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improvement" /></a></div><div class="bkr_bib"><h1 id="_NBK588850_"><span itemprop="name">Monitoring services and collecting data for quality improvement</span></h1><div class="subtitle">Advocacy services for adults with health and social care needs</div><p><b>Evidence review K</b></p><p><i>NICE Guideline, No. 227</i></p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2022 Nov</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-4782-9</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2022.</div></div><div class="bkr_clear"></div></div><div id="niceng227er11.s1"><h2 id="_niceng227er11_s1_">Monitoring services and collecting data for quality improvement</h2><div id="niceng227er11.s1.1"><h3>Key theme</h3><ul><li class="half_rhythm"><div>Monitoring services and collecting data for quality improvement</div></li></ul><div id="niceng227er11.s1.1.1"><h4>Introduction</h4><p>The aim of this review is to identify key aspects of monitoring and data collection which can be used to improve the quality of advocacy services.</p><p>Recommendations about advocacy have been made in a number of existing NICE guidelines. However, these have identified a lack of evidence relating to advocacy that would meet inclusion criteria for standard evidence reviews. Therefore, it was agreed that recommendations for this guideline would be developed by adopting and adapting advocacy-related recommendations from existing NICE guidelines, using a formal consensus process based on statements generated from a call for evidence, and documents identified by the guideline committee, and informal consensus methods to address any areas of the guideline scope that are not covered by the existing NICE guidelines or the formal consensus process.</p></div><div id="niceng227er11.s1.1.2"><h4>Summary of the inclusion criteria</h4><p>Please see <a class="figpopup" href="/books/NBK588850/table/niceng227er11.tab1/?report=objectonly" target="object" rid-figpopup="figniceng227er11tab1" rid-ob="figobniceng227er11tab1">Table 1</a> for a summary of the inclusion criteria applied to evidence received in response to the call for evidence and identified by the guideline committee.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng227er11tab1"><a href="/books/NBK588850/table/niceng227er11.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng227er11tab1" rid-ob="figobniceng227er11tab1"><img class="small-thumb" src="/books/NBK588850/table/niceng227er11.tab1/?report=thumb" src-large="/books/NBK588850/table/niceng227er11.tab1/?report=previmg" alt="Table 1. Summary of the inclusion criteria." /></a><div class="icnblk_cntnt"><h4 id="niceng227er11.tab1"><a href="/books/NBK588850/table/niceng227er11.tab1/?report=objectonly" target="object" rid-ob="figobniceng227er11tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Summary of the inclusion criteria. </p></div></div></div><div id="niceng227er11.s1.1.3"><h4>Methods and process</h4><p>The process for identifying, adopting and adapting recommendations from existing NICE guidelines, the call for evidence and formal consensus methods are described in <a href="/books/NBK588850/bin/supplement-1-methods-pdf-11258616349.pdf">supplementary material 1</a>.</p><p>Declarations of interest were recorded according to <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s 2019 conflicts of interest policy</a>
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<u>(see Register of Interests)</u>.</p></div><div id="niceng227er11.s1.1.4"><h4>Effectiveness evidence</h4><div id="niceng227er11.s1.1.4.1"><h5>Included studies</h5><div id="niceng227er11.s1.1.4.1.1"><h5>Existing NICE guidelines</h5><p>Existing recommendations relevant to monitoring services and collecting data for quality improvement were identified from 2 NICE guidelines ([NG108] Decision-making and mental capacity, [NG189] Safeguarding adults in care homes). The audiences for these guidelines included: people with the condition or users of a services and their families and carers; health and social care professionals, practitioners and providers; service managers; commissioners, local authorities, and Safeguarding Adults Boards; and other staff who come into contact with people using services (for example, housing, education, employment, police and criminal justice staff). Both NG108 and NG189 specifically listed independent advocates (with statutory and non-statutory roles) among their target audiences.</p></div><div id="niceng227er11.s1.1.4.1.2"><h5>Formal consensus</h5><p>A single call for evidence was undertaken for all topics included in the scope of this guideline. Additional documents were identified by the guideline committee. See the study selection flow chart in <a href="#niceng227er11.appa">appendix A</a>.</p><p>Twelve documents were identified for this review (<a class="bibr" href="#niceng227er11.s1.ref3" rid="niceng227er11.s1.ref3">Lawson 2017</a>, <a class="bibr" href="#niceng227er11.s1.ref4" rid="niceng227er11.s1.ref4">Lawson 2020</a>, <a class="bibr" href="#niceng227er11.s1.ref5" rid="niceng227er11.s1.ref5">Macadam 2013</a>, <a class="bibr" href="#niceng227er11.s1.ref6" rid="niceng227er11.s1.ref6">Mercer 2020</a>, <a class="bibr" href="#niceng227er11.s1.ref7" rid="niceng227er11.s1.ref7">National Development Team for Inclusion [NDTi] 2014b</a>, <a class="bibr" href="#niceng227er11.s1.ref8" rid="niceng227er11.s1.ref8">NDTi 2014c</a>, <a class="bibr" href="#niceng227er11.s1.ref9" rid="niceng227er11.s1.ref9">NDTi 2016a</a>, <a class="bibr" href="#niceng227er11.s1.ref10" rid="niceng227er11.s1.ref10">NDTi 2016b</a>, <a class="bibr" href="#niceng227er11.s1.ref11" rid="niceng227er11.s1.ref11">Newbigging 2012</a>, <a class="bibr" href="#niceng227er11.s1.ref12" rid="niceng227er11.s1.ref12">Ridley 2018</a>, <a class="bibr" href="#niceng227er11.s1.ref13" rid="niceng227er11.s1.ref13">Roberts 2012</a>, <a class="bibr" href="#niceng227er11.s1.ref14" rid="niceng227er11.s1.ref14">Turner 2012</a>).</p><p>Four documents focused on providers and commissioners of independent advocacy (<a class="bibr" href="#niceng227er11.s1.ref3" rid="niceng227er11.s1.ref3">Lawson 2017</a>, <a class="bibr" href="#niceng227er11.s1.ref4" rid="niceng227er11.s1.ref4">Lawson 2020</a>, <a class="bibr" href="#niceng227er11.s1.ref9" rid="niceng227er11.s1.ref9">NDTi 2016a</a>, <a class="bibr" href="#niceng227er11.s1.ref10" rid="niceng227er11.s1.ref10">NDTi 2016b</a>). Two documents focused on people living with learning disabilities (<a class="bibr" href="#niceng227er11.s1.ref13" rid="niceng227er11.s1.ref13">Roberts 2012</a>, <a class="bibr" href="#niceng227er11.s1.ref14" rid="niceng227er11.s1.ref14">Turner 2012</a>). Two documents focused on people detained under the amended Mental Health Act 1983 (including people with and without capacity and children under the age of 16) (<a class="bibr" href="#niceng227er11.s1.ref11" rid="niceng227er11.s1.ref11">Newbigging 2012</a>, <a class="bibr" href="#niceng227er11.s1.ref12" rid="niceng227er11.s1.ref12">Ridley 2018</a>). Two documents focused on people living with disabilities (<a class="bibr" href="#niceng227er11.s1.ref7" rid="niceng227er11.s1.ref7">NDTi 2014b</a>, <a class="bibr" href="#niceng227er11.s1.ref8" rid="niceng227er11.s1.ref8">NDTi 2014c</a>). One document each focused on: people who use social care services (<a class="bibr" href="#niceng227er11.s1.ref5" rid="niceng227er11.s1.ref5">Macadam 2013</a>) and independent advocacy services (<a class="bibr" href="#niceng227er11.s1.ref6" rid="niceng227er11.s1.ref6">Mercer 2020</a>).</p></div></div><div id="niceng227er11.s1.1.4.2"><h5>Excluded studies</h5><div id="niceng227er11.s1.1.4.2.1"><h5>Formal consensus</h5><p>Documents not included in this review are listed, and reasons for their exclusions are provided in <a href="#niceng227er11.appd">appendix D</a>.</p></div></div></div><div id="niceng227er11.s1.1.5"><h4>Summary of included studies</h4><p>Summaries of the documents included in the formal consensus process for this review are presented in <a class="figpopup" href="/books/NBK588850/table/niceng227er11.tab2/?report=objectonly" target="object" rid-figpopup="figniceng227er11tab2" rid-ob="figobniceng227er11tab2">Table 2</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng227er11tab2"><a href="/books/NBK588850/table/niceng227er11.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figniceng227er11tab2" rid-ob="figobniceng227er11tab2"><img class="small-thumb" src="/books/NBK588850/table/niceng227er11.tab2/?report=thumb" src-large="/books/NBK588850/table/niceng227er11.tab2/?report=previmg" alt="Table 2. Summary of documents included in the formal consensus process." /></a><div class="icnblk_cntnt"><h4 id="niceng227er11.tab2"><a href="/books/NBK588850/table/niceng227er11.tab2/?report=objectonly" target="object" rid-ob="figobniceng227er11tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of documents included in the formal consensus process. </p></div></div><p>See the full evidence tables for documents included in the formal consensus process in <a href="#niceng227er11.appb">appendix B</a> and a summary of the qualitative assessment of these documents in <a href="#niceng227er11.appc">appendix C</a>.</p></div><div id="niceng227er11.s1.1.6"><h4>Summary of the evidence</h4><div id="niceng227er11.s1.1.6.1"><h5>Existing NICE guidelines</h5><p>A total of 3 existing recommendations related to monitoring services and collecting data for quality improvement were identified from the 2 NICE guidelines. The committee agreed all 3 recommendations should be adapted.</p><p>See <a href="#niceng227er11.appf">Appendix F</a> for a list of the existing recommendations, a summary of the supporting evidence behind these recommendations, and the decisions made based on the committee’s discussion of these recommendations.</p><p>The quality of existing NICE guidelines was assessed using the Appraisal of Guidelines for Research & Evaluation Instrument (AGREE II). See the results of the quality assessment in <a href="#niceng227er11.appc">appendix C</a>.</p></div><div id="niceng227er11.s1.1.6.2"><h5>Formal consensus round 1</h5><p>Three included documents (<a class="bibr" href="#niceng227er11.s1.ref3" rid="niceng227er11.s1.ref3">Lawson, 2017</a>; <a class="bibr" href="#niceng227er11.s1.ref9" rid="niceng227er11.s1.ref9">NDTi, 2016a</a>; <a class="bibr" href="#niceng227er11.s1.ref10" rid="niceng227er11.s1.ref10">NDTi, 2016b</a>) were assessed using AGREE II. Three documents (<a class="bibr" href="#niceng227er11.s1.ref5" rid="niceng227er11.s1.ref5">Macadam, 2013</a>; <a class="bibr" href="#niceng227er11.s1.ref6" rid="niceng227er11.s1.ref6">Mercer, 2020</a>; <a class="bibr" href="#niceng227er11.s1.ref12" rid="niceng227er11.s1.ref12">Ridley, 2018</a>) were assessed using the Risk of Bias in Systematic reviews (ROBIS) checklist and 6 included documents (<a class="bibr" href="#niceng227er11.s1.ref4" rid="niceng227er11.s1.ref4">Lawson, 2020</a>; <a class="bibr" href="#niceng227er11.s1.ref7" rid="niceng227er11.s1.ref7">NDTi, 2014b</a>; <a class="bibr" href="#niceng227er11.s1.ref8" rid="niceng227er11.s1.ref8">NDTi, 2014c</a>; <a class="bibr" href="#niceng227er11.s1.ref11" rid="niceng227er11.s1.ref11">Newbigging, 2012</a>; <a class="bibr" href="#niceng227er11.s1.ref13" rid="niceng227er11.s1.ref13">Roberts, 2012</a>; <a class="bibr" href="#niceng227er11.s1.ref14" rid="niceng227er11.s1.ref14">Turner, 2012</a>) were assessed using the Critical Appraisal Skills Programme (CASP) tool for qualitative research. See the results of the quality assessment in the evidence tables in <a href="#niceng227er11.appb">appendix B</a> and quality assessment tables in <a href="#niceng227er11.appc">appendix C</a>.</p><p>The committee were presented with 139 statements in round 1 of the formal consensus exercise; responses were received from 11 of 13 committee members. Sixty-eight of these statements reached ≥80% agreement in round 1 and were included for the discussion with the committee. Forty statements had between 60% and 80% agreement. Thirty-seven of these were redrafted for round 2 and the remaining 3 statements were discarded; 2 statements were not used because the revisions required to address the comments were already covered by existing statements and 1 statement was not used because the committee agreed the issue raised by the statement would be addressed by recommendations made elsewhere in this guideline. Thirty one statements had <60% agreement; of these, 12 were redrafted for round 2, because the comments raised addressable issues and suggestions for revision, and the remaining 19 statements were discarded.</p><p>See <a href="#niceng227er11.appg">appendix G</a> for the statements that were rated by the committee and results of round 1, which are provided in Table 12.</p></div><div id="niceng227er11.s1.1.6.3"><h5>Formal consensus round 2</h5><p>The committee were presented with 51 statements in round 2 of the formal consensus exercise; responses were received from 12 of 13 committee members. Two sets of 3 statements were combined into 1 statement each, 1 set of 3 statements was combined in 2 statements and a pair of statements was combined; additionally, 1 statement was split into 3 statements and another was split into 7 statements. Forty-one statements reached ≥80% agreement and were included for the discussion with the committee. Nine statements had between 60% and 80% agreement. Five of these were included for the discussion with the committee, because the comments related to how the statements might inform recommendations rather than the content of the statements, and the remaining 4 statements were discarded. One statement had <60% agreement and was discarded.</p><p>See <a href="#niceng227er11.appg">appendix G</a> for the statement that was rated by the committee and results of round 2, which are provided in Table 13.</p></div></div><div id="niceng227er11.s1.1.7"><h4>Economic evidence</h4><p>Economic considerations will be taken into account together with resource impact.</p></div><div id="niceng227er11.s1.1.8"><h4>The committee’s discussion and interpretation of the evidence</h4><div id="niceng227er11.s1.1.8.1"><h5>The outcomes that matter most</h5><p>In the methods used for this guideline (adopting and adapting existing recommendations and formal consensus) no outcomes were considered formally by the committee; therefore, the committee were not required to determine which outcomes were critical or important.</p></div><div id="niceng227er11.s1.1.8.2"><h5>The quality of the evidence</h5><div id="niceng227er11.s1.1.8.2.1"><h5>Existing NICE guidelines</h5><p>The quality of the existing NICE guidelines was assessed using AGREE II. Overall, the guidelines are of a very high quality (2 or more domains scored ≥90%) and are recommended for use. One guideline scored lower in stakeholder involvement because there were fewer experts by experience included in the committee group compared to other guidelines. A few guidelines scored lower due to vague descriptions of facilitators and barriers to implementing recommendations in the applicability domain. In addition, the committee considered whether the recommendation could be generalised to a new context when making a decision about adopting or adapting the recommendations, which is documented in the benefits and harms section and <a href="#niceng227er11.appf">appendix F</a>.</p></div><div id="niceng227er11.s1.1.8.2.2"><h5>Formal consensus</h5><p>The quality of some of the documents identified by the committee and through the call for evidence was assessed using ROBIS and the AGREE II tool, which is explained in detail in the <a href="/books/NBK588850/bin/supplement-1-methods-pdf-11258616349.pdf">methods</a> supplement for this guideline. ROBIS is intended for use in assessing the quality of systematic reviews but was also used for the purpose of this guideline to assess a number of reviews that were not intended by the authors to be systematic as it was the best available tool. The AGREE II instrument is intended for use assessing the quality of systematically developed clinical practice guidelines, including assessments of methodological rigour and transparency. Therefore, some domains of ROBIS and the AGREE II tool may be less relevant for these documents and they would not have followed reporting guidelines for systematic reviews. All supporting material published with documents was reviewed to inform quality assessment, however it was not feasible to contact the authors of each document. Therefore it is plausible that the documents may have scored lower on quality assessments than the underlying methodology would warrant had authors made their full methodology available or if more appropriate tools were available. The committee were aware of this in their discussions of the existing recommendations and statements extracted from documents identified from the call for evidence. Where shortcomings in the quality of documents impacted the committee’s opinions about using the statements, this is described in the benefits and harms section below. On the whole however, where there was full committee support for a statement extracted from a lower quality document, the committee made the recommendation because their experiential knowledge corroborated the statement and strengthened the argument to use it as the basis for a recommendation.</p><p>The quality of 3 documents (<a class="bibr" href="#niceng227er11.s1.ref3" rid="niceng227er11.s1.ref3">Lawson, 2017</a>; <a class="bibr" href="#niceng227er11.s1.ref9" rid="niceng227er11.s1.ref9">NDTi, 2016a</a>; <a class="bibr" href="#niceng227er11.s1.ref10" rid="niceng227er11.s1.ref10">NDTi, 2016b</a>) were assessed using the AGREE II instrument. High quality documents were defined as those where any two domains scored ≥ 70%. The 3 documents were not deemed to be high quality. The included documents scored between 22% and 28% for stakeholder involvement; between 4% and 46% for applicability; between 8% and 10% for rigour of development and between 0% and 17% for editorial independence. Overall, the documents did not provide sufficient information on the stakeholder involvement in the development of the document. It was unclear whether the likely barriers and facilitators to implementation, strategies to improve uptake, and resource implications of applying the document were considered. The methods used to formulate and update the recommendations, and details on whether a systematic process had been used to gather and synthesise the evidence, were not clearly described. Declaration of any bias or competing interests from the document development group members were not reported.</p><p>The included document scored between 22% and 61% for scope and purpose, and between 22% and 56% for clarity of presentation. Generally, the overall aim, specific health questions and target population for the documents were described, but details were sometimes limited. The document did not present recommendations in a clear and concise structure and format.</p><p>The quality of 3 documents (<a class="bibr" href="#niceng227er11.s1.ref5" rid="niceng227er11.s1.ref5">Macadam, 2013</a>; <a class="bibr" href="#niceng227er11.s1.ref6" rid="niceng227er11.s1.ref6">Mercer, 2020</a>; <a class="bibr" href="#niceng227er11.s1.ref12" rid="niceng227er11.s1.ref12">Ridley, 2018</a>) were assessed using the ROBIS checklist for systematic reviews. One document (<a class="bibr" href="#niceng227er11.s1.ref5" rid="niceng227er11.s1.ref5">Macadam, 2013</a>) was judged to have unclear risk of bias because insufficient details were provided to enable a judgement to be made. Two documents (<a class="bibr" href="#niceng227er11.s1.ref6" rid="niceng227er11.s1.ref6">Mercer, 2020</a>; <a class="bibr" href="#niceng227er11.s1.ref12" rid="niceng227er11.s1.ref12">Ridley 2018</a>) were judged to be at high risk of bias.</p><p>Methodological limitations included a lack of clear reporting or an absence of reporting about eligibility criteria. Other concerns related to insufficient information on study selection, lack of critical appraisal of included papers, and an absence of testing the robustness of the review findings.