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Independent Mental Capacity Advocates

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If you don’t have any family members or friends who can be involved in the decision-making process and you haven’t made an Advance Decision or Lasting Power of Attorney, then an Independent Mental Capacity Advocate (IMCA) may be appointed.

The role of an IMCA is to support and protect the rights of vulnerable people who lack capacity and have nobody to speak for them. An IMCA won’t be the person that makes the final decision, but it’s their job to gather and present any information that will help the decision-maker (your doctor) to take action in your ‘best interests’. They will try to find out what your wishes would have been and put your perspective across.

They should ask questions on your behalf, ensure your rights are upheld, and check that the decision-maker has acted appropriately.

It is the responsibility of your local authority or NHS organisation to make sure that IMCAs are available to represent people who lack capacity. The person or team responsible for your care (such as your social worker or hospital doctor) has a legal duty to ‘instruct’ (refer you to) an IMCA if:

  • a decision needs to be made about serious medical treatment provided by the NHS; or
  • it is proposed that you have a long-term stay in a care home (for longer than eight weeks) or in hospital (for longer than 28 days); or
  • it is proposed that you move to different accommodation on a long-term basis;


  • you are over 16 years old and lack capacity; and
  • there is nobody, apart from paid staff or professionals, who is willing and able to be consulted about the decision.


Read our factsheet for more information on how decisions are made for me if I lack capacity