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A MAP OF INDEPENDENT ADVOCACY ACROSS SCOTLAND

CONCLUSION

Independent Advocacy has moved on and has been developed considerably over the last three years. This is due to the commitment and enthusiasm of all those involved in the planning processes. However, as cited in the Introduction, there is still a long way to go before independent advocacy is available to all who need it in Scotland.

There continues to be significant variances in the total funding of independent advocacy per head of population between the 15 NHS Boards and 32 Local Authorities. In some local planning areas there continues to be a significant imbalance in investment in advocacy between Health and Local Authority.

Overall, the total statutory funding of advocacy has risen from 2,722,026 in 2000/01 to 6,278,898 in 2003/04, an increase of 3,556,872. In the current financial year the statutory investment in advocacy has increased by 36% (an increase of 1,669,578). As a percentage of NHS Board and Local Authority total allocation, total advocacy funding has risen by 0.01% to 0.06% for 2003/04. As funding per head of the population ¹, total advocacy funding has increased from 0.90 in 2002/03 to 1.23 (an increase of 33p) in 2003/04.

These figures indicate that statutory investment in advocacy provision has increased, and that the pace of funding since 2000/01 has remained constant. The percentage increase of independent advocacy provision has increased significantly in 2003/04 than for non-independent advocacy. However there remains - a continuing need for non-independent advocacy agencies to move towards independence.

¹. Based on total population figures for each NHS Board Area for 2002, provided by the Scottish Executive, Health Department.

Overarching Recommendations for all planning partners:

• More secure funding is necessary to place existing and new advocacy organisations on a sounder footing. A commitment to three-year funding is required
• There continues to be an imbalance in funding of advocacy provision in some areas between the NHS Board and Local Authority. This funding imbalance needs to be addressed
• Despite funding deficits in some of the NHS Board areas, there needs to be a recognition among senior statutory sector management in line with Government expectations, of the important and necessary role of independent advocacy
• Commissioners should ensure that all Advocacy Organisations have robust and long-term Service Level Agreements
• All new advocacy provision should be independent or developed, so that it can work towards independence within the first three years of its existence. Existing non-independent advocacy organisations should consider how they can move towards independence
• There is a continuing need to build on the capacity of existing generic advocacy organisations in rural settings
• It is essential that Local Funding Partners continue to raise awareness and understanding of the role and value of independent advocacy amongst their staff and other appropriate service providers. We recommend that Commissioners engage with The Scottish Independent Advocacy Alliance to enable this process
• Local planning partners should develop an "advocacy training strategy" which is specific to the needs of their area. The Scottish Independent Advocacy Alliance should be involved in this process
• Local planning partners, including advocacy organisations, need to consider how they promote advocacy amongst the general public. Wider promotion of existing services, to potential referrers and public, with accessible literature including publications in minority languages, and systems of subsidised translation and interpretation for advocacy agencies working with people who might need this
• The independent advocacy planning processes need to be more inclusive and representative. More structured planning processes with clear lines of communication and accountability, and links into the wider decision making structures are required. Improved networking and communication between independent advocacy organisations and groups, along with joint working where appropriate, will in the future be the key to ensuring that there is a fully integrated approach to developing independent advocacy in Scotland
• Local planning partners need to consider how they involve and consult with people using services in a meaningful and transparent way. If service users are continually supported to express their views, and these are taken into account, this will go a long way towards the development of advocacy that is responsive to need
• Local planning partners need to monitor and review the advocacy provision in their areas on an annual basis to assess whether advocacy needs are being met and to prioritise how independent advocacy provision is developed further
• Local planning partners are required to submit the next round of three-year advocacy plans to the Scottish Executive, through the Advocacy Safeguards Agency, by the end of February 2004. Thereafter, written annual reviews of advocacy plans will be required for submission by the same date in the subsequent two years
• Local funding partners, as part of "a best practice framework", are required to invest in independent evaluations of the advocacy organisations in their areas.

Gaps in Independent Advocacy Provision

There are still significant gaps in independent advocacy provision for children and young people, older people, people with dementia, physical disabilities and ethnic minorities. Perhaps the largest gap concerns "hidden" groups that fall outwith the major client group categories such as homeless people, people with a substance abuse problem, those leaving prison and other marginalised individuals.

Recommendations for the Development of Independent Advocacy:

• All planning partners must consider the development of advocacy for all people with a mental health disorder to meet the requirements of the Mental Health Care and Treatment (Scotland) Act 2003
• Some consideration must be given to "collective advocacy". This report indicates that there has been little increase in the statutory investment in collective advocacy. Planning partners should take this into consideration and review the need for collective advocacy provision in their areas
• There is very little advocacy provision for people from ethnic groups. Commissioners and advocacy providers need to give this due consideration. The capacity of existing advocacy organisations needs to be developed if they are to provide advocacy which is ethnically and culturally appropriate
• There is a lack advocacy provision for older people, for all people with dementia, and for children and young people. Independent Advocacy needs to be designed in away that responds to need and that doesn't discriminate against people who fall outwith the 16-65 age range
• The independent advocacy needs of people with physical disabilities should be addressed, particularly for the deaf community. An ASA focus day identified that there are issues, specifically, about communication in relation to interpretation services that need to be considered in order to provide advocacy to the deaf community
• Generic advocacy organisations should consider recruiting paid or unpaid staff who have specialist skills to enable them to work with individuals from specific care groups that need more focused help, for example people who have dementia
• Independent Advocacy provision for "hidden groups" that fall outwith the major client group categories. All funding partners need to address this issue, ensuring that independent advocacy is available to all who need it. It has recently been suggested that generic advocacy organisations should be developed in urban settings. These generic advocacy organisations would operate as a point of referral to existing advocacy organisations and should also provide direct independent advocacy for those who fall through the net, and who are not currently served by the existing organisations. If this developmental idea was taken on board, new funding would have to be sought, and should not affect funding packages already in place for existing advocacy organisations.

The above recommendations apply across all NHS Board areas and should be addressed by all. However, it is clear from the information provided for the purpose of this report that the independent advocacy planning processes are at different stages of development and are unique to the needs of the specific geographical areas.

ASA will continue to assist health and local authority commissioners to develop these recommendations and to develop independent advocacy across Scotland and across all health and social care groups.

Recently ASA has been asked by the Scottish Executive Health Department to update the existing guidance on independent advocacy. Commissioners, advocacy organisations and people using advocacy will be consulted as part of this process.

We hope this updated report provides an accurate reflection of the development of independent advocacy provision in Scotland. The report is an organic resource which we hope to refine and improve on a recurring basis. Finally, ASA would like to take this opportunity to thank everyone involved in the production of this report.

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