IMCA involvement in accommodation decisions and care reviews
Who should instruct the IMCA?
Local authorities and NHS trusts are accountable for compliance with the law with regard to IMCA instruction for accommodation decisions and care reviews.
Responsibility sits with:
- the local authorities if the accommodation is provided as a consequence of an assessment carried out under the NHS and Community Care Act 1990
- the NHS trust managing the hospital where an eligible person is an inpatient
- the NHS trust arranging and funding healthcare in an independent or voluntary hospital
- the NHS trust funding accommodation as part of NHS continuing healthcare.
It is a legal requirement that IMCAs check that the instruction has come from an authorised person. Local authorities and NHS organisations may authorise a wide range of people to instruct IMCAs. This helps to ensure that the legal duty to instruct an IMCA in accommodation decisions is met for all eligible individuals.
Good practice is for the following professionally qualified people to be authorised to instruct IMCAs:
- social workers
- community nurses, including community psychiatric nurses
- care managers
- admission nurses
- occupational therapists
- ward managers
- PCT commissioners.
It is possible for local authorities and NHS trusts to authorise people other than their own employees to instruct IMCAs. This may be particularly appropriate where there are joint heath and social working arrangements. Examples include primary care mental health services.
The commissioning document of the IMCA service and/or local engagement protocol should specify who is authorised to give instruction. This information should be made available to all those people who can and should instruct.