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Commissioning independent advocacy under the Care Act

Published: October 2014
Last updated: October 2022

This resource is aimed at commissioners charged with meeting the duties to provide advocacy under the Care Act 2014. It will help commissioning officers in local authorities think through their duties and understand what they are required to do to comply with the requirements of the Act. It also sets out the relationship to advocacy requirements under other legislation and summarises good practice in advocacy.

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Key messages

  • Local authorities must involve people in decisions about their care and support, and provide an independent advocate where the person has substantial difficulty being involved and has no appropriate individual to support them. It is important that you clearly understand the local authority’s advocacy duties under the Care Act 2014 and how they interact with other advocacy duties.
  • Commissioning integrated advocacy may offer benefits including easier access to multi-skilled advocates, improved working relationships, and better communication.
  • Co-production maximises the effectiveness of independent advocacy commissioning and offers an opportunity to explore the challenges in your area.
  • An ‘equality and diversity’ thread should run through your commissioning activities, ensuring compliance with human rights and equality law.
  • Keep in mind the driving principles of the Care Act – the promotion of wellbeing and the prevention, delay and reduction of the need for care and support – as well as standards for good commissioning and measuring the quality of advocacy services to ensure best value and outcomes.
  • Analyse and review a range of information to help you understand current and future demand for advocacy, as well as how your local authority meets its existing statutory advocacy duties in practice.
  • Work in partnership with providers and other stakeholders and services and encourage collaboration to secure the best use of local capacity and best value for money.
  • Ensure the advocacy offer is widely known and understood.
  • Set clear expectations for providers and practitioners in line with advocacy duties set out in the Care Act. These should be reflected in specific, outcome-focused specifications and contracts.
  • Because demand and funding will fluctuate, you should be flexible about procurement and contractual arrangements.

Advocacy duties

This section explains advocacy duties under the Care Act 2014, other advocacy duties local authorities have, and how they might interact. It is not intended as a replacement for detailed, local, legal analysis of the Act, but to help you get to grips with what commissioners need to do.

Advocacy and the duty to involve

Local authorities must involve people in decisions made about them and their care and support. No matter how complex a person’s needs, local authorities are required to help people express their wishes and feelings, support them in weighing up their options, and assist them in making their own decisions.

When does the advocacy duty apply?

The advocacy duty applies from the point of first contact with the local authority and at any subsequent stage of the assessment, planning, care review, safeguarding enquiry or safeguarding adult review. If it appears to the authority that a person has care and support needs, then a judgement must be made as to:

  • whether that person has substantial difficulty in being involved
  • if there is an absence of an appropriate individual to support them.

An independent advocate must be appointed to support and represent the person for the purpose of assisting their involvement if these two conditions are met and if the individual is required to take part in one or more of the following processes described in the Care Act:

  • a needs assessment
  • a carer’s assessment
  • the preparation of a care and support or support plan
  • a review of a care and support or support plan
  • a child’s needs assessment
  • a child’s carer’s assessment
  • a young carer’s assessment
  • a safeguarding enquiry
  • a safeguarding adult review.

The advocacy role may also involve assisting a person to challenge a decision or process made by the local authority; and where a person cannot challenge the decision even with assistance, then to challenge it on their behalf. This guidance from Voiceability includes routes to challenge under the Care Act.

Judging ‘substantial difficulty’

Local authorities must consider, for each person, whether they are likely to have substantial difficulty in engaging with the care and support process. The Care Act defines four areas where people may experience substantial difficulty. These are:

  • understanding relevant information
  • retaining information
  • using or weighing information
  • communicating views, wishes and feelings.

Who is an ‘appropriate individual’ to assist a person’s involvement?

If the person being supported doesn’t want that person to support them, that’s not an appropriate adult. You can’t force an advocate on someone.

Co-production workshop participant

Local authorities must consider whether there is an appropriate individual who can facilitate a person’s involvement in the assessment, planning or review process, and this includes four specific considerations. The appropriate individual cannot be:

  • already providing care or treatment to the person in a professional capacity or on a paid basis
  • someone the person does not want to support them
  • someone who is unlikely to be able to, or available to, adequately support the person’s involvement
  • someone implicated in an enquiry into abuse or neglect or who has been judged by a safeguarding adult review to have failed to prevent abuse or neglect.

