Hospital clinicians' attitudes towards a statutory advocacy service for patients lacking mental capacity: implications for implementation

Journal of Health Services Research & Policy
Lydia LukeAnthony J Holland

Abstract

To examine attitudes to the Mental Capacity Act's new statutory Independent Mental Capacity Advocate (IMCA) service in England and Wales and consider the implications for its delivery. Quantitative data describing all referrals to the seven pilot IMCA services (January 2006-March 2007) and qualitative data from semi-structured interviews with 18 doctors, 21 senior nurses and one discharge planning manager in four general hospitals in England. Of 127 hospital-based referrals to the seven pilot IMCA services, 29 (23%) were for patients facing serious medical treatments, 52% of whom were judged to lack decision-making capacity due to a learning disability; ninety-eight (77%) were for patients facing a change of accommodation upon hospital discharge, 62% of whom were elderly and lacked capacity due to dementia. While aware of the potential benefits of the IMCA service, clinicians were generally negative about the contribution advocates could make to patients' medical care and thought they could only contribute usefully in a minority of ethically complicated decisions. In contrast, they were more positive about the involvement of advocates in hospital discharge decisions and hoped that they would improve current discharge practice. ...Continue Reading

References

Jan 18, 2002·Journal of Urban Health : Bulletin of the New York Academy of Medicine·UNKNOWN New York City Department of Health HIV Epidemiology Group
Jun 16, 2006·Journal of Health Psychology·Uwe Flick

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Citations

Aug 29, 2013·Health & Social Care in the Community·Val WilliamsPauline Heslop
May 7, 2010·Nursing Ethics·Riitta SuhonenHelena Leino-Kilpi
Aug 3, 2017·British Journal of Community Nursing·Helen Marshall, Sally Sprung
Apr 3, 2019·International Journal of Nursing Practice·Yuko YamaguchiAtsuko Fukuda
Dec 15, 2020·Neuro-oncology Practice·Andrea PaceLinda Dirven

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