</p><p>The quality of 6 documents (<a class="bibr" href="#niceng227er11.s1.ref4" rid="niceng227er11.s1.ref4">Lawson, 2020</a>; <a class="bibr" href="#niceng227er11.s1.ref7" rid="niceng227er11.s1.ref7">NDTi, 2014b</a>; <a class="bibr" href="#niceng227er11.s1.ref8" rid="niceng227er11.s1.ref8">NDTi, 2014c</a>; <a class="bibr" href="#niceng227er11.s1.ref11" rid="niceng227er11.s1.ref11">Newbigging, 2012</a>; <a class="bibr" href="#niceng227er11.s1.ref13" rid="niceng227er11.s1.ref13">Roberts, 2012</a>; <a class="bibr" href="#niceng227er11.s1.ref14" rid="niceng227er11.s1.ref14">Turner, 2012</a>) were assessed using the CASP checklist for qualitative research. One document (<a class="bibr" href="#niceng227er11.s1.ref11" rid="niceng227er11.s1.ref11">Newbigging, 2012</a>) was judged to have minor methodological limitations. The remaining 5 documents (<a class="bibr" href="#niceng227er11.s1.ref4" rid="niceng227er11.s1.ref4">Lawson, 2020</a>; <a class="bibr" href="#niceng227er11.s1.ref7" rid="niceng227er11.s1.ref7">NDTi, 2014b</a>; <a class="bibr" href="#niceng227er11.s1.ref8" rid="niceng227er11.s1.ref8">NDTi 2014c</a>; <a class="bibr" href="#niceng227er11.s1.ref13" rid="niceng227er11.s1.ref13">Roberts, 2012</a>; <a class="bibr" href="#niceng227er11.s1.ref14" rid="niceng227er11.s1.ref14">Turner, 2012</a>) were judged to have serious methodological limitations because of insufficient detail relating to participant recruitment, data collection and data analysis. Other concerns related to the lack of adequate consideration for the relationship between researcher and participants, and lack of consideration regarding ethical issues.</p></div></div><div id="niceng227er11.s1.1.8.3"><h5>Benefits and harms</h5><p>The committee acknowledged that the majority of statements had been extracted from a documents judged to be of lower quality. However they were in full agreement with these statements and because their own knowledge and experience chimed with the point being made they concluded it would be important to make recommendations on that basis and that the benefits of doing so outweighed any risks of excluding these statements altogether.</p><div id="niceng227er11.s1.1.8.3.1"><h5>Recording of anonymised information</h5><p>Several statements (6, 10, 11, 14, 15, 31 and 34) covered recording information about people who use advocacy services. For clarity and to avoid repetition, the committee agreed to combine these statements into one recommendation covering information that should be recorded about people using advocacy services. From their knowledge and experience, the committee were aware that there is variation in what information about people using advocacy services is collected. They agreed that collecting information about this is important in order to capture how services are used, as this will help to identify gaps in service provision and assess if services are meeting local needs. The committee discussed the different types of information mentioned in the statements and agreed that the following information should be recorded: information on the nine protected characteristics from <a href="https://www.legislation.gov.uk/ukpga/2010/15/section/4" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">The Equality Act 2010</a>, communication preferences, reasons for referral, and type of location, for example whether people are in an urban or rural area and whether they live in independence accommodation or a care home. Statements 15 and 34 specifically mentioned recording information on protected characteristics. The committee agreed that this was particularly important based on their knowledge and expert witness testimony (see evidence review F) that some populations are over-represented in mental health services and under-represented in advocacy services. Therefore, collecting information on protected characteristics would help to identify whether there are particular groups that are not receiving services that they would benefit from and help to reduce health and other inequalities. The committee agreed to include type of location in the data that could be collected as this is an example of something that would fall within the area of demographic characteristics (covered by statements 16, 15 and 34) that was not already covered by the inclusion of protected characteristics. Furthermore, including data on type of location could help to identify place based gaps in the availability and provision of advocacy. The committee also discussed that information on communication needs and preferences (covered by statement 10) and reasons for referral (covered by statement 11) are useful to record because it provides information about the profile of a person, which can then inform what the local need is, rather than simply collecting information about their characteristics. For the same reason, the committee agreed that it was important to record information about whether advocacy is instructed or non-instructed.</p></div><div id="niceng227er11.s1.1.8.3.2"><h5>Collecting information on the impact of advocacy services</h5><p>There were a large number of statements related to collecting data about the impact of advocacy services. The committee agreed that these statements could be broadly grouped into those related to the format or source of information (statements 19, 21, 33, 79-81, 97-98, 102, 109, 112, 125 and 135) and those that related to what outcomes should be measured in order to demonstrate the impact of advocacy services (statements 8, 13, 22, 23, 40, 55-72, 92, 94, 101, 103, 108, 110, 111, 114, 115 and 125).</p><p>The committee discussed that information about the impact of advocacy services is not routinely collected in a standardised format and agreed that doing so would facilitate evaluation of the data thereby helping to find out if services are effective and where improvements are needed. The committee discussed the different methods of collecting this information mentioned in the statements, including survey data (covered by statement 80), case studies (covered by statements 21, 81 and 102), numbers or proportion of people reporting or achieving an outcome (covered by statement 79), and people’s experiences and views of advocacy services (covered by statements 19, 21, 79, 97-98, 102, 109, 112, 125 and 135). The committee agreed that all of these sources of information would be helpful to determine the effectiveness of advocacy services and for quality improvement so included them as examples in the recommendation. The committee discussed that although services may not routinely collect this information, most advocacy services should already have methods of collecting this information. In addition, statement 77 highlighted the need to analyse or evaluate data that is collected. The committee agreed that this is an important step in order to facilitate the sharing of key information with other organisations, which is discussed in more detail below.</p><p>The committee discussed that it is important to measure outcomes that show the impact of advocacy services across a broad range of areas to gain sufficiently detailed and meaningful information that can lead to real improvements in services. The committee agreed that currently advocacy services are largely focused on individual outcomes but that understanding population level needs provides a broader view of the services required in an area. The committee discussed that services, which are responsive to people’s needs, are likely to be more efficient than those that only focus on the needs of some individuals. Although this would be a change in practice, the committee agreed it would help to commission more effective advocacy services and generate improvements across health and care systems. The committee also acknowledged that having a broader view of services is consistent with developments in Health and Social Care services, such as the move to Integrated Care Systems. The committee discussed the outcomes covered by the statements and agreed they could be categorised in terms of impact on individuals (statements 23, 40, 57-61, 70, 94, 101, 103 and 108), the health and care system (covered by statements 62-64 and 115), communities (covered by statements 13, 22, 64-68 and 110), and the how advocacy services are run (covered by statements 69, 70-72 and 111), according to the Advocacy Outcomes Framework (<a class="bibr" href="#niceng227er11.s1.ref9" rid="niceng227er11.s1.ref9">NDTi 2016a</a>). The committee discussed that there are many outcomes from these different domains that could be investigated in order to understand the impact of advocacy and commission effective services, which gives services flexibility to collect information in different ways. The examples given in the recommendation were based on the content of the statements and the committee’s knowledge and experience.</p></div><div id="niceng227er11.s1.1.8.3.3"><h5>Measuring outcomes that show the impact of advocacy services</h5><p>There were a number of statements that addressed the need to identify and define outcomes (statements 83-87) and agreeing outcomes and how these should be recorded, collaboratively (statements 37, 54, 78, 84 and 128). Further, statement 92 highlighted a lack of consistency in the information requested by commissioners. The committee discussed the merits of collaborative working in advocacy services and agreed that by gathering a range of perspectives and sharing insights for areas for improvement there is a broader and more holistic understanding of population needs. The committee discussed that collaborative work also offered the opportunity for different care providers to agree and work towards the same goal, which could lead to improved outcomes and more effective services, and so made a recommendation in line with this.