The role of an ‘appropriate individual’ under the Care Act is potentially fuller and more demanding than that of an individual with whom it is ‘appropriate to consult’ under the Mental Capacity Act (MCA). Under the Care Act the appropriate individual’s role is to facilitate the person’s involvement, not merely to consult them and make decisions on their behalf.

Sometimes the local authority will not know at the point of first contact or at an early stage of the assessment whether there is someone appropriate to assist the person in engaging. As a result, an advocate may be appointed only for it to be discovered later that there is an appropriate person available. The appointed advocate can at that stage ‘hand over’ to the appropriate individual.

Alternatively, the local authority may agree with the person, the appropriate individual and the advocate that it would be beneficial for the advocate to continue their role, although this is not a specific requirement under the Care Act. Equally, it is possible that the local authority will consider someone appropriate who may then turn out to have difficulties in supporting the person to be involved in the process. At that point arrangements for an independent advocate must be made.


There are times when an independent advocate must be provided for a person who has substantial difficulty even though they have an appropriate individual (family member, carer or friend) to support them. These are:

  • where a placement is being considered in NHS-funded provision in either a hospital (for a period exceeding four weeks) or in a care home (for a period of eight weeks or more), and the local authority believes that it would be in the best interests of the individual to arrange an advocate
  • where there is a disagreement between the local authority and the appropriate person, and both agree that an independent advocate would be beneficial to the individual.

Ordinary residence

Local authorities are required to make sure there is sufficient provision of independent advocacy for all who qualify, and this could include adults placed into their area. As understanding of local communities may be important, the advocate should be from the area where the person is resident when the assessment, planning or review takes place. It is therefore important to have policies in place that address appointing advocates:

  • from advocacy services out of the area, if there is no direct commissioning relationship already in place
  • for people temporarily placed out of the area
  • for people moving area when an advocate is already involved. The same advocate should continue if at all possible.


Local authorities are also responsible for assessing and meeting the social care needs of adult prisoners (not just on discharge from prison, but also while in custody). All prisoners are treated as if they are resident in that area for the purposes of the Care Act, for as long as they reside in that prison. Prisoners are entitled to the support of an independent advocate in the same circumstances as people in the community. You should therefore work with custodial managers to ensure there is a sufficient supply of advocates for this environment. Local authority areas containing prisons should build this into their plans for meeting the requirements of the Act.

Information and advice

The Care Act places a duty on local authorities to ensure that all adults in their area have access to information and advice on care and support, and information and advice to keep them safe from abuse and neglect. Prior to making contact with the local authority, there may be some people who require independent advocacy to access information and advice. This need should be built into any analysis of demand that you make.

Continuing health care

The duty to provide advocacy in the Care Act applies equally to those people whose needs are being jointly assessed by the NHS together with the local authority, or where a ‘joint package’ of support is planned, commissioned or funded.

However, a report from NDTi has found that people are often left without advocacy support when accessing NHS Continuing Healthcare and other health funded support and that legislation and guidance does not sufficiently provide for this. Commissioners should therefore consider carefully how they will ensure that people receive any advocacy support needed in relation to these processes.

Historically, continuing health care arrangements have often been difficult for people who use services, their carers and friends to understand and be involved in. Local authorities and health partners will therefore want to consider the benefits of providing access to independent advice or independent advocacy beyond the requirements of the Care Act, by including those people who do not have substantial difficulty and/or those who do have an appropriate person to support their involvement. Effective joint commissioning arrangements would include:

  • supporting the person holistically, providing a seamless service and avoiding duplication
  • reducing communication breakdown
  • the involvement of the person, their family and carers
  • effective partnership working between health and social care, addressing needs together, and extending beyond the statutory requirements
  • improved communication and continued care to achieve joint outcomes.


The independence of the advocacy service is an important consideration for all commissioners. For services to be meaningful and acceptable to those they are designed to support, they must have the confidence of individuals, carers and the public. Anything compromising that independence could easily undermine confidence.

The Care Act regulations for independent advocacy are clear: providers of advocacy must be independent of the local authority, with their own constitution, code of practice and complaints procedure. Advocates under the Care Act will be managed by, and primarily accountable to, the advocacy organisation that recruits and employs them, thereby maintaining their independence from the local authority.


Once appointed, all independent advocates under the Act should work towards the National Qualification in Independent Advocacy (3614), or IAP City & Guilds level 4 within a year of being appointed, and achieve it in a reasonable amount of time thereafter. The qualification is competency-based. To successfully complete the three core units (401–403) candidates are required to provide evidence of real work practice.

The Certificate comprises three mandatory units and one optional unit. Mandatory units (these must be taken first) are:

  • Principles and practice of independent advocacy (401)
  • The legislative framework which impacts upon the independent advocacy role (402)
  • Entitlements to independent advocacy (403).

In addition, given the role of the advocate under the Care Act and the close relationship with the Mental Capacity Act and independent mental capacity advocacy (IMCA), you may wish to encourage advocates to complete unit 404 (independent mental capacity advocacy) and unit 406 (independent advocacy within adult social care).

After completing the Independent Advocacy qualification, providers should be expected to ensure that all independent advocates have access to further relevant training.

This may cover:

  • understanding safeguarding and the responsibilities of the advocate
  • non-instructed advocacy
  • care and support planning (or person-centred planning)
  • good practice in challenging decisions or the decision-making process effectively
  • supported decision-making (how to effectively support an individual who is experiencing difficulty with decision-making).

For more detailed guidance, please see the Care and Support Statutory Guidance, section 7.

Other statutory advocacy duties (not related to the Care Act 2014)

Local authorities have a number of other statutory duties to ensure access to advocacy which are described below. You should work closely with colleagues in assessment and care management, as well as accessing legal advice to gain a full understanding of these duties and how they interact.

Interactions between statutory advocacy duties

Independent advocacy under the duty imposed by the Care Act 2014 is similar in many respects to independent advocacy under the Mental Capacity Act. Regulations have been designed to enable independent advocates to carry out both roles. However, the duty to provide independent advocacy under the Care Act is broader, and applies in a wider set of circumstances. It provides support to:

  • people who have capacity but have substantial difficulty in being involved in the care and support process
  • people in relation to their assessment and/or care and support planning regardless of whether a change of accommodation is being considered for the person
  • people in relation to the review of a care and/or support plan
  • people in relation to safeguarding processes (though independent mental capacity advocates may be involved if the authority has exercised its discretionary power under the Mental Capacity Act)
  • carers who have substantial difficulty in engaging, whether or not they have capacity
  • people who have someone who is appropriate to consult for the purpose of best interests decisions under the Mental Capacity Act, but where that person is not able or willing to assist with advocacy in any other capacity.

There are people who qualify for advocacy under the Care Act but not for an independent mental capacity advocate. Many people who qualify for independent advocacy under the Mental Capacity Act will also qualify for independent advocacy under the Care Act. To enable a person to receive seamless advocacy and not to have to repeat their story to different advocates, the same person can provide support in both roles, provided they are trained and qualified to do so.

If someone has previously had access to an IMHA and is being jointly assessed by the NHS and local authority (often under what is called a Care Programme Approach), they should be considered for an advocate under the Care Act, if they have substantial difficulty in being involved and if there is no appropriate person to support their involvement.

The Care Act extends the range of situations and people to whom there is a duty to make advocacy available. Nothing in the Act prevents advocacy being provided in other circumstances. Commissioners should consider how they will extend access to advocacy beyond the minimum legal requirements, in order to better meet the needs of the local population.

