The Mental Capacity Act (MCA) 2005 came into force in early 2007 and
introduced the statutory role of the Independent Mental Capacity Advocate
(IMCA) to support people who lack capacity to make certain decisions. This
with dementia or mental ill health
with learning disabilities
with physical disabilities
who have had a stroke
with acquired brain injuries
who are unconscious or in a coma
From the 1st October 2007,
Local Authorities and NHS Trust bodies in Wales had a duty to instruct an
IMCA to support an individual if they meet the criteria as laid out in the
What is an IMCA?
IMCA role is set out in the Code of Practice, but would
Meeting in private
with the person who lacks capacity and attempting to communicate with them
using whatever means are appropriate.
Speaking with the
decision-maker and any other relevant professionals to understand what is
Getting the views of
anybody else who can give information about the wishes, feelings, beliefs
and values of the person who lacks capacity.
Finding out what support
the person who lacks capacity has had or needs, to
help them make the specific decision.
findings to the decision maker.
Who instructs an IMCA?
The person who instructs an IMCA is the professional who will
ultimately have to make the decision concerning serious medical treatment
or a change of accommodation, or is responsible for a care review or an
adult protection case.
When should an IMCA become involved?
IMCA must be instructed for people
lacking capacity who have no-one other than paid staff to support them
A National Health
Service (NHS) body is proposing to provide, withhold or stop serious
medical treatment (SMT).
A NHS body is
proposing to arrange a stay in hospital lasting longer than 28 days.
A NHS body or local
authority is proposing to arrange accommodation (or a change of
accommodation) in a care home for a period of longer than eight weeks.
An IMCA may also be instructed on behalf of a person lacking capacity for:
Care reviews, where
no-one else is available to be consulted.
cases, whether or not family or friends are involved.
there any exceptions?
The only circumstances where an IMCA need not be involved are
situations when an emergency decision is required. For example:
To provide emergency
life-saving medical treatment.
Where the person would
be homeless unless they were accommodated in a care home.
Referrals can only be accepted from relevant personnel employed by a Local
Authority or NHS Trust.