FAQs
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Frequently Asked Questions
What is an IMCA?
An IMCA is appointed to support and represent a person who lacks capacity and is faced with a serious decision relating to medical treatment or a change of residence. The IMCA will try to ascertain the person’s wishes, feelings, beliefs and values, which they will then present to the decision maker (the person proposing the change for that person). The person may lack capacity for many reasons, some of which include, learning disability, mental health, acquired brain injury, severe dementia. The IMCA is acts independently of the person instructing them and must work with regard to The Mental Capacity Act (2003) and it’s Code of Practice.
An IMCA will have appropriate experience and training relevant to the role. They will have had a CRB (criminal record bureau check and certificate) and be approved by the Local Authority to practice in the area.
Who gets an IMCA?
Under the Mental Capacity Act (2005), a decision maker will instruct an IMCA when a person lacks capacity to make a decision regarding serious medical treatment or change of residence and has no family or friends to support them. If the person has got family or friends, but they live far away or do not wish to be involved, an IMCA may be instructed.
How many people with no friends or family will be entitled to an IMCA?
The CSIP website (etc……….) estimates that at any time 1.2 million people in England and Wales are likely to lack capacity. Of these 155,000 have severe or profound learning disabilies and 350,000 have severe dementia. Of these numbers, CSIP estimate that 39,000 people a year throughout England and Wales may need support regarding serious medical treatment and a further 69,000 may need support regarding change of accommodation.
Who decides that family or friends are not appropriate to consult with and who tells them?
It is the decision maker who would decide that a family or friends are inappropriate. It is also their duty to inform the family or friends, not the role of the IMCA.
What is the difference between and advocate and an IMCA?
An IMCA works with very specific criteria – serious medical treatment or change of residence. An advocate could support a person with much wider issues; however, an advocate normally acts on instruction from their client, an IMCA act in best interest.
Who pays for the IMCA?
It is a statutory service financed by central government.
What will the function of an IMCA be?
The Mental Capacity Act (2005) sets out the main function as;
· to support
a person who lacks capacity so they can participate in the decision as much
as possible
· to speak with the person in private
· to find out what they can about the person’s likely wishes, feelings,
beliefs and values likely to influence this person if they had capacity.
· Communicate with anyone involved in the provision of care and treatment
for that person.
· To ascertain whether any alternative courses of action are possible
· To request a further medical opinion when necessary
· Access health and social care records that are relevant to the decision
and take copies where necessary.
· To ensure the decision to be made is explored from all angles
· present this information in the form of a report to the decision maker
· challenge the decision maker where necessary (the act sets our circumstances
S36(3).
Why do IMCAs get access to records?
An IMCA does not have the benefit of years of personal knowledge of the person who lacks capacity that a carer or social worker may have.
What is an NHS body?
For the purpose
of the Act, an NHS body means a body in England, which can be any of the following:
1 Strategic Health Authority
2 NHS Foundation Trust
3 Primary Care Trust
4 NHS Trust
5 Care Trust
What is Serious Medical Treatment?
The Act states
that that above involves providing, withdrawing or withholding treatment in
cases where
a) A single treatment is proposed but there is a fine balance between the benefit
to the patient and the risks or burdens it would result in.
b) A case where there is a choice of treatments and the decision of which one
to use is finely balanced
c) A treatment being proposed would be likely to result in serious consequences
for the patient.
Examples of the above could include diagnostic examinations, tests and dental
treatment, which may require an anaesthetic. Other examples include electro-convulsive
therapy (ECT), non-therapeutic sterilisation, major surgery, withdrawal of artificial
nutrition and hydration (ANH), caesarean section, abortion, DNAR (do not attempt
resuscitation) and oncology related issues. In some cases a court application
will have to be made and the IMCA will go through the Official Solicitor.
What if I have a complaint?
If you have a complaint regarding something which has happened, or regarding the service, the IMCA will be able to give you the name of the person within the Local Authority who will deal with your concerns.
How soon will I
get a response to a referral?
The service aims to respond to received referrals within 24 hours.
Who can refer?
Anyone can make a referral, although it is anticipated that the majority of referrals will come from the health and social care sector.
How do I make a referral?
You can make a referral by downloading the referral form from the Internet site; www.imca@nwas.org.uk or by contacting the IMCA by phone on 0845 680 0513. If you have read the frequently asked questions and are still unsure whether the person meets the criteria please call us so it can be discussed in confidence.
Who monitors the IMCA service?
The IMCA service reports on a quarterly basis to their commissioning body, the local authority.