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A MAP OF INDEPENDENT ADVOCACY ACROSS SCOTLAND

LOTHIAN ADVOCACY

NHS Lothian

Lothian NHS Board (formerly known as Lothian Health)
Lothian Primary Care Trust
Lothian University Hospitals NHS Trust
West Lothian Healthcare Trust
There are four local authorities within Lothian NHS Board area:
City of Edinburgh Council
East Lothian Council
Midlothian Council
West Lothian Council

Advocacy Planning Process

The Lothian Advocacy Implementation and Planning Group comprises NHS Lothian and its Statutory Partner Agencies: Lothian Primary Care Trust; West Lothian Healthcare Trust; Lothian University Hospital Trust; City of Edinburgh Council; East Lothian Council; Midlothian Council and West Lothian Council.

The Advocacy Planning Group is tasked with the remit of overseeing implementation, ongoing monitoring and review, and making recommendations to the NHS Lothian and Lothian Local Authorities Liaison Group.

It is essential that the independent advocacy projects and users/potential users of advocacy services are part of the annual review and future planning process. There are plans to develop a pan-Lothian Reference Group which reflects the needs of people accessing advocacy in the planning process.

Advocacy Organisations in Lothian

*Previously known as "East Lothian Parents and Pupils Against Bullying" (ELPPAB)

Project details

• Independent
• Professional and volunteer advocacy
• Children and young people and their parents
• East Lothian
• To be evaluated by ASA in 2003

*reviewed annually

*Ace Advocacy is in the process of looking for premises in West Lothian

Project details

• Not independent
• Managed by Enable
• Citizen Advocacy
• Learning Disabilities
• West Lothian

Project details

• Independent
• Short or long term, and crisis advocacy offered by trained volunteers
• Individual mental health service users living in the community
• City of Edinburgh
• Evaluated by Bonnar Associates August 1999
• Have requested an ASA evaluation, date to be confirmed

+ 2% uplift expected for 2003/04 *reviewed annually

Project details

• Independent
• Collective and Self-advocacy
• Adults who use or have used mental health services
• City of Edinburgh
• Have requested an ASA evaluation, date to be confirmed

+ 2% uplift expected for 2003/04 *reviewed annually

Project details

• Independent
• Individual Volunteer Advocacy
• Adults who use or have used mental health services
• East Lothian
• Have requested an ASA evaluation, date to be confirmed

+ 2% uplift expected for 2003/04 *reviewed annually

Project details

• Independent
• Collective and Self-advocacy
• Adults who use or have used mental health services
• Midlothian
• Have requested an ASA evaluation, date to be confirmed

+ 2% uplift expected for 2003/04 *reviewed annually

Project details

• Independent
• Professional advocacy, including short term crisis advocacy
• Older people in and moving into care homes and delayed discharge hospital beds
• City of Edinburgh, East Lothian, Midlothian and West Lothian
• Evaluated in 2000 by CITS, in 2003 by STEGO Consultants

*Although recurring this funding will be subject to an evaluation
+ An additional 3,500 has been carried over by East Lothian Council from 2002/03
1 Uplift for 2003/04 to be confirmed

Project details

• Independent
• Collective advocacy
• People with mental health difficulties
• East Lothian

Project details

• Independent
• Professional, Volunteer and Collective Advocacy
• People aged 18 to 65 with mental health problems
• West Lothian

+ 2% uplift expected for 2003/04 *reviewed annually
1 Uplift for 2003/04 to be confirmed

Project details

• Independent
• Citizen and Self-advocacy
• People of all ages with learning disabilities and complex needs
• Edinburgh
• CAIT Evaluation in 2000

Project details

• Independent
• Citizen, Crisis and Self-advocacy
• People of all ages with learning disabilities and complex needs
• West Lothian
• CAIT Evaluation in 2000

Project details

• Independent
• Collective Advocacy
• For adult patients and ex-patients with mental health problems
• Specific wards of the Royal Edinburgh Hospital and Day Hospitals

Project details

• Independent
• Collective and Self Advocacy
• People with learning difficulties
• Edinburgh and Midlothian
• People First Scotland was evaluated approximately 4 years ago.

Funding

Project details

• The independent status of this organisation is currently being considered
• Volunteer and Community Advocacy
• For people living with and affected by HIV/AIDS
• Lothians

*This funding will be reviewed annually

Project details

• Independent
• Citizen and Crisis Advocacy
• For people labelled as having a learning disability
• Edinburgh and within the Learning Disability Service of Lothian Primary Care Trust, which consists of rehabilitation houses in Edinburgh, Midlothian and West Lothian
• CAPE Evaluation in 1999 and again in 2001

1 Uplift for 2003/04 to be confirmed

Project details

• Not Independent
• Volunteer and Group Advocacy
• For carers and former carers (up to two years from the end of caring)
• Edinburgh and the Lothian area
• To be evaluated by ASA in 2003

1 Uplift for 2003/04 to be confirmed

Vocal received an additional non-recurring 25,000 from NHS Lothian at the end of 2002/03 in respect to the gap in their funding, as a result of their Community Fund ending.

Additional Advocacy Organisations / proposals have been cited by the Lothian Funding Partners, however more detailed information has not been provided for the purpose of this Map. Funding details have however been included under "Total Statutory Funding for Lothian Advocacy 2003/04".

These organisations include:

*Ind (this refers to the Independent status of the project).
+ The transitional rehab monies will be used to develop the new individual independent advocacy service at the Royal Edinburgh Hospital.

Total Statutory Funding for Lothian Advocacy in 2003/4

These figures do not include SE Section 9 or 10 funding or any other funding sources, other than Statutory.

