The Role of the Independent Complaints Advocacy Service

Philippa Thompson ICAS Director, South of England Advocacy Projects, Kirstie Blencowe ICAS Director, POhWER, Alicia Raymond ICAS Director, Carers Federation

ICAS update April 2007:

Tendering process

Award of three new contracts by DH from 1st April 2006

5 year contracts for the delivery of service

Based on 9 English regions

Carers Federation – NE, NW, Yorkshire and Humberside and East Midlands

POhWER – East of England, London and West Midlands

SEAP – South East and South West

What is independent advocacy?

Advocacy is a way of empowering people to:

articulate their views, wishes and feelings themselves, or through a competent and independent voice

safeguard their rights

In order to:

ensure that services are accessible and appropriate, and identify gaps in service provision

ensure that the voice of the person is heard, and influences decisions made about him/her by those in a position of power



Service providers (Statutory, Private & Voluntary)?

Best Interests:

  • Advocate does not influence/take view
  • Act as impartial conduit for client’s views regardless of own opinion


  • Life-threatening threshold
  • Client informed of limits
  • Client kept involved if breach conditions met


  • Self-advocacy
  • Client-led
  • Client in control of advocacy process
  • Nothing without consent of client

Service Provision

Generic service – accessible to all

Self advocacy and supported advocacy

Balance between remote support – telephone and email – and specialist support

Community and office based

National complaints statistics 2006/07 (draft figures)

7,561 new cases (supported or specialist advocacy

17,944 client contact (self advocating or signposting)?

6,437 cases closed

5,876 live cases at 31 March 2007

Complaint level

  • Local Resolution 86%
  • Healthcare Commission 10%
  • P. H. S. Ombudsman 4%

Practitioner Area

  • Medical 71%
  • Nursing, Midwifery, Health Visitor 7%
  • Dentistry 5%

Cause of grievance

  • Multiple Aspects Clinical Treatment 12.8%
  • Misdiagnosis 12.6%
  • Attitude of staff 10.2%

Client age

  • 0 -16 6%
  • 17 – 59 52%
  • 60+ 27%
  • not stated 15%

Clients who disclosed a disability (1500+)

  • Physical Disability 49%
  • Mental Illness 25%
  • Learning Difficulty 4%
  • Other Disability 21%

Prison Clients

  • Initial contacts 92
  • Ongoing support 76

ICAS Focus on harder to reach groups:

  • Prisons
  • Mental Health
  • People with learning disabilities
  • People with physical disabilities
  • Travellers
  • Children and young people
  • Black and ethnic minority groups

Case study

Care of patient with breast cancer

  • Palliative care issues
  • Short staffing
  • Communication breakdown
  • Compounded by time of year


  • Matron shared experience and now sits on palliative care team
  • Two side wards dedicated to terminally ill patients
  • Extra staff training
  • Specialist equipment
  • Renamed the suite in memory of the patient

Working in partnership

With NHS providers , PALS and Patient Forums , With community and voluntary sector service providers , With other advocacy services

Through Networking plans, Shared knowledge, information and understanding, Referral protocols

ICAS providers working in partnership


  • Joint publications and promotional materials
  • Common branding
  • Shared knowledge, information and understanding
  • Referral protocols

What is happening now?

  • Revised Self Help Information Pack
  • Website development
  • Multi-media DVD
  • Posters
  • Leaflets in ethnic minority languages and Braille

What the future holds

  • Integration of health and social care complaints procedures
  • Sharing information for effective service improvement
  • Networking plans to build relationships
  • Seamless transition for ICAS

ICAS… 5 years on