</p></div><div id="niceng227er11.s1.1.8.3.4"><h5>Evaluating the effectiveness and quality of advocacy services</h5><p>There were a number of statements (119b, 125, 130, 131 and 132) that highlighted the need for commissioners to monitor advocacy services. Additionally, statement 3 covered the sharing of information between advocacy groups and commissioners in order to determine if needs are being met. The committee agreed that commissioning is the continual process of planning, agreeing and monitoring services, and encompasses many actions including continuous quality assessment. However, in the committee’s experience, commissioners do not always use information gathered from advocacy services to inform improvements in practice. The committee agreed that commissioners should evaluate the data to identify themes and insights they can use to generate continuous improvement in services. The committee agreed that this is necessary because, in their experience, feedback from people using advocacy services is not always positive.</p></div><div id="niceng227er11.s1.1.8.3.5"><h5>Sharing of information from data collected through delivery of advocacy services</h5><p>Several statements (22, 96, 99, 100, 105, 106, 107, 116) covered sharing information with other organisations, particularly in relation to highlighting areas where improvement is needed. In the committee’s experience, sharing of information is necessary to enable services to respond to the issues raised and make changes as required to improve the quality of services and ensure they meet the needs of the population. However, this is not happening consistently. The committee agreed that the sharing of information would also facilitate collaboration between services. They were also aware that addressing common themes and issues affecting people using the service with commissioners and providers of other services is stated in the Advocacy Quality Performance Mark (2018). Statements 1, 24, 25 in partnership working (see evidence review G) were also used to inform this recommendation as they covered advocacy services increasing awareness of issues and highlighting gaps in service provision.</p></div><div id="niceng227er11.s1.1.8.3.6"><h5>Evaluating information reported by advocacy services</h5><p>Statements 100 and 109 covered taking appropriate action in response to feedback. Similarly, statements 8 and 9 in partnership working (see evidence review G) covered acting on trends and themes for service change and improvement. The committee agreed that it is important that this is done in order to enable improvements to services as outlined above. However, in the committee’s experience, this is not happening consistently. They agreed that the action required, namely evaluating the information reported by advocacy services and making any changes to services that are needed, should be stated more clearly and the statements combined to avoid unnecessary repetition.</p></div><div id="niceng227er11.s1.1.8.3.7"><h5>Fulfilment of statutory duties</h5><p>Statement 95 covered advocacy providers reporting on the extent to which partners fulfil statutory duties in relation to advocacy and safeguarding. The committee discussed the seriousness of safeguarding and were aware that sometimes advocates are not informed about safeguarding concerns in a timely manner. The committee agreed that it is not the responsibility of advocates to decide whether statutory duties are being fulfilled or not, but that they are in a good position to play a part in recognising when this is not being done. This was supported by statement 93, which covered the need for reporting and assurance on safeguarding from all partners. Further, the committee agreed that this activity could be incorporated into processes for collecting and sharing information, discussed above.</p></div><div id="niceng227er11.s1.1.8.3.8"><h5>Monitoring of safeguarding processes</h5><p>An existing recommendation from the NICE guideline on safeguarding in adult care homes [NG189] covered Safeguarding Adults Boards being assured that local authorities monitor how residents and their advocates are included in safeguarding enquiries. Further details about the committee’s decisions to adopt or adapt existing NICE recommendations in the area of monitoring services and collecting data are given in <a href="#niceng227er11.appf">appendix F</a>. The committee agreed that this was important and were aware that the ‘Making Safeguarding Personal’ documents from the Local Government Association (<a class="bibr" href="#niceng227er11.s1.ref3" rid="niceng227er11.s1.ref3">Lawson 2017</a>, <a class="bibr" href="#niceng227er11.s1.ref4" rid="niceng227er11.s1.ref4">2020</a>) highlighted concerns about the quality of safeguarding and that the role of advocacy in safeguarding can be strengthened. The committee were aware that there is a statutory requirement to involve an independent advocate to support people subject to a safeguarding enquiry or safeguarding adult review, as outlined in the statutory guidance for the 2014 Care Act (<a class="bibr" href="#niceng227er11.s1.ref17" rid="niceng227er11.s1.ref17">Department of Health & Social Care 2022</a>). They agreed that monitoring the involvement of advocates is an important way of ensuring that this legal duty is being upheld. The committee agreed that the recommendation should cover all safeguarding activity, not just safeguarding enquiries, as advocacy involvement earlier in the process could help prevent situations escalating to formal enquiries; this is consistent with the ‘Making Safeguarding Personal’ approach mentioned above. Finally, the committee agreed to broaden the scope of the recommendation as limiting the population in the existing recommendation was due to the population of interest for NG189, rather than a limit on the responsibilities of Safeguarding Adults Boards.</p></div><div id="niceng227er11.s1.1.8.3.9"><h5>Monitoring provision of information</h5><p>Another existing recommendation from NG189 covered local authorities and commissioners monitoring whether care homes tell residents about advocacy and the criteria for accessing it and how advocates are involved in the management of safeguarding concerns. The committee agreed it was important that both of these are monitored but agreed the actions required by the recommendations would be clearer if they were separated, so split the recommendation into two. As with the above recommendation, the committee agreed that monitoring the involvement of advocates in safeguarding would help to ensure that the legal right described above is upheld. However, the wording was amended as the committee agreed that the role of advocates in safeguarding is to support those experiencing safeguarding concerns, not to manage these. The committee agreed that local authorities and commissioners should monitor whether health and social care providers give information about advocacy services to help drive improvements in access to advocacy for those who need it, as in the committee’s experience, information about advocacy services is not provided consistently (see evidence review C).</p></div><div id="niceng227er11.s1.1.8.3.10"><h5>Agreed methods of collecting data</h5><p>There were a number of statements (7, 26, 31, 34, 89, 90, 91, 117, 125, 127, 131 and 132) that highlighted the need to agree methods of collecting data (and that such methods need to consistent and robust). The committee discussed that recording and collecting data is a core part of contracts set by commissioners. The information and data used by commissioners is diverse, as it varies according to area and local need. The committee agreed that standardised data recording and collection methods, where the same type of information is collected by different commissioners and in different areas, would produce comparative data that is more consistent and transparent. This transparency and the ability to compare data across services may in turn help improve the quality of services by holding people to account. The committee agreed that a coordinated approach across the sector could facilitate robust data collection and recording, and so they made a recommendation in light of this. However, it is not within the remit of NICE guidelines to recommend that this be standardised nationally, as recommended in statements 131 and 132.</p></div><div id="niceng227er11.s1.1.8.3.11"><h5>Methods of quality assurance</h5><p>Statement 2 covered commissioners monitoring contracts to ensure that advocates are working to published quality standards. The committee agreed that quality standards are important for providing a benchmark against which performance can be measured in order to promote a consistent, high quality service and identify where improvements are needed. However, as advocacy is an emerging field, relative to other areas of health and social care, there are no evidence-based standards currently in place. Statement 5 covered two examples of monitoring tools, the <a href="https://www.ndti.org.uk/projects/advocacy-quality-performance-mark" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Advocacy Quality Performance Mark</a> (QPM) and Lost in Translation. The committee were aware that the QPM is a widely used quality assurance assessment, which is given to organisations demonstrating excellent service provision in line with QPM standards (<a class="bibr" href="#niceng227er11.s1.ref20" rid="niceng227er11.s1.ref20">NDTi 2018a</a>), the Advocacy Charter (<a class="bibr" href="#niceng227er11.s1.ref21" rid="niceng227er11.s1.ref21">NDTi 2018b</a>), and the Advocacy Code of Practice (<a class="bibr" href="#niceng227er11.s1.ref19" rid="niceng227er11.s1.ref19">NDTi, Empowerment Matters 2014</a>). The QPM is available to providers of statutory and non-statutory independent advocacy and is recognised by the <a class="bibr" href="#niceng227er11.s1.ref18" rid="niceng227er11.s1.ref18">Mental Capacity Act 2005</a> Code of Practice (<a class="bibr" href="#niceng227er11.s1.ref16" rid="niceng227er11.s1.ref16">Department for Constitutional Affairs 2007</a>), although it is not a legal requirement specified in the Mental Capacity Act itself. Given that the effectiveness of the Quality Performance Mark was not reviewed as part of this guideline and is not legally required, the committee were unable to make a strong recommendation supporting its use. However, they agreed that it is an example of an external quality accreditation that commissioners may want to consider. Further, in the absence of being able to make a stronger recommendation about published quality standards, the committee agreed it was important that commissioners check that advocacy providers have robust methods of quality assurance in place to ensure that providers are taking steps to ensure that they are delivering a high quality service, irrespective of the methods used to assess this.</p></div><div id="niceng227er11.s1.1.8.3.12"><h5>Gathering feedback from advocacy service users</h5><p>Statement 134 covered advocacy providers having consistent, practical and robust methods of seeking feedback that: avoids conflicts of interest; standardises who feedback should be sought from and what information should be collected; and tailors the format and method based on the communication needs and preferences of the individuals. The committee were aware that often collecting feedback could be difficult, as some people prefer to move on after using a service. However, the committee agreed that it was important to get feedback from those using advocacy services so that services are responsive to population needs and can make changes needed in order to improve the service provided. The committee agreed that the concept of having consistent and robust methods of seeking feedback would be covered by the recommendation above on developing data collection methods. The committee discussed that avoiding a conflict of interest is important in order to assure that feedback is honest and meaningful. The committee discussed that this can be difficult as the person providing the service would typically be the point of contact regarding feedback, but were aware of ways that this could be done that would minimise the involvement of the provider, such as anonymous electronic surveys. The committee were concerned that standardising what information is collected and from whom, could risk excluding key people, as this may vary depending on the context. For example, getting feedback from people’s families or carers may be particularly important in the case of non-instructed advocacy. Similarly, the committee agreed that there should be flexibility in what information is collected and the space for open-ended feedback to avoid being too prescriptive and allow individuals to raise what is important to them. Therefore, the committee agreed that maximising the opportunity for feedback was more important than standardisation. The committee agreed on the importance of supporting individual preferences and communication needs to facilitate getting information from the full spectrum of people accessing services. Without this, there may be a risk of excluding certain groups from feedback and, therefore, having an incomplete view of whether services are meeting the needs of the local population and any improvements needed. The committee acknowledged that, this might also include seeking feedback from families and carers, where people would be unable to provide feedback themselves. The committee agreed that tailoring the format and methods of seeking feedback is crucial for enabling feedback that can drive meaningful change as required, so made a separate recommendation about this to give it more prominence.</p></div><div id="niceng227er11.s1.1.8.3.13"><h5>Adhering to statutory duties</h5><p>The existing recommendation from the NICE guideline on decision-making and mental capacity [NG108] covered ensuring that statutory duties to involve advocacy are adhered to and monitored and that failure in statutory duties are addressed. From their knowledge and experience, the committee were aware that there is a longstanding issue of referrals not being made when they are necessary. The committee agreed it is important to ensure that referrals are made when they should be and that in cases where this is not happening, this needs to be addressed. The committee discussed that complying with statutory duties is essential so that rights are upheld. The committee agreed that commissioners have the power to help enforce this compliance, as they are the ones responsible for the funding and the contracts, so adapted the recommendation to focus on commissioners.</p></div><div id="niceng227er11.s1.1.8.3.14"><h5>Keeping independence and integrity of advocacy organisations</h5><p>Statement 4 covered that outcomes or activity monitoring should not compromise the independence or integrity of advocacy providers. From their knowledge and experience, the committee were aware that in some cases advocates might face pressure from other services or commissioners to prioritise certain outcomes or not to raise their concerns. The committee agreed that it is not possible for advocates to remain independent when put under such pressures so made a recommendation to ensure that this core tenant of advocacy is protected. Further, the committee discussed that sometimes advocates are asked for unnecessary information that could be used to identify individuals. Not only would sharing such information potentially be a breach of the 2018 Data Protection Act, it could be damaging to relationships between advocates and the people they support. Therefore, the committee agreed it is important that individual privacy is also protected during monitoring and incorporated this into the recommendation.</p></div><div id="niceng227er11.s1.1.8.3.15"><h5>Regular support and supervision</h5><p>Statement 121d covered advocacy organisations ensuring arrangements are in place for the regular support and supervision of Independent Mental Health Advocates (IMHAs). The committee agreed that supervision is crucial for ensuring consistency across services and that advocates are meeting the required standards. Further, it provides an important opportunity for developing skills and learning from others. For these reasons, the committee agreed that this recommendation should apply to all advocates, not just IMHAs. The committee agreed that this recommendation should be moved to the area of training for advocates (see evidence review I).</p></div><div id="niceng227er11.s1.1.8.3.16"><h5>Research recommendation</h5><p>Statements 49/51a and 50/51b recommended that research should focus on identifying the components of advocacy services which are effective for the wide range of people using the service and that there should be a focus on identifying the most effective components of advocacy services for specific groups, for example people living with dementia and people from black and minority ethnic groups. Similarly, statement 133 covered evaluating the impact of specialist health advocacy in order to further understand its benefits. In addition, statement 27 recommended that future research should distinguish between short and long term outcomes and statement 29, that research should include an assessment of cost-effectiveness. On the basis of these statements and their knowledge about gaps in evidence, about the factors that make an advocacy service effective, the committee recommended that future research should examine the effectiveness of advocacy delivered in different ways, for example, delivered by a peer advocate, in the same age group as the person being supported, with the same ethnicity as the person being supported, by an advocate who has completed culturally competent advocate training or by an advocate with lived experience.</p><p>They agreed the success of these different approaches should be assessed using individual level outcomes including independence and control, social care related quality of life and physical and mental health related quality of life as well as service or organisation outcomes such as service use, referral rates and the competency and wellbeing of advocates. They also agreed about the importance of wider, community level outcomes such as social inclusion and access to community services. As well as a quantitative assessment of the effectiveness of different approaches the committee also agreed about the importance of understanding people’s views and experiences about these different approaches, which is why they recommended mixed, quantitative and qualitative research to gain a complete understanding. For the full details of the research recommendation including the rationale and PICO table, see <a href="#niceng227er11.appe">appendix E</a>.</p></div><div id="niceng227er11.s1.1.8.3.17"><h5>Statements not used in this review</h5><p>There were a number of statements carried forward to committee discussions that were not ultimately used to inform recommendations. Statements 24, 75, 76, 82 and 113 were not used because they did not provide enough detail about what action should be taken. Similarly, statement 104 did not provide detail about what the multiagency approach should be used to review and reflect on concerns, issues and adverse events, and the committee agreed that organisations should already have processes in place for reviewing serious incidents and near misses, so they did not think a recommendation about this was needed. Statements 20, 121a, 137 and 138, which covered commissioners ensuring that requirements for recording, reporting, and monitoring are added to contracts, were also not used to inform recommendations as the committee agreed the concepts covered in these statements (for example, specifying requirements for recording, reporting, and monitoring in contracts, clear leadership, and sufficient staffing levels) are not specific to advocacy services and are standard processes that should be happening anyway.</p><p>Statement 41 covered commissioners developing benchmarks that can be used to measure the performance and quality of advocacy services. This statement was not used to inform a recommendation as the committee agreed it would partly be covered by the recommendation discussed above on agreeing objectives and outcomes and that other benchmarks (such as waiting times for meetings) would be a standard part of contracts that is happening anyway. There were several other statements that were not used to inform recommendations as the committee agreed they would be, at least in part, covered by other recommendations made in this area. Statement 1 covered quarterly reporting between advocacy providers and commissioners. The committee were not sure that reporting information on a quarterly basis was feasible, or necessary, but the need for reporting information more broadly is covered above. The combined statements 46, 47 & 48 suggested future research focussing on comprehensive mapping of advocacy organisations. The committee agreed that mapping of advocacy services, including identifying trends, was an ongoing monitoring activity and covered by the recommendations above, rather than a research activity. Statement 124 covered two key concepts: having a plan for how services will meet a diverse range of needs and undertaking equalities monitoring. The committee agreed that the concept of equalities monitoring would be addressed by the recommendation above that included collecting information about protected characteristics and that ensuring services can meet diverse needs would be covered by:
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<ul><li class="half_rhythm"><div>the recommendation above that included making changes needed to services in order to meet the needs of all communities they work with,</div></li><li class="half_rhythm"><div>recommendations 1.6.1, 1.6.2 and 1.6.12 under the area of effective advocacy (see evidence review F),</div></li><li class="half_rhythm"><div>recommendation 1.7.10 under partnership working (see evidence review G), and</div></li><li class="half_rhythm"><div>recommendation 1.9.1 under training for advocates (see evidence review I).</div></li></ul></p><p>Other statements were not used to inform recommendations because the committee agreed that the concepts covered were already addressed by recommendations made in other areas of this guideline. Statement 12, which covered requesting and recording information about any known risks to ensure safety of advocates is covered by recommendation 1.7.7 under the area of partnership working (see evidence review G). Statement 35 covered developing agreement about the definitions and role of advocacy to improve data collection and service evaluation. The committee agreed that the issues of uncertainty in the role of advocates would be dealt with by recommendations 1.8.6, 1.8.7 and 1.8.9 under planning and commissioning (see evidence review H) about specifying the role of advocates in contracts. Statement 119a was about the quality of IMHA services depending on the effectiveness of commissioning, with a number of examples of how effective commissioning could be achieved. The committee agreed that how to achieve effective commissioning was already covered by recommendations made under the area of planning and commissioning (see evidence review H). Statement 119c highlighted the need for interfaces between IMHA services and other forms of advocacy being easy to navigate. The committee agreed that this issue was addressed by recommendation 1.4.5 under improving access (see evidence review D). Statement 120 about the quality of IMHA services being influenced by the availability and accessibility of IMHA services, was not used to inform a recommendation as the committee agreed that the areas of the statement were already covered by other recommendations in this guideline, such as:
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<ul><li class="half_rhythm"><div>availability and access (including increasing uptake) is covered by recommendations in the improving access section (see evidence review D),</div></li><li class="half_rhythm"><div>eligibility for IMHA services is covered by recommendations in the legal right section (see evidence review A), and</div></li><li class="half_rhythm"><div>understanding the role of IMHA services is covered by recommendations in the training for practitioners section (see evidence review J).</div></li></ul></p><p>Statement 121b covered services being able to respond to changing needs and retaining high quality staff and expertise. The committee agreed that the recommendation about basing commissioning on assessment of local needs (recommendation 1.8.1 in planning and commissioning, see evidence review H) would enable services to respond to changing needs and that recommendations made in the training advocates section (see evidence review I) would help rating high quality staff and expertise. The committee agreed the issue in statement 121g, namely the quality of IMHA services being improved by IMHAs being able to devote the time needed to each individual case, would be addressed by recommendation 1.8.6 in planning and commissioning (see evidence review H). Statement 122 covered IMAH services having a clear recovery focus and link with opportunities for peer support. The committee agreed that having a recovery focus was covered by recommendation 1.6.2 under the area of effective advocacy (see evidence review F) and that peer support was just one example of a source of support that advocates should be routinely providing people with information about.</p><p>Finally, statement 126 about the quality of IMHA services being influenced by the understanding of other health professionals, was not used to inform a recommendation because the committee agreed that it was a broad statement and particular areas were covered by other recommendations in this guideline, such as:
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<ul><li class="half_rhythm"><div>understanding and respecting the role is covered by recommendations in the training practitioners section (see evidence review J),</div></li><li class="half_rhythm"><div>promoting access is covered by recommendations in the improving access section (see evidence review D),</div></li><li class="half_rhythm"><div>developing staff and training is covered by recommendations in the training advocates section (see evidence review I),</div></li><li class="half_rhythm"><div>common concerns are covered by recommendations in the partnership working section (see evidence review G), and</div></li><li class="half_rhythm"><div>organisational context is covered by recommendations in the planning and commissioning section (see evidence review H).</div></li></ul></p></div></div><div id="niceng227er11.s1.1.8.4"><h5>Cost effectiveness and resource use</h5><p>It is not expected that collecting data or the type of data that is collected will lead to any long term increase in resource use as the vast majority of centres will already have data collection and monitoring processes in place, however there will be some upfront costs for some recommendations discussed below. There is likely be benefits in terms of providing advocacy services through more complete and standardised collected data and the way it is used and monitored. Data collection including resource use, especially at the population level, should allow for the design and commissioning of more effective and cost effective services in future.</p><p>There will be some short term costs from these recommendations where monitoring, data collection or quality assurance systems are not in-line with the recommendations. There will also be some upfront costs from initial meetings between advocacy services and commissioners to decide on which data to collect, develop consistent reporting methods and to ensure dissemination around insight from data collection are consistent and effective. This will most likely be achieved through the development of protocols or operating procedures. These will require some update after development to allow them to change with practice or problems identified in their use but this is expected to be minimal. As above better and standardised monitoring, data collection and quality assurance should lead to more effective and efficient advocacy services with potentially saving large costs.</p></div></div><div id="niceng227er11.s1.1.9"><h4>Recommendations supported by this evidence review</h4><p>This evidence review supports recommendations 1.8.8, 1.11.2 to 1.11.18 and 1.9.5, and the research recommendation on the effectiveness and acceptability of providing advocacy through different approaches. Other evidence supporting these recommendations can be found in the evidence reviews on partnership and working (see evidence review G).</p></div></div><div id="niceng227er11.s1.rl.r1"><h3>References – included studies</h3><ul class="simple-list"><div id="niceng227er11.s1.rl.r1.1"><h4>Existing NICE guidelines</h4><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref1"><p id="p-123">
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<strong>National Institute for Health and Care Excellence 2018</strong>
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</p>National Institute for Health and Care Excellence (2018). Decision-making and mental capacity (NICE Guideline 108). Available at: <a href="https://www.nice.org.uk/guidance/ng108/evidence/full-guideline-pdf-6542486605" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/guidance/ng108/evidence<wbr style="display:inline-block"></wbr>​/full-guideline-pdf-6542486605</a></div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref2"><p id="p-124">
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<strong>National Institute for Health and Care Excellence 2021</strong>
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</p>National Institute for Health and Care Excellence (2021). Safeguarding adults in care homes (NICE Guideline 189). Available at: <a href="https://www.nice.org.uk/guidance/ng189/resources/safeguarding-adults-in-care-homes-pdf-66142030079941" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/guidance/ng189/resources<wbr style="display:inline-block"></wbr>​/safeguarding-adults-in-care-homes-pdf-66142030079941</a></div></p></li></ul></div><div id="niceng227er11.s1.rl.r1.2"><h4>Formal consensus</h4><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref3"><p id="p-125">
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<strong>Lawson 2017</strong>
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</p>Lawson, J. (2017). Making Safeguarding Personal. What might ‘good’ look like for advocacy?