Gaps in Independent Advocacy

• People who do not fit the usual care groupings
• People who are isolated and not in touch with services
• People with a physical disability
• People who are at transition points, moving between different kinds of care or provision
• People with a mental health problem including dementia
• Vulnerable children and young people
• Refugee and asylum seekers
• People from ethnic minority communities
• People who are homeless
• People who have a drug addiction
• People in acute hospital settings
• People with alcohol problems
• Older people living in their own homes
• People who are victims of crime

Priorities for Development *

• Commitment to fund independent evaluations and continued support for existing projects that are known to be providing quality advocacy
• People with a physical disability
• Older people including those living in their own homes
• To develop a strategy to address the advocacy needs of children and young people, including looked after children
• To develop a strategy to address the advocacy needs of people from ethnic minority groups. Some consideration has to be given to how mainstream advocacy projects make their services accessible to this community
• The development of advocacy for people with a mental health disorder to meet the requirements of the Mental Health Care and Treatment (Scotland) Act 2003
• Carers
• Children and Adults with Learning Disabilities
• Development of a Pan Lothian Reference Group which reflects the needs of people accessing advocacy in the planning process

* These priorities are not in any particular order

Conclusions

NHS Lothian and its planning partners have achieved much of what they set out to do in 2002/03. Additional investment has gone to developing services for vulnerable older people and for people with learning disabilities.

A great deal of advocacy activity has been happening throughout the Lothians. NHS Lothian and its statutory funding partners, advocacy organisations and service users are to be commended for this.

Two new advocacy projects have been commissioned in 2002/03: Enable is to provide a citizen advocacy project in West Lothian; and Midlothian Council has commissioned an independent volunteer-led advocacy project for people with a mental health disorder (40,000 NHS Lothian). In addition to these projects, NHS Lothian (through money allocated for HIV) has funded Positive Voice, an independent advocacy project for people living with and affected by HIV.

At the end of the financial year 2002/03 two existing advocacy services, Powerful Partnership and VOCAL had come to the end of their time-limited funding. The Lothian-wide planning group prioritised continued support for existing projects that are known to be providing quality services. Both projects have now received funding from NHS Lothian and its funding partner, the City of Edinburgh Council.

NHS Lothian, in 2002/03, allocated an additional 50,000 for the development of advocacy, and this money is recurring for development purposes: 30,000 was allocated to the City of Edinburgh; 10,000 to West Lothian and 5,000 each to Midlothian and East Lothian.

The 30,000 allocated to Edinburgh was split in three ways: 10,000 has been used to commission a needs assessment to establish what supplementary support/independent advocacy is needed to support people with physical disabilities in Lothian; 10,000 has been allocated to develop publicity materials to raise the awareness of independent advocacy, including an advocacy handbook and the development and implementation of training on independent advocacy; the remaining 10,000 will be used in some part to fund evaluations.

The development money allocated to West Lothian and Midlothian was given to EARS to further the development of independent advocacy for older people.

The development money allocated to East Lothian has been used to commission an independent advocacy needs assessment. This should provide the planning partners with: a strategic overview of needs in relation to advocacy; analysis of gaps in provision; a clearer insight into stakeholders' expectations and aspirations, and a clearer sense of priorities for development. The needs assessment will inform funding priorities.

A great deal of work has begun in Edinburgh with regard to the development of advocacy for people with a mental health disorder, to meet the requirements of the Mental Health Care and Treatment (Scotland) Act 2003. The Strategic Development Group for Mental Health, Advocacy Implementation Group had led on this and the group is currently addressing the impact of the statutory provisions relating to advocacy in the new Act.

The SDG for Mental Health has also secured some funding to develop independent advocacy for people with mental health problems using the Royal Edinburgh Hospital (30,000 has been allocated to the REH from the Advocacy Development monies for 2003/04). Two Service Specifications have been developed, one to commission an independent individual professional advocacy service, and the other to commission an independent management agency to support the collective advocacy role of the Patients' Council. It is hoped that the commissioning process will be complete by the autumn. The Independent Professional Advocacy Service will be incremental in its development, the aspiration is that this service will eventually meet the needs of all people with a mental health disorder who use the Royal Edinburgh Hospital and its associated day and community services. However, for this to happen, further financial investment is required.

An additional 30,000 has been secured from a Mental Illness Specific Grant to develop independent individual advocacy for young people with mental health problems.

A review of all mainstream services (including advocacy) for older people with mental health problems has commenced, particular to Edinburgh.

The Strategic Development Group for Dementia Advocacy sub-group are currently working on a proposal to develop advocacy for all people with dementia in both hospital and community settings.

A new healthy living centre has been established in Edinburgh for the lesbian, gay, bi-sexual and transgender community. One of the core services that is to be offered by the Centre is advocacy, however this is still in a developmental stage.

Recently, a funding proposal submitted by NHS Lothian to the Change and Innovation Fund to develop independent advocacy for carers through Vocal, for children in NHS settings and for mental health patients residing in the Royal Edinburgh Hospital has been awarded. Funding details have not been confirmed.

Finally, some consideration has to be given to the following issues:

• The need for clarity around funding streams. Advocacy Providers are not always clear where funding is coming from, particularly in relation to Lothian Health and its Local Authority Funding Partners.
• The need for clarity around the planning process between the strategic development groups in Edinburgh and the Lothian Independent Advocacy Planning Group
• The Lothian Independent Advocacy Planning Team has made a commitment to fund independent evaluations for all advocacy provision Lothian-wide. Some further discussion is required to take this proposal forward.
• All funding partners need to ensure that three year funding agreements are written into Service Level Agreements
• Although further developments are underway, the Lothian Independent Advocacy Plan continues to struggle to meet the advocacy needs of people who do not fit into the existing remits of the specialist advocacy organisations or groups.
• Some further consideration has to be given to education and awareness. Both service providers and the general public need to be informed about the role and value of independent advocacy.

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