Right or Might?

It’s time to announce the results of  our survey on the progress in commissioning advocacy to meet Care Act duties.  Before I set out the results, let me quote Lord Michael Bichard, (Chair of the Board, SCIE ) from his introduction to guidance on commissioning advocacy for the Care Act.

 “Access to independent advocacy lies at the very heart of the Care Act” 

That suggests that a problem in commissioning independent advocacy would indicate a significant problem in implementation of the Care Act.  So let’s see what the survey data shows.

I’m afraid it doesn’t paint a great picture; in fact it looks grim,  and depressingly familiar.   In this post I’m going to try to let the data speak for itself, with a couple of lines of explanation or comment where needed. I will explore some of the implications for individuals, advocacy services and local authorities shortly.

34 organisations responded to the survey, and their work covers at least 60 local authority areas. The responses come from the period – 15th  to 31st of January. Responses were to a set of multiple choice questions, designed to read in a neutral way. The questions are set out in bold. Options and response rates are set out below each question. Any comment or explanation then follows in italics.

Do you believe local social care and health services will be able to identify and refer people who have a right to advocacy through the Care Act?

Definitely 18%
Probably 14%
I don’t think they will 68%
I know they won’t 0%

Less than one third of respondents believe that people will be able to identify and refer people to a service which will be legal right in under two months.

 

Has the provider of Care Act advocacy been decided in your local authority?

Yes – and we will be providing it 16%
Yes, but we won’t be providing it 4%
Currently out to tender 12%
The local authority is looking at this, but it is yet to be decided 36%
We don’t know what’s happening 32%

The decision on who will be providing Care Act advocacy has only been made in 20% of cases. 80% lies uncertain. That has implications for identification and referral.

 
Has an amount of funding for Care Act advocacy been set?

Yes, very clearly using social care data 5%
There is a rough estimate but I’m not sure how it’s been arrived at 5 %
The commissioners aren’t committing to this 37%
Commissioners are openly stating that they have no idea what to expect 53%

Advocacy services are being asked to prepare to deliver a statutory function, but only one in ten knows what level of funding is available. 

 

Is there any relationship between projected uptake and proposed funding?

Clear & realistic link 0%
Some relationship, but unclear 29%
Unrealistic relationship 14%
No relationship 36%
Commissioners just saying what’s in their budget 21%

This paints a worrying picture, with no local authorities showing a clear and realistic link between expected uptake and funding. However, if the comments given  below this question are added into the data the picture gets even worse … 

Clear & realistic link 0%
Some relationship, but unclear 14%
Unrealistic relationship 7%
No relationship 68%
Commissioners just saying what’s in their budget 11%

 

 

Do you believe that there will be sufficient advocacy provision to ensure that people will have access to their rights under the Care Act?

Yes, I’m confident of it 0%
I think so 11%
I’m not sure 22%
I don’t think so 52%
I know there won’t be 15%

Only one in nine respondents think that funding might be sufficient to ensure sufficient access; and none of those would go so far as to say they are confident about this. Two thirds of respondents were sceptical.

 

Do you have any plans on how you might respond if you become aware of a shortage of Care Act Advocacy?

We have a clear action plan which will involve legal challenge 0%
We will seek an informal, local resolution 56%
We’re not sure / will play it by ear 40%
I don’t think there’s much we can do, that’s the funding environment 4%

There are  no clear plans to legally challenge this situation at the moment (although some respondents did say they were considering this). Local resolution seems to be the preferred way forward. I find myself asking if this is the best way of tackling what seems to be a national problem.

 

So, grim reading. Despite clearly stated guidelines in the Impact Assessment of the Care Act, despite statements from SCIE about the central importance of independent advocacy to the Care Act, confusion and concern abound. There is a real risk that this important legal right will be only a might.