An Independent Mental Capacity Advocate (IMCA) supports a person who:

  • Lacks capacity to make certain important decisions
  • Has no one who can support them with the decision that are not paid staff

The decisions for which an IMCA is needed are:

  • Serious medical decisions where:
    • There is a finely balanced decision between a choice of treatments
    • What is proposed is likely to have serious consequences (serious and prolonged pain, distress or side effects)
    • Have potentially major consequences for the patient and their future life choices

Where an urgent decision has to be made (for example to save someone’s life), then an IMCA is not needed. Any serious medical treatment following on from this would however still require an IMCA.

  • Change of Accommodation/Residence decisions made by the NHS or Local Authority where:
    • It is provided or arranged by the Local Authority or NHS
    • Is for a placement in hospital for more than 28 days
    • Is for a placement in a care home for more than 8 weeks

An IMCA can also support with these, although a Care Act referral is usually more appropriate:

  • A care review – reviewing arrangements when accommodation has been arranged by the NHS or Local Authority
  • Safeguarding – where a change of accommodation is proposed as a result.

For more information, see Chapter 10 of the Mental Capacity Act Code of Practice: