Anna Murphy IMCA Pilot Manager

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• Anna Murphy - IMCA Pilot Manager

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IMCA Pilots

• 49 Organisations tendered for the IMCA Pilots
• 7 nationally, AM one in the North West,
  commissioned by DH
• Cheshire and Merseyside Regional Approach
• January 2006 April 2007
• IMCA Pilot Network meetings chaired by the DH
• Piloting the IMCA role, raising awareness,
  agreeing referral mechanisms, operational issues
  of IMCA Service.
• Development work, policies, procedures feed into
  implementation in April 2007
• Liaise with the University of Cambridge
  extension of their contract to research SMT IMCA
  decisions.

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IMCA Criteria

• Person lacks capacity, a decision specific test
  of capacity. Require a written record of the
  decision
• Person has no friends or family, or where the LA
  or NHS body deems that there is no-one
  appropriate or practicable to consult with on the
  decision e.g family out of area, or limited
  knowledge of the person.

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IMCA Functions

• Section 37
• Provision of Serious Medical Treatment
• Treatment which involves providing, withholding
  or withdrawing treatment in circumstances where
• a case where single treatment is being
  proposed,and there is a fine balance between its
  benefits to the patient and the burdens and risks
  it is likely to entail for him
• in a case where the choice of treatments, a
  decision as to which one to use is finely
  balanced
• what is proposed would be likely to involve
  serious consequences for the patient
• e.g. Choice of treatments e.g. chemotherapy
  and surgery for certain types of cancer, ECT for
  non-detained patients, major surgery, withholding
  or withdrawing of life sustaining treatment.
• BUT IMCA does not apply when
• A persons treatment is regulated by Part 4
  Mental Health Act
• Treatment is urgent

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Section 38 Provision of accommodation by an
NHS Body

• NHS Body propose to make changes to a
  person's residence for over
• 28 days.
• e.g Hospital to a nursing home
• BUT IMCA does not apply
• If the person is accommodated as a result of
  being under the Mental Health Act
• If the move is urgent and under the time stated
• However
• If the Decision Maker believes that accommodation
  is likely to be over the period of time they must
  then instruct an IMCA.

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Section 39 Provision of accommodation by Local
Authority

• LA propose to make changes to a person's
  residence for over 8 weeks.
• BUT IMCA does not apply when
• The person is accommodated as a result of being
  under the Mental Health Act
• If the move is urgent
• However
• If Decision Maker believes that accommodation is
  likely to be over the period of time must then
  instruct an IMCA.

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Extension of the role

• IMCA Regulations extend the powers of LA / NHS to
  instruct IMCAs in certain cases of accommodation
  reviews and adult protection cases.
• There should be published local guidance on the
  above issue.
• Adult Protection Procedures Applies equally to
  a
• Person who has been abused
• Who has been neglected
• A person who is alleged to be the abuser
• The IMCA criteria of friends and family does not
  apply in Adult Protection Cases.

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An IMCA will

• Support a person who lacks capacity
• Obtain and evaluate relevant information on the
  persons behalf
• Ascertain as far as possible the persons wishes
  and feelings
• Represent and advocate for that person
• Investigate if the person has an advanced
  decision
• Ascertain alternative courses of action, and
  present this information to DM.
• Obtain a further medical opinion when necessary

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IMCAs can

• Meet someone in a private room
• Assist in challenging the decision on someone's
  behalf
• Utilise local resolution processes regarding the
  decision/ process use PALS service, question
  and negotiate with DM on the options, decisions
  proposed
• Access the formal complaints procedure
• Access legal advice for the person
• Refer the issue to the Court of Protection
• Access records

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IMCA

• Statutory function
• No choice but to refer to the IMCA service
  Decision Makers have an obligation under the
  MCA 1st April despite the general delay in MCA
• Reactive service Decision Makers make referrals
• Know and understand the criteria IMCA not for
  everyone and anyone
• Refer as soon as you know they meet the criteria
• Find out local IMCA provider - Dont just refer
  to any advocacy service
• Know you referral mechanisms, fax, phone, written
  referrals, email.
• Agreed locally who refers - individual / team.

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IMCA Pilot Contact Details

• Tel [phone]
• Email headoffice_at_advocacymatters.com
• Web www.advocacymatters.com

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Contacts

• Anna Murphy
• amurphy_at_advocacymatters.com