Summary
Advocacy has become a very broad and vague term, and here we look
at the problems that can result, especially in the context of commissioning.
We suggest that -
• it’s important to ‘translate’ what’s
required or offered into more specific language;
• commissioners must recognise that there are limits to the
extent to which ‘the system’ can dictate the form and
focus of advocacy - and that this limit varies according to the
type of advocacy required;
• clarity about the purpose of the ‘advocacy’ may
reveal that, in reality, a different kind of resource is required.
|
|
Is
everybody talking about the same thing?
These days, it seems, the word ‘advocacy’ is mentioned
as part of the role of everyone who has a concern for people with
learning disabilities. In some ways that’s a good thing. It
underlines the important point that we should all be concerned to
help people with learning express their views and defend their rights
– whether we are support workers, care managers, parents, nurses,
teachers, friends, or have some other involvement.
Less helpfully, however, ‘advocacy’ has become a very
broad term, and one that is often used in a very vague way. To add
to the confusion, there are different kinds of advocacy – for
example professional advocacy, citizen advocacy, and of course self-advocacy.
So even when someone is called an ‘advocate’ it may not
be clear what their role is.
We believe that this kind of confusion is at the root of many of
the problems that we see emerging around advocacy. People may discuss
the provision of advocacy and think they have reached an agreement,
without realising that they have very different expectations. This
could be a problem when advocacy – or some other service that
looks like advocacy – is offered to a person with a learning
disability or family members, or when service provider staff are
‘on the receiving end’ of advocacy. But the most obvious
difficulties occur when an advocacy service is being commissioned.
If there is a lack of clarity about what will be delivered in return
for funding, and how the contract or grant will be monitored and
supported, there is a very high risk that the arrangement will fail
all the stakeholders. |
|
Clarity in commissioning
So the first step for each side in the commissioning process must
be to unpack the word ‘advocacy’, identifying clearly
what the expectations are. From there, discussions need to take
place between the two sides to establish –
• who the advocacy service is for;
• what the advocacy is intended to provide to the people who
receive it, and how that will be measured;
•how the advocacy will benefit the commissioning agency, and
how these benefits will be measured;
•a shared vision of what advocates will be doing, and whether
there are any limits to the kinds of issues they should take up,
or to the kinds of action that would be acceptable;
• arrangements to support the advocacy, including a protocol
for dealing with conflicts (for example between the advocacy scheme
and a service provider).
As this list suggests, commissioners are almost certain to want
to gain something for themselves from the advocacy. (If there were
no benefit to them whatsoever, why would they be funding it?) Moreover,
if they are spending public money, they will want to ensure that
the funding for advocacy fits with overall spending priorities.
As a consequence, they may wish to target the advocacy at certain
groups (users of one kind of service, for example) or to particular
areas (complaints procedures, perhaps, or relocation of services).
Here lies another cause of difficulties.
|
 |
|
System priorities or advocacy principles?
Advocacy, in its ‘pure’ form, is accountable
to the person who is receiving it. Yet commissioners, for the understandable
reasons outlined above, may want to target or limit it. It may be
acceptable to limit the advocacy to people in certain groups. But
to dictate the scope of the advocacy provided to people in that
group would be to compromise a fundamental principle of advocacy:
to insist, for example, that advocacy must only focus on day services
and ignore problems a person is having at home. Similarly, self-advocacy
groups are the obvious source for people to be involved in Partnership
Boards and other consultation initiatives. On the other hand, self-advocacy
groups need to be allowed to set their own agenda and priorities,
and not be drawn by councils or service providers into serving as
tame ‘user representatives’, at the beck and call of the
professionals.
The tension that results from these differing expectations can,
if unchecked, lead to –
• commissioners feeling impatient and angry because the advocacy
project is not delivering what they expected;
• advocacy organisations feeling under-valued and undermined;
• advocacy projects that have been diverted or suppressed,
and are delivering little that has value for anybody.
If this tension is to be eased and accommodated, it’s important
to recognise that some activities within the broad umbrella of ‘advocacy’
lie closer to the sphere of services than others.
At one extreme, there are roles such as care manager and support
worker. People in these roles have a professional duty to act as
advocates within their role, and to maintain some ‘psychological
distance’ from their employing agency in order to make this
possible. But the fact remains that such people are accountable
to their employers, and these employers are entitled to specify
the work that they do.
At the other extreme is advocacy that arises naturally through the
connections that a person with ordinary people in the community.
