Independent Mental Capacity Advocacy (IMCA)

The Mental Capacity Act 2005 introduced the Independent Mental Capacity Advocacy (IMCA) Service from 1 April 2007.

This Service is available to people aged 16 or over who:

  • have been formally assessed to be lacking mental capacity
  • and have no appropriate friends or family to consult in certain situations.

The role of the IMCA service is to:

  • to provide independent safeguards for people who lack capacity to make certain important decisions and, at the time the decisions need to be made, have no-one else (other than paid staff) to support or represent them or be consulted
  • be independent.

An IMCA must be instructed by the decision maker, and then consulted, for people lacking capacity who have no-one else to support them (other than paid staff), whenever:

  • an NHS body is proposing to provide serious medical treatment, or
  • an NHS body or local authority is proposing to arrange accommodation (or a change of accommodation) in hospital or a care home, and
  • the person will stay in hospital longer than 28 days, or
  • they will stay in the care home for more than eight weeks.

An Independent Mental Capacity Advocate may be instructed to support a person who lacks capacity when:

  • a care review is proposed and no one else is available to consult
  • it is proposed to take protective measures under the safeguarding adult procedures.

Making a referral to the IMCA Service

The IMCA Service across Derby is provided by the Derbyshire IMCA Service.

Direct Referral line: 01332 380224 - Fax: 01332 293884 -

Referral forms can be downloaded from Mind - Derbyshire

Factors that would need to be considered to decide whether friends or family could be considered inappropriate to consult are:

  • they also lack capacity
  • they are not available, perhaps because of geographical distance
  • they don’t wish to be involved, perhaps because of a relationship breakdown
  • there is real evidence that there may be a conflict of interest.

Where friends or family are involved they cannot be excluded because they disagree with the proposed course of action - one or more of the above factors would have to apply.

If it’s decided that friends or family are inappropriate to consult, it is the responsibility of the decision maker to record the reason why they have made this decision.

Useful downloads and links