Independent Mental Capacity Advocacy (IMCA)

Support for people who have been assessed as ‘lacking capacity’ to make specific decisions. Part of our Care and Support Statutory Advocacy service.


Who should be referred to the IMCA service?

The local authority/NHS decision maker MUST refer if someone has no ‘appropriate’ family and friends and lacks capacity to make a decision about one of the following:

  • Serious medical treatment.
  • Long term moves (more the 28 days in hospital/8 weeks in a care home).
  • Deprivation of Liberty Safeguards.

The local authority/NHS decision maker MAY refer if someone lacks capacity to make a decision about one of the following:

  • Care review - with no ‘appropriate’ family or friends.
  • Safeguarding referral - victim or alleged perpetrator, regardless of family and friends.

How do you know if someone lacks capacity?

You may be assessed as lacking the ability to make a decision, and needing an IMCA, if you cannot do one or more of the following:

  • Understand information given to you about the decision.
  • Retain the information for long enough to make the decision.
  • Use or weigh up the information as part of the decision making process.
  • Communicate your decision (by any means, e.g. talking, sign language or blinking).

The assessment must be specific to the decision which needs to be made, for example your medical treatment, not a generic test of capacity. Whether and how such assessments are recorded may vary according to the seriousness of the decision made.

Deprivation of Liberty Safeguards (DoLS)

Managing Authorities (Care Homes or NHS Hospitals) and Supervisory Bodies (Local Authority) have a duty to consult an IMCA when assessing a potential Deprivation of Liberty if there are no appropriate family or friends to consult about the decision. In some situations, it may also be appropriate for an IMCA to be requested to offer support to the person deprived of their liberty, or their Relevant Person’s Representative after a DoLS authorisation has been granted.

The DoLS IMCA will ensure that all relevant factors, including the person's wishes and feelings are taken into consideration, by those making decisions about whether or not to grant a deprivation of liberty. If an authorisation has been granted the IMCA can support the person deprived of their liberty or their Representative to understand what DoLS means and how it is affecting them. They can also support the person or Representative to challenge the authorisation if appropriate. 

You can find out more about DoLS here.

Relevant Person’s Representative

Within this service, we would represent a person who has been deprived of their liberty after a decision has been made that it would be in their best interests. We would ensure that the reasons for the deprivation are still relevant and that any measures that are put in place to support the person who is deprived of their liberty are being carried out.

How to Refer

If you are not sure whether an IMCA is relevant or not, call us on 0300 222 5947 and we can talk you through the situation and advise you of the best route forward. Referrals can be made by authorised staff in the local authority or the NHS.

You can refer someone by calling 0300 222 5947 or by completing the referral form for professionals below. You must return this in one of the following ways:

1. Post the referral form to our Head Office: VoiceAbility Unit 1, The Old Granary, Westwick, Oakington CB24 3AR

2. Email to via a secure method, for example the following are acceptable if you have access to one of these:

  • Sophos email (available to Coventry and Warwickshire Partnership NHS Trust staff)
  • Egress email (available to Warwickshire County Council staff)
  • email (available to Coventry City Council staff)

3. Email from a CJSM account to

For data security reasons, do not email referral forms unless you are using a secure method, even if you password protect documents. If you do not have access to a secure email, or simply prefer to call us, please phone 0300 222 5947 to make the referral, instead of completing the form.

It is essential that we keep people’s data secure, please remember that it is your responsibility to send information to us securely. We are continuing to review secure email routes. If we are able to offer any additional referral routes we will add them to this page.

Information for people who would like an advocate or who have been referred for IMCA

You will need to ask a medical professional to refer you to our service. If you have difficulty with this, you can call us on 0300 222 5947.

There is more information about IMCA in the info sheet that you can download below.