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Local Government Association. Available at: <a href="https://www.local.gov.uk/sites/default/files/documents/25.30%20-%20Chip_MSP%20Advocacy_WEB_2.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.local.gov<wbr style="display:inline-block"></wbr>​.uk/sites/default/files/documents/25<wbr style="display:inline-block"></wbr>​.30<wbr style="display:inline-block"></wbr>​%20-%20Chip_MSP%20Advocacy_WEB_2.pdf</a> [Accessed 07/04/2021]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref4"><p id="p-126">
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<strong>Lawson 2020</strong>
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</p>Lawson, J., Petty, G. (2020). Strengthening the role of advocacy in Making Safeguarding Personal, Local Government Association. Available at: <a href="https://www.local.gov.uk/sites/default/files/documents/25.167%20Strengthening%20the%20role%20of%20advocacy%20in%20MSP_04.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.local.gov<wbr style="display:inline-block"></wbr>​.uk/sites/default/files/documents/25<wbr style="display:inline-block"></wbr>​.167<wbr style="display:inline-block"></wbr>​%20Strengthening%20the<wbr style="display:inline-block"></wbr>​%20role%20of%20advocacy<wbr style="display:inline-block"></wbr>​%20in%20MSP_04.pdf</a> [Accessed 07/04/2021]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref5"><p id="p-127">
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<strong>Macadam 2013</strong>
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</p>Macadam, A., Watts, R., Greig, R. (2013). SSCR Scoping Review: The Impact of Advocacy for People Who Use Social Care Services. Available at: <a href="https://www.ndti.org.uk/assets/files/SSCR-scoping-review_SR007.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/SSCR-scoping-review<wbr style="display:inline-block"></wbr>​_SR007.pdf</a> [Accessed 06/04/2021]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref6"><p id="p-128">
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<strong>Mercer 2020</strong>
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</p>Mercer, K., Petty, G. (2020). Scoping Exercise Report – An overview of advocacy delivery in relation to Personal Health Budgets and other Health Funded support. Available at: <a href="https://www.ndti.org.uk/assets/files/Advocacy-Health-Funded-Support-Report-pdf.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/Advocacy-Health-Funded-Support-Report-pdf<wbr style="display:inline-block"></wbr>​.pdf</a> [Accessed 07/05/2021]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref7"><p id="p-129">
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<strong>National Development Team for Inclusion 2014b</strong>
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</p>National Development Team for Inclusion (2014b). Office for Disabilities Issues Access to Advocacy Project: Summary Findings Minister’s Briefing Note. Unpublished</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref8"><p id="p-130">
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<strong>National Development Team for Inclusion 2014c</strong>
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</p>National Development Team for Inclusion (2014c). Office for Disabilities Issues Access to Advocacy Project: Executive Summary. Unpublished</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref9"><p id="p-131">
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<strong>National Development Team for Inclusion 2016a</strong>
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</p>National Development Team for Inclusion (2016a). Advocacy Outcomes Framework. Measuring the impact of independent advocacy. Available at: <a href="https://www.ndti.org.uk/assets/files/Advocacy_framework.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/Advocacy_framework.pdf</a> [Accessed 06/04/2021]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref10"><p id="p-132">
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<strong>National Development Team for Inclusion 2016b</strong>
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</p>National Development Team for Inclusion (2016b). Advocacy Outcomes Toolkit. An accompanying guide to the advocacy outcomes framework. Available at: <a href="https://www.ndti.org.uk/assets/files/Advocacy_Outcomes_Toolkit.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/Advocacy<wbr style="display:inline-block"></wbr>​_Outcomes_Toolkit.pdf</a> [Accessed 06/04/2021]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref11"><p id="p-133">
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<strong>Newbigging 2012</strong>
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</p>Newbigging, K., Ridley, J., McKeown, M., Machin, K., Poursanidou, D., Able, L., et al. (2012). The Right to Be Heard: Review of the Quality of Independent mental Health Advocate (IMHA) Services in England, University of Central Lancashire. Available at: <a href="https://www.firah.org/upload/notices3/2012/uclan.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.firah.org<wbr style="display:inline-block"></wbr>​/upload/notices3/2012/uclan.pdf</a> [Accessed 13/05/2021]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref12"><p id="p-134">
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<strong>Ridley 2018</strong>
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</p>Ridley, J., Newbigging, K., Street, C. (2018). Mental health advocacy outcomes from service user perspectives, Mental Health Review Journal, Vol. 23(4), 280–292.</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref13"><p id="p-135">
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<strong>Roberts 2012</strong>
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</p>Roberts, H., Turner, S., Baines, S., Hatton, C. (2012). Advocacy by and for adults with learning disabilities in England. Available at: <a href="https://www.ndti.org.uk/assets/files/IHAL_2012-03_Advocacy.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/IHAL_2012-03_Advocacy<wbr style="display:inline-block"></wbr>​.pdf</a> [Accessed 06/04/2021]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref14"><p id="p-136">
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<strong>Turner 2012</strong>
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</p>Turner, S. (2012). Advocacy by and for adults with learning disabilities in England: Evidence into practice report no.5, Improving Health and Lives: Learning Disabilities Observatory. Available at: <a href="https://www.ndti.org.uk/assets/files/IHAL-ev-_2012-01.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/IHAL-ev-_2012-01.pdf</a> [Accessed 06/04/2021]</div></p></li></ul></div><div id="niceng227er11.s1.rl.r1.3"><h4>Other</h4><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref15"><p id="p-137">
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<strong>Care Act 2014</strong>
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</p>Care Act
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2014, c. 23. Available at: <a href="https://www.legislation.gov.uk/ukpga/2014/23/contents/enacted" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.legislation<wbr style="display:inline-block"></wbr>​.gov.uk/ukpga/2014<wbr style="display:inline-block"></wbr>​/23/contents/enacted</a> [Accessed 31/01/2022]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref16"><p id="p-138">
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<strong>Department for Constitutional Affairs 2007</strong>
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</p>Department for Constitutional Affairs (2007). <a class="bibr" href="#niceng227er11.s1.ref18" rid="niceng227er11.s1.ref18">Mental Capacity Act 2005</a>: Code of Practice. Available at: <a href="https://www.gov.uk/government/publications/mental-capacity-act-code-of-practice" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.gov.uk/government<wbr style="display:inline-block"></wbr>​/publications<wbr style="display:inline-block"></wbr>​/mental-capacity-act-code-of-practice</a> [Accessed 15/02/2022]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref17"><p id="p-139">
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<strong>Department of Health & Social Care 2022</strong>
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</p>Department of Health & Social Care. Care and support statutory guidance. Available at: <a href="https://www.gov.uk/government/publications/care-act-statutory-guidance/care-and-support-statutory-guidance#using-the-care-act-guidance" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.gov.uk/government<wbr style="display:inline-block"></wbr>​/publications<wbr style="display:inline-block"></wbr>​/care-act-statutory-guidance<wbr style="display:inline-block"></wbr>​/care-and-support-statutory-guidance#using-the-care-act-guidance</a> [Accessed 31/01/2022]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref18"><p id="p-140">
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<strong>Mental Capacity Act 2005</strong>
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</p>Mental Capacity Act, 2005 (c.9). Available at: <a href="http://www.legislation.gov.uk/ukpga/2005/9/contents" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.legislation<wbr style="display:inline-block"></wbr>​.gov.uk/ukpga/2005/9/contents</a> [Accessed 23/02/2021]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref19"><p id="p-141">
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<strong>National Development Team for Inclusion and Empowerment Matters CIC (2014)</strong>
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</p>National Development Team for Inclusion and Empowerment Matters CIC. (2014) Advocacy Quality Performance Mark (QPM). Recognising Quality in independent advocacy. Code of Practice 2014</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref20"><p id="p-142">
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<strong>National Development Team for Inclusion 2018a</strong>
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</p>National Development Team for Inclusion. (2018a). Advocacy QPM: Assessment Workbook. Available at: <a href="https://qualityadvocacy.org.uk/wp-content/uploads/2021/12/QPM-Assessment-Workbook_V4_V1.3_Dec-2021.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https:<wbr style="display:inline-block"></wbr>​//qualityadvocacy<wbr style="display:inline-block"></wbr>​.org.uk/wp-content<wbr style="display:inline-block"></wbr>​/uploads/2021/12/QPM-Assessment-Workbook_V4_V1<wbr style="display:inline-block"></wbr>​.3_Dec-2021.pdf</a> [Accessed 16/02/2022]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng227er11.s1.ref21"><p id="p-143">
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<strong>National Development Team for Inclusion 2018b</strong>
