Independent Mental Capacity

Advocacy (IMCA)


The Independent Mental Capacity Advocacy Service is a statutory service provided under the Mental Capacity Act (2005), which aims to represent and protect people who lack capacity to make certain decisions themselves.


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What is lack of capacity?

Whenever the term ‘a person who lacks capacity’ is used, it means a person who is unable to make a particular decision at the time it needs to be made. This may be because they have a mental health diagnosis, or cognitive condition, is unconscious or barely conscious, perhaps as a result of an accident, or use/misuse of drugs or alcohol.

A person’s capacity may vary over time or may depend on the type of decision that needs to be made.

Some people may always lack capacity to make some decisions, for example, due to a condition or severe learning disability that has perhaps affected them from birth.  Some such people may, however, go on to learn new skills that enable them to gain capacity and make decisions and take actions for themselves as their lives progress.

What is the role of an IMCA?

The role of an IMCA is to:

  • Ascertain as far as possible the person’s wishes and feelings.
  • Support a person who lacks the capacity to participate in the decision-making process.
  • Obtain and evaluate relevant information on behalf of the service user.
  • Consult with staff, professionals and others who know the person well.
  • Decide whether to ask for a second medical opinion where it is a serious medical treatment decision..
  • Explore alternative options and choices and ensure they are considered for the individual.
  • Secure the individual’s rights
  • Challenge professionals where appropriate
  • Our IMCAs can also support individuals through the Court of Protection processes, and have significant experience in supporting individuals in the role of a ‘Litigation Friend’.

Who is eligible for an IMCA?

  • People who lack the capacity to make specific decisions about serious medical treatment and/or changes to accommodation. The individual will have no suitable family or friends available for appropriate consultation.
  • Perpetrators of ‘safeguarding adults’ proceedings.
  • Those involved in a review of an accommodation decision, where it is felt that the person would benefit from an IMCA.
  • A hospital or Care Home requesting authorisation to deprive a person of their liberty.
  • A person who is deprived of their liberty.

What is deprivation of liberty?

When a person lacks the mental capacity to make decisions about the care or treatment they need, and may be at risk if that care is not provided, it is sometimes in their best interests to deprive them of their liberty to keep them safe and prevent harm. Legislation exists to ensure that no one is deprived of their liberty without good reason, and that if someone does indeed need to be deprived of their liberty in these circumstances, that person still has specific rights.

One of these rights is to have a Relevant Person’s Representative (RPR) to protect their interests throughout the process.  An RPR can be a friend or family member, but it is often a Paid RPR from Advocacy providers. Sometimes family and friends find it difficult to support their loved ones to challenge there deprivation of liberty as they feel the care home/or hospital is the best place for their loved one to stay.

IMCA and deprivation of liberty safeguards

Section 39 of the Mental Capacity Act 2005 sets out the different IMCA roles:

  • Section 39A IMCAs are instructed when there is an assessment in response to a request for a standard authorisation, or a concern about a potentially unauthorised deprivation of liberty.
  • Section 39C IMCAs cover the role of the RPR when there is a gap between appointments.
  • Section 39D IMCAs support the person, or their RPR, when a standard authorisation is in place.

Read more about Deprivation of Liberty Safeguarding

Deprivation of Liberty Safeguarding

Who can make a referral?

Referrals for an IMCA can be accepted from any third party.  However, we can only take formal instructions from the decision-maker who is responsible for the overall decision.  All referral in relation to DoLS must be made by the Supervisory Body.

Make a referral

We are one of the highest quality providers of advocacy support in Lancashire, Trafford and St Helens. To make a referral, please see below.

If you are unsure whether a referral is appropriate, please contact us on 0300 323 0965 for more advice.

Upon receiving a referral, if the individual is eligible for the service, an IMCA will make contact with them within 3 working days.

For DoLS cases, the IMCA will make contact sooner.

Make a referral

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