Plainly, it would not be appropriate (except in rare situations
where there was a question of abuse) for a service organisation
to try to control advocacy in that context. This kind of advocacy
is extremely precious, because it is based on personal commitment,
truly independent of services, and can help to promote inclusion.
The disadvantage, from the point of view of services, is that it
is very difficult to measure, organise, or influence.
So we can think of different kinds of advocacy activity falling
at different points on a spectrum. The further it falls from the
‘service’ end of the spectrum, the less it is appropriate
for social services agencies to try to influence it. These include
an increasing number of roles that are intended to help people make
and implement person-centred plans. They are often taken to be forms
of advocacy because they are focused on the needs and wishes of
the individual, and are positioned organisationally at some distance
from the main sphere of services. However, they are more accurately
regarded as services to the individual. These roles include –
Person-centred planning facilitation.
If someone has responsibility to support the development of person-centred
plans, then they have a duty to ensure that the process and the
outcome reflect the person’s wishes. In that sense they are
involved in advocacy, but they are not in the role of advocate.
There should be other people involved in the process who will be
much better placed to act as advocate. The facilitator is providing
a service, partly to the individual. Since they are probably being
paid, one way or another, by services, to deliver a set of outcomes,
they are also in a position of accountability to the council or
a service provider.
Service broker
This term is used in various ways, sometimes just borrowing from
the mainstream equivalents such as financial brokers. However, it
has a specific meaning which is linked to the individualised funding
model developed in North America. In this model, the broker is a
person independent of service providers and of the agencies which
allocate funds (i.e. the local council, in the UK). The broker answers
to the individual (possibly supported by family and friends) and
can help as required with tasks from planning through to implementation.
The costs are ultimately met from public funds, but should be routed
in a way that does not compromise independence. The broker is providing
a technical support service. Though accountable to the individual,
the role of broker is integral to the individualised funding system.
Direct Payments adviser
Here again, the adviser is providing a
service to the individual, but the efficient delivery of that service
(as required by individuals) is necessary for the operation of the
wider system – in this instance, the Direct Payments system.
The exact balance of those two lines of accountability will depend
on the way the support scheme is set up.
If we map out these roles on the spectrum, it looks something like
this:
|
|
| |
|
|
|
|
• Care
manager
• Support worker
|
|
Open to control
by services, subject to professional ethics. |
| •
Person-centred planning facilitator |
Services may dictate people to be assisted, with performance
measured on numbers assisted and quality of plans, but need to
respect the orientation of the role to individuals, families,
and community.
|
| • Crisis advocate
(may be called in by services on specific issue) |
Compromised form of advocacy, delivering a service to meet the
requirements of services, at the expense of true independence.
Further undermined if over-constrained by commissioners.
|
• Direct Payments
adviser
• Service broker (North American model) |
Services may dictate cost of assistance to be given, and minimum
standards, but form of assistance (within agreed range) set by
recipient.
|
| • Professional
advocate (problem-solving on issues identified by the person) |
Services may dictate overall level of resources, and categories
of people served, but issues and type of action should not be
constrained (except on basic ethical legal standards).
|
| • Self-advocacy
group |
May choose to provide a ‘service’ (e.g. user representation)
but should not be required (or pressured) to do so by services.
|
| • Citizen advocate |
Benefits difficult to quantify, and relationships between advocacy
partners are essentially private. Hence monitoring and performance
measures limited to basic numbers.
|
•
Identified circle of support
• Family and friends |
May make
specific commitments (e.g. for person-centred planning). Otherwise
rightly beyond control of services. |
| |
|
In the realm of private
and community life
|
|
|
|
|
If you work within services, and are at the point of thinking
that there is a need to increase the availability of services/opportunities
under the broad heading of ‘advocacy’, you might ask
yourself this question:
What exactly do we – the service
system – expect to be delivered to us by this resource,
beyond the simple reassurance that something new has been made
available for people who rely on services?
If your answer includes specific requirements, and/or a list of
detailed measures that you would want to use to evaluate the service,
then you need to consider carefully whether they are compatible
with the form of advocacy you are considering – and indeed
with any form of advocacy.
More positively, however, your answers
may also reveal that the real requirement is not for advocacy,
but for a task with a more specific focus. There may still be
a need to ensure that the role required for this task is kept
distinct from the service system as a whole (perhaps to uphold
its independence, or its orientation to the community). But a
tighter focus may suggest a way to provide the help that people
need, and on terms that can properly be set and measured by the
service system.
Selected resources
|
|
| |
|
|
