or two cost-benefit analyses, advocacy has been largely overlooked as a research topic. As a result, it is hard for us to demonstrate our value to funders, policymakers and the public. This counts against us when policy decisions are being made, and when people choose which collecting tins to put their spare change into.

So it’s a big yes to research, but a resounding no to more of the same. The only saving grace of the ODI report is its conclusion that ‘ ...a lack of robust data relating to numerical indicators of need does not mean that there is not a need for advocacy. In fact, the qualitative evidence that does exist, and which gives reasons for why advocacy might be needed, presents a very persuasive case for the necessity of advocacy for disabled people.’

Well that’s ok then – so when will we get the money? About £20 million should just about do it.

Ah, there’s a catch. The report also recommends ‘further research’. And this is where things take on a darker hue.....

One of the suggestions is that the further research might include a comparative study between disabled people with access to independent advocacy, and those without. That’s right; the research proposes to identify a group of disabled people who don’t have access to advocacy, and then continue to deny them access in order to compare them to a lucky few who do have advocates. I’m sure I don’t need to explain to you the dodgy ethics of such a proposal.

Ultimately, this kind of research will only take us so far. The bottom line is that wherever there is an imbalance of power and resources; an inequity of information; or a mismatch of articulacy; advocacy will come in handy. You can quote me on that. But of course, I don’t have enough evidence to prove it......

You can read the report for yourself here: http://www.officefordisability.gov.uk/research/research-reports.php#iar

make a date with SCTV

2009-12-03T05:07:00.001-08:00

Isn't it great when you discover something that's actually pretty decent?
It doesn't happen as often as I'd like....
But this week I discovered something quite wonderful called 'Social Care TV', a project of the Social Care Institute for Excellence (SCIE).
It is basically an online TV channel with all kinds of short films about social care, many of which are also linked to training resources. Earlier this week I had the chance to attend the launch of a series of short films designed to raise awareness of the Mental Capacity Act. The four films all illustrate some of the dilemmas that the MCA was designed to resolve, and are backed up with addtional training materials. Hence they can be used with all kinds of audiences as a training and awareness raising tool. They are designed with frontline staff in mind, and hence use a number of well known actors from the likes of Eastenders - Nasty Nick even pops up in one of them!

I would thoroughly recommend you all to have a look, they are at http://www.scie.org.uk/socialcaretv/default.asp

I have suggested to SCIE that they might choose advocacy for one of their future productions - watch this space!

First (of many!) blogs from A4A CEO

2009-12-01T02:17:00.000-08:00

Well this is the first of what will hopefully become a weekly blog from me. My intention is to use the blog as a way of keeping you informed about what we are doing at Action for Advocacy (A4A); what I feel are some of the biggest issues facing the sector; and some observations on advocacy, public services and life in general. Feel free to pass the details on to colleagues and friends if you feel they might be interested. I'm using the term 'you' because the blog is targetted primarily at those working within and alongside the advocacy sector. If that does prove to be the case, then I will already know most of you, hence the informal tone of the blog.

For those of you out there who haven't yet come across A4A (where have you been?!), A4A is a resource and support agency for independent advocacy schemes in England and Wales. We have the following broad aims:

To 'advocate for advocacy' at a strategic level
To support the development of independent advocacy schemes
To facilitate effective networking between advocates and advocacy schemes
To promote good practice and information sharing across the advocacy sector.

We have ten staff and three offices: In London, York and Coventry. If you want to find out more about us, please visit our website at www.actionforadvocacy.org.uk