Joined-up advocacy commissioning

Local authorities are not required to commission one organisation to provide different types of advocacy, but there are advantages to doing so. Integrated advocacy can be of benefit because many people will require advocacy support under more than one statutory duty, whether it be under the Care Act, Mental Health Act, Mental Capacity Act or any non-statutory advocacy that may also be provided by the local authority. The advantages of packaging the commissioning of different advocacy together include:

  • clearer and easier access to support for people requiring advocacy through single points of contact, and easier and joined-up referral pathways
  • facilitating the provision of multi-skilled advocates, so that people can have a single advocate working on their behalf and not have to tell their story repeatedly
  • allowing advocates and their clients build a meaningful working relationship, based on trust
  • improving outcomes in non-instructed advocacy by giving the advocate more time to get to know the person properly and more fully understand their views, wishes and feelings as well as their family and other relationships (especially people who need additional support to communicate)
  • better and more consistent communication with health and social care professionals, greater coordination and reduced fragmentation of services, and understanding of advocacy referral pathways
  • better community engagement and embedding of services in the local authority, with less confusion about advocacy providers and routes to access support.

It seems that local authorities have advocacy services for people with learning difficulties, people in the mental health system and so on, and one of the things that I think is really worrying is that people are not just experiencing an individual impairment or illness, they’ve often got two or three things that are very important and it’s understanding that holistic approach to what they might need and how they might need supporting.

Co-production workshop participant

Commissioning advocacy: inclusion, empowerment and human rights

This section outlines the different types of advocacy and includes some principles of good practice and some challenges to consider to support commissioners to better understand and specify relevant services. It is informed by input from people who use services and carers.

I think advocacy is something about rights. I think it’s about people knowing what their rights are and having access to that information and the advocate feeling that they have a role in which they’re being heard and have some strength in the wider discussion. People have a right to have their voices heard to the end of their lives.

Co-production workshop participant

Principles and types of advocacy

The Advocacy Code of Practice states that advocacy is taking action to help people say what they want, secure their rights, represent their interests and obtain services they need. Advocates and advocacy providers work in partnership with the people they support and take their side. Advocacy promotes social inclusion, equality and social justice.

It is helpful for commissioners to consider the value of these different types of advocacy and how they may benefit people with different needs and from different communities. Some advocacy services were concerned that the introduction of the Care Act could result in the range of advocacy support decreasing, as resources became targeted only at advocacy that was required by law.


Guidance on market shaping and the commissioning of care and support in relation to the Care Act 2014 states that local authorities should take a co-production approach to market shaping and commissioning. Advocacy under the Care Act should be commissioned in meaningful partnership with people who use services and carers.

Quality advocacy services are person-centred and developed using a co-production approach that aims to maximise the participation of people who use services and their carers. Co-production means delivering services based on an equal and reciprocal relationship between people who use services, carers and professionals, and results in the provision of support that meets individual goals as well as needs. For co-production to flourish, both within advocacy providers and in local authority commissioning, organisational structures, processes and culture, staff values and attitudes may need to change.

SCIE has a collection of co-production resources providing more information and practical guidance.

Co-production means that what you have to say as a service user is just as important as what other people have to say about the service you receive.

Co-production workshop participant

Challenges to the provision of independent advocacy

Co-production enables honest conversations between those who use, provide and commission advocacy to help develop and improve the service. People who use and provide advocacy have supported the update of this guide and have identified the following challenges to the provision of independent advocacy under the Care Act. Consider whether any of them may be a challenge in your area:

  • ensuring the individual is placed at the heart of advocacy provision
  • providing information and advice about advocacy and the benefits it offers in a range of ways and places, particularly now information and services are more often provided online
  • making sure social care staff understand the value of advocacy, and are fully aware of how and when to refer individuals for this support
  • ensuring advocacy is made available to those who need it despite the time and budget pressures social care staff face
  • being clear about how people can challenge a decision not to provide advocacy
  • ensuring the views of those who have accessed advocacy services and those who have been advised they did not meet the criteria are captured and understood, and recognising that some need advocacy support to do this
  • recognising the complexity of needs people using advocacy services may have, and the difficulty of supporting them to address these needs within a limited timescale
  • providing good-quality post-qualifying training for advocates
  • supporting self-advocacy, which may require more time than other types of advocacy, but which should be the ultimate aim
  • encouraging and supporting the market of advocacy providers, ensuring specialist services are available to meet local needs where required.

