MCA advocacy: the second year

The Department of Health has just reported on the second year of Independent Mental Capacity Act (IMCA) activity.

There have been increases across the board, with women more likely than men to have an IMCA, and those over 80 years-of-age the likeliest of all. Because of some schoolboy errors, however, the report’s conclusions about adult protection work are too pessimistic.

The largest rises were in the use of IMCAs in care reviews and with serious medical treatment, where the first year’s figures had been troublingly low. Decisions about a change in accommodation were also more likely to involve IMCAs, but overall, the Department doesn’t think that the service is reaching all the people it needs to.

When it comes to adult protection work, where the new report is equally downbeat, the picture is a little more complicated. This is for two reasons:

* The report mis-states the rate of increase in IMCA referrals. There were 681 in 2007/08 and 960 in 2008/09, a rise of 41 per cent (not the 29 per cent claimed).
* And the report has an exaggerated view of the powers of local authorities. It says an IMCA may be appointed even where there is only an allegation of abuse. In fact, that step can be taken only where adult protection proceedings have already been commenced or are at least in prospect. (That state-of-affairs was the subject of adverse comment last autumn, following research into the use of IMCAs in adult protection proceedings.)

These reservations notwithstanding, the latest figures are troubling. They show, for example, that while Cornwall made 50 adult protection referrals to IMCAs in 2008/09, and Devon made 43 and Birmingham 33, only 20 local authorities made more than ten referrals, and ten local authorities made no referrals at all.