What is Advocacy in Health and Social Care?

Louise Petty

September 16, 2024

5 min read

Many patients within the health and social care system find it difficult to express their views, stand up for their rights and have their opinions heard, whether it’s because of a disability, mental health problem or an illness. In these cases, an advocate can help. As a healthcare professional, it’s important that you understand what advocacy is; in this article, we’ll look closely at who can act as an advocate, the role an advocate plays and why advocacy in health and social care is so important for patient welfare.

Advocacy in health and social care is when a patient gets support from someone else – an advocate – to help them express their views, wishes, feelings and concerns and to stand up for their rights on their behalf. Advocacy is required when the patient lacks the ability to do these things on their own (self-advocacy).

Advocates ensure a patient’s rights and best interests are upheld throughout their interactions with the health and social care system. They are an independent individual and act separately from the NHS, council and other healthcare services the person accesses.

An advocate can be appointed from a professional advocacy service or they can be a friend, family member or unpaid carer that the patient has chosen themselves. Note that paid carers cannot act as advocates.

In some situations, patients are legally entitled to an advocate. In England and Wales this is known as ‘statutory advocacy’ and includes:

Independent Mental Health Advocates (IMHAs) who support patients currently being assessed or receiving treatment under the Mental Health Act 1983.
Independent Mental Capacity Advocates (IMCAs) who support patients who lack capacity to make certain decisions under the Mental Capacity Act 2005.
Social care advocates who support patients who have difficulty understanding, retaining or using information, or who have difficulty communicating their views, wishes and feelings, under the Care Act 2014 or Social Services and Wellbeing Act (Wales).

What is the Role of an Advocate?

The exact role of an advocate in health and social care depends on the patient’s specific needs but, in general, they are there to support the choices, views, interests and wellbeing of the individual when it comes to decisions about their care. In all circumstances, the advocate should get to know the patient so they can truly support and represent them.

The role of an advocate includes:

Actively listening to the views and concerns of the patient.
Helping the patient to find information they need.
Discussing different options with the patient.
Providing information in a format the patient can understand.
Helping the patient to make informed decisions.
Encouraging active participation wherever possible.
Contacting people on behalf of the patient.
Explaining the patient’s wishes and views to others.
Making phone calls or sending emails on behalf of the patient.
Accompanying the patient to appointments and meetings.
Supporting, reassuring and empowering the patient.

On the other hand, an advocate cannot and should not:

Make decisions on behalf of a patient without consulting them first.
Tell the patient what to do.
Give their personal opinion on what the patient should do.
Make judgments about the patient’s choices, wishes and feelings.
Make assumptions about what’s best for the patient.
Argue with the patient if they disagree with their choices.
Act in a manner that could surmount to discrimination.

There are many examples of ways an advocate can help support a patient in a health and social care setting, including:

Accompanying the patient to their medical appointments to ensure they’re receiving the right care.
Speaking to the patient’s doctor on their behalf, whether on the phone, in person or via letter, to explain the patient’s needs.
Helping the patient understand the benefits they’re entitled to and helping them make claims or attend meetings.
Assisting the patient to create a residential care home or nursing home plan and ensuring it matches their individual needs and wishes.
Helping the patient with budget management and paying their healthcare bills.
Carrying out a care needs assessment with the best interests of the patient in mind.
Acting as a point of contact for the patient if a healthcare professional needs to communicate information to them.
Explaining the different options available to the patient in a manner they can understand, such as options for residential care, appointments or medication changes.
Speaking on behalf of the patient to make a formal complaint about the health and social care system, ensuring their rights are upheld.
Representing the patient in meetings to ensure all their questions are answered, all points are covered, the patient is given all available options and the rights and dignity of the patient involved are upheld at all times.
In the case of independent mental capacity advocates, making decisions about the patient’s care and treatment on their behalf and in their best interests.

Patient with a health and social care advocate

Advocacy is an important part of many people’s health and social care arrangements as it enables them to maintain their independence, dignity and basic rights throughout all stages of the health and social care system.

Dignity in care is vital for patient wellbeing, as it helps people retain control over their independence whilst in a care environment. Having an advocate does not remove a patient’s control and should not restrict a patient’s independence: the advocate is there to support the patient and ensure their dignity, individuality and wishes are maintained.

Another reason advocacy is important in health and social care is because, under the Mental Capacity Act 2005, patients are given legal protection if they are unable to make their own decisions about their care because they lack capacity to do so. This might be because of a disability, mental health condition, illness or injury which makes it difficult to make informed choices about where to live and what medication to take, for example. These people are entitled to an independent mental capacity advocate (IMCA) who will represent the patient and support them in any decision-making processes.

How Can an Advocate Support an Individual?

The following top tips for advocates will help you understand more about your role as an advocate and how you can help support the person you’re advocating for:

Ask lots of questions – ask questions to the person you’re representing, to the people you’re speaking with on their behalf and to the healthcare professionals involved in their care. You can never know too much.
Be assertive – especially in meetings and appointments, it’s important that you stand up for the person you’re advocating for, fight for their views and ensure they are heard.
Communicate well – communication needs to be clear and regular between you, the person you’re advocating for and all healthcare professionals involved with the person. Effective communication in health and social care is about more than just the words you use, but also your body language, tone of voice and listening skills.
Know the system – ensure you’re familiar with the health and social care services the person uses, how it works and who’s involved. You need to understand everything about the person’s daily routines and experiences.
Document everything – it’s a good idea to keep a written or typed note of everything you’ve done on behalf of a person, including actions taken, decisions reached and information given, in case you need to refer back to it at a later date. Include names, dates and times of events.
Build relationships with everyone – it’s important that you have a positive relationship with the person you’re advocating for but also with the healthcare professionals they encounter. Get to know the names of the nurses, doctors, carers and therapists the person deals with to help you better support the person you’re working with.
Listen well – active listening means truly hearing what the person you’re advocating for is saying. Pick a method of communication that works best for them, whether that’s verbal or non-verbal, to ensure you’ve really heard their views and wishes.
Be creative and adaptable – advocacy can be challenging for everyone involved and it can require you to think on your feet to come up with new solutions and methods.
Follow up on everything – if you’ve spoken to someone or attended a meeting or appointment on behalf of a person, then ensure you follow up with them to ensure the agreed actions have been completed and the appropriate decisions have been made.
Remember there’s no right way to advocate – there’s no rulebook explaining exactly how to be an advocate, so often it’s up to you and the person you’re advocating for to come up with methods that work best for the both of you.

Advocacy in health and social care is when a person supports a patient to have their views and wishes heard and their rights upheld. A good advocate listens well to their subject and really gets to know them, so they can successfully represent them in meetings, appointments and in all decisions relating to their care. Advocates play an important role in maintaining a patient’s dignity and rights in all aspects of health and social care.