Equality, diversity and compliance with the Equality Act 2010

Advocacy projects should be able to meet the needs of diverse local populations.

Publicly funded advocacy providers must comply with the public sector equality duty (PSED) (Equality Act 2010) by paying due regard, when carrying out their functions, to the need to eliminate discrimination, advance equality of opportunity and foster good relations between people who share a ‘protected characteristic’.

The protected characteristics are:

  • age
  • disability
  • gender reassignment
  • marriage and civil partnership
  • pregnancy and maternity
  • race
  • religion or belief
  • sex and sexual orientation.

For further information on complying with the public sector equality duty please see the Equality and Human Rights Commission (EHRC) guidance.

Local authorities must pay due regard to the public sector equality duty when commissioning advocacy services.

To ‘pay due regard’ means that when making decisions a local authority:

must … have due regard to the need to:

  • eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act
  • advance equality of opportunity between people who share a protected characteristic and those who do not
  • foster good relations between people who share a protected characteristic and those who do not.
PSED essential guidance

And in order to have due regard:

Those who exercise its functions must be aware of the general equality duty’s requirements. Compliance with the general equality duty involves a conscious approach and state of mind. General regard to the issue of equality is not enough to comply.

PSED essential guidance

As a commissioner, you should:

  • identify the advocacy needs of people who share protected characteristics in the local authority
  • undertake analysis of access to, experiences of and outcomes from current advocacy provision and use this analysis to inform your commissioning of future advocacy provision
  • ensure contracts with providers are designed in such a way as to meet the advocacy needs of people who share protected characteristics
  • include in contracts requirements on providers to monitor access to, experience of and outcomes from, service provision for people who share protected characteristics
  • engage with users of advocacy services who share protected characteristics and with organisations representing people who share protected characteristics, to identify issues regarding access to, experience of and outcomes from commissioned advocacy services for these groups.

Standards and quality

The advocacy Quality Performance Mark (QPM) is a robust, quality assessment and assurance system for providers of independent advocacy. It is a tool used to benchmark independent advocacy services against a framework. The eight key quality areas that form the Mark are as follows.

Learning from COVID-19

Advocates and advocacy organisations demonstrated flexibility and imagination in ensuring continuity of provision during the pandemic. Remote methods of working were rapidly introduced, and in many instances, steps were taken to ensure that people who draw on support services were met with safely in-person.

Together advocacy organisations established a set of principles underpinning how to deliver advocacy effectively during and beyond the pandemic. These highlight and confirm the vital importance of advocates meeting with people face-to-face whenever required. Without this it can be hard to gain a full understanding of the person’s communication, views and situation. This can include identifying potential safeguarding concerns.

Contracts for advocacy should encourage continued access to advocacy online and by telephone, where this is genuinely the way in which the person drawing on advocacy support prefers to communicate, while ensuring that advocacy is always available in-person when wanted or needed.

It was at times difficult for advocates and other professionals to meet with people who lived in care homes or who were patients in hospital. In the event of future restrictions, commissioners will want to bear in mind ADASS guidance to:

…use the commissioning or contracting role and relationships to encourage and support NHS, independent sector and local authority service providers to promote people’s ability to access to advocacy. This needs to be available both face-to-face in Covid-safe ways and by facilitating video and telephone meetings.

Overview of commissioning independent advocacy

In this section

This section aims to provide an overview of good practice in commissioning independent advocacy. It draws on work from:

  • the Institute for Public Care, Oxford Brookes University
  • the Institute of Local Government Studies, University of Birmingham
  • the Care Act, and Care and Support Statutory Guidance.

I think sometimes we can get too stuck on, ‘Okay, we’ve commissioned a contract for this through IMCA, commissioned a contract for [an] IMHA, got one for NHS complaints advocacy and now we’ve got one for Care Act advocacy.’ We want to encourage people to think creatively about the different duties.

Co-production workshop participant

What is commissioning?

‘Commissioning’ is a broad concept with competing definitions. For our purposes, it represents a systematic approach to planning and resourcing public services. The aim of all social care commissioning activity by local authorities is to achieve the best possible outcomes for the community as a whole and for individuals who require care and support. So it’s about promoting better lives.

This includes people who may need care and support at some time in the future.

Commissioning should ensure that there are personalised approaches to meeting people’s needs, in all services and settings. It must also achieve the best value and comply with legislation.

When we say commissioning, we don’t always mean buying a new service, but what it might be is looking at a number of different options to fill the demand that might come along with these new duties.

Co-production workshop participant

Commissioning for better outcomes (TLAP) provides a clear definition of commissioning and Social care commissioning beyond COVID-19 (SCIE) provides guidance for commissioners that may help them develop good approaches during the COVID-19 pandemic and into the future.

A commitment to commission in asset-based ways presents opportunities for more holistic approaches to meet statutory duties as well as collaborate to deliver them.

While there are many models of commissioning and purchasing available, they all fundamentally break down into four key areas (illustrated below):

  • Analyse: understand the needs that must be addressed, the values and purpose of the agencies involved, and the environment in which they operate
  • Plan: identify the gaps between what is needed and what is available, and decide how these gaps will be addressed
  • Do: secure services and ensure they are delivered as planned
  • Review: monitor the impact of services and approaches and ensure any future commissioning activities take the findings of this review into account.

Importantly, commissioning and procurement are closely linked, as shown in the illustration below (Figure 1). However, commissioning doesn’t have to involve procurement – there are lots of ways of responding to needs and gaps.

Highlighted in the outer circle are commissioning activities. They must inform the ongoing development of procurement activities (if procurement is the most appropriate commissioning route) which are illustrated in the inner circle.

Each set of activities are grouped against the four elements of the commissioning cycle and are equally important, and these must be equitable and transparent – offering opportunities for all stakeholders to influence the types of service provided.

Market shaping and commissioning for advocacy

The Care Act itself does not specifically mention commissioning, but it is included in the vocabulary of the chapter of the statutory guidance ‘Market shaping and commissioning’ and is seen as a core part of implementing the requirements of the Act.

The Care Act promotes the following commissioning principles:

  • focusing on outcomes and wellbeing
  • promoting quality services, including via workforce development and remuneration and ensuring appropriately resourced care and support
  • supporting sustainability
  • ensuring choice
  • co-production with partners.

Commissioners may wish to consider how they will further develop advocacy under the Care Act, as a part of their strategies to shape future advocacy support to meet the overall needs of their local population. Research undertaken following the implementation of the Care Act found that good practice in commissioning advocacy includes:

  • working with advocacy providers to develop solutions and overcome barriers
  • working with people who use services, carers and the local community to understand what is important to them
  • incentivising providers to work together and with local communities recognising that partnerships take time and investment
  • realising the potential of market shaping and its role in building the capacity of user-led and community organisations to deliver advocacy under the Care Act
  • sustaining provision by agreeing three-year contracts as a minimum and including flexibility to respond to changes in demand.

Standards for good commissioning

Here we reproduce the key principles of good commissioning identified by the Commissioning for Better Outcomes programme at the University of Birmingham, in partnership with Think Local Act Personal. These set out 12 commissioning standards across four domains.

NDTi have developed a framework that highlights the outcomes advocacy services have the potential to deliver. This may be helpful when considering the commissioning of these services.

Commissioning tasks

This section seeks to enable local authorities to think through the commissioning tasks to ensure that good quality advocacy is available for all adults who are entitled to it under the provisions of the Care Act. It can be used in conjunction with SCIE’s commissioning self-assessment tool, which is designed to help commissioners think through where they are now and what they need to do.





Complete the self-assessment tool with the checklists above.

  • Use in conjunction with the Commissioning tasks section above.
  • Score yourself green, amber or red under each commissioning area.
  • For each area you score green, record your key strengths in this area in the box provided.
  • Once you have completed the self-assessment, identify actions to address areas for development. Prioritise areas you have scored red.
  • If you identify an area in which you think your authority is particularly strong, please share it with SCIE.

Case studies

These case studies are intended to help you, as a commissioner, think about different models for the provision of advocacy in your area.

Easy read resources

These easy read guides explain what independent advocacy is, and how councils should commission advocacy.