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</p>National Development Team for Inclusion. (2018b). The Advocacy Charter (Poster). Available at: <a href="https://www.ndti.org.uk/assets/files/Advocacy-Charter-A3.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/Advocacy-Charter-A3.pdf</a> [Accessed 16/02/2022]</div></p></li></ul></div></ul></div></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng227er11.appa"><h3>Appendix A. Study selection for formal consensus process</h3><p id="niceng227er11.appa.et1"><a href="/books/NBK588850/bin/niceng227er11-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Study selection for formal consensus process Study selection for scope area: Monitoring services and collecting data for quality improvement</a><span class="small"> (PDF, 125K)</span></p></div><div id="niceng227er11.appb"><h3>Appendix B. Evidence tables</h3><p id="niceng227er11.appb.et1"><a href="/books/NBK588850/bin/niceng227er11-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Evidence tables for scope area: Monitoring services and collecting data for quality improvement</a><span class="small"> (PDF, 509K)</span></p></div><div id="niceng227er11.appc"><h3>Appendix C. Quality Assessment</h3><p id="niceng227er11.appc.et1"><a href="/books/NBK588850/bin/niceng227er11-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Quality assessment tables for scope area: Monitoring services and collecting data for quality improvement</a><span class="small"> (PDF, 223K)</span></p></div><div id="niceng227er11.appd"><h3>Appendix D. Excluded studies</h3><div id="niceng227er11.appd.s1"><h4>Excluded studies for scope area: Monitoring services and collecting data for quality improvement</h4></div><div id="niceng227er11.appd.s2"><h4>Formal consensus (documents identified by the call for evidence and the guideline committee)</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng227er11appdtab1"><a href="/books/NBK588850/table/niceng227er11.appd.tab1/?report=objectonly" target="object" title="Table 8" class="img_link icnblk_img figpopup" rid-figpopup="figniceng227er11appdtab1" rid-ob="figobniceng227er11appdtab1"><img class="small-thumb" src="/books/NBK588850/table/niceng227er11.appd.tab1/?report=thumb" src-large="/books/NBK588850/table/niceng227er11.appd.tab1/?report=previmg" alt="Table 8. Excluded studies and reasons for their exclusion." /></a><div class="icnblk_cntnt"><h4 id="niceng227er11.appd.tab1"><a href="/books/NBK588850/table/niceng227er11.appd.tab1/?report=objectonly" target="object" rid-ob="figobniceng227er11appdtab1">Table 8</a></h4><p class="float-caption no_bottom_margin">Excluded studies and reasons for their exclusion. </p></div></div></div><div id="niceng227er11.appd.s3"><h4>Excluded economic studies</h4><p>No economic evidence was considered for this scope area.</p></div></div><div id="niceng227er11.appe"><h3>Appendix E. Research recommendations – full details</h3><div id="niceng227er11.appe.s1"><h4>Research recommendations for scope area: Monitoring services and collecting data for quality improvement</h4></div><div id="niceng227er11.appe.s2"><h4>E.1.1. Research recommendation</h4><p>What is the effectiveness and acceptability of providing advocacy through different approaches?</p></div><div id="niceng227er11.appe.s3"><h4>E.1.2. Why this is important</h4><p>Research on this question is needed because there is currently no national evidence to inform decisions based on a shared understanding of what good advocacy looks like and what makes it effective. Research would take a broad view of factors which have a possible impact on the availability, effectiveness and acceptability of advocacy. Factors to consider include commissioning arrangements (particularly how statutory and non-statutory advocacy are commissioned), what makes good advocacy, how advocacy can and should be measured, what people want from an advocate, different models of delivery, what factors make a good advocate, long term funding of advocacy and how it is costed, training and support for advocates, use and efficacy of the Quality Performance Mark in assessing the quality of advocacy services.</p><p>Research into these factors will help commissioners, users and providers of advocacy to understand what quality advocacy looks like, which will help improve consistency, efficacy and the use of public resources. This will lead to increased confidence in advocacy by people who draw on advocacy and their family members.</p><p>It is important that research clearly identifies the individual and various factors which may influence the effectiveness of advocacy including take up of advocacy services by specific groups within the population. Examples of these factors include the availability of choice of advocate based on gender specific, shared culture or ethnic background as the person drawing on advocacy. It will also be important to explore other factors that may influence the effectiveness or acceptability of advocacy such as whether the advocate has lived experience of drawing on health, care or advocacy services.</p><p>Research will also need to consider the different types of advocacy, including peer, self, 1:1, group and non-instructed advocacy and establish how effective they are in achieving their stated goal of promoting voice, choice and increasing citizenship.</p></div><div id="niceng227er11.appe.s4"><h4>E.1.3. Rationale for research recommendation</h4><p id="niceng227er11.appe.et1"><a href="/books/NBK588850/bin/niceng227er11-appe-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (187K)</span></p></div><div id="niceng227er11.appe.s5"><h4>E.1.4. Modified PICO table</h4><p id="niceng227er11.appe.et2"><a href="/books/NBK588850/bin/niceng227er11-appe-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (179K)</span></p></div></div><div id="niceng227er11.appf"><h3>Appendix F. Existing NICE recommendations</h3><p id="niceng227er11.appf.et1"><a href="/books/NBK588850/bin/niceng227er11-appf-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 11. Existing NICE recommendations for scope area: Monitoring services and collecting data for quality improvement</a><span class="small"> (PDF, 151K)</span></p></div><div id="niceng227er11.appg"><h3>Appendix G. Formal consensus</h3><p id="niceng227er11.appg.et1"><a href="/books/NBK588850/bin/niceng227er11-appg-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Additional information related to scope area: Monitoring services and collecting data for quality improvement</a><span class="small"> (PDF, 322K)</span></p></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence review underpinning recommendations 1.8.8, 1.11.2 to 1.11.18 and 1.9.5, as well as research recommendation 1 in the NICE guideline</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2022.</div><div class="small"><span class="label">Bookshelf ID: NBK588850</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/36745719" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">36745719</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng227er11tab1"><div id="niceng227er11.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Summary of the inclusion criteria</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK588850/table/niceng227er11.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng227er11.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_niceng227er11.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Country</th><td headers="hd_b_niceng227er11.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">UK</td></tr><tr><th id="hd_b_niceng227er11.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Geographical level</th><td headers="hd_b_niceng227er11.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>National*</p>
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<p>*For policy or guidance documents, this means, the policies and recommendations apply nationally. For original research, this means the studies have been conducted in the national policy and practice context of our scope, i.e., the English health and social care system</p>
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</td></tr><tr><th id="hd_b_niceng227er11.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication date</th><td headers="hd_b_niceng227er11.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2011 onwards</td></tr><tr><th id="hd_b_niceng227er11.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_niceng227er11.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Primary qualitative or quantitative studies (including unpublished research), excluding case-studies</p>
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<p>Systematic reviews of qualitative or quantitative studies, excluding case-studies</p>
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<p>Guidelines or policy documents that are based on qualitative or quantitative evidence, excluding case-studies</p>
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</td></tr><tr><th id="hd_b_niceng227er11.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Topic areas</th><td headers="hd_b_niceng227er11.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Monitoring services and collecting data for quality improvement</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng227er11tab2"><div id="niceng227er11.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of documents included in the formal consensus process</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK588850/table/niceng227er11.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng227er11.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Document</th><th id="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Evidence base</th></tr></thead><tbody><tr><td headers="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng227er11.s1.ref3" rid="niceng227er11.s1.ref3">Lawson 2017</a>
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</p>
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<p>Report</p>
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<p>England</p>
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</td><td headers="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Those who have duties to commission and arrange advocacy services for safeguarding adults</td><td headers="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Report drawing on existing literature (including statutory guidance and core principles for safeguarding) to set out what needs to be done and what needs to be addressed to make safeguarding personal</td></tr><tr><td headers="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng227er11.s1.ref4" rid="niceng227er11.s1.ref4">Lawson 2020</a>
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</p>
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<p>Briefing report</p>
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<p>England</p>
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</td><td headers="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Those who have duties to commission and arrange advocacy services for safeguarding adults</td><td headers="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Briefing generated by a series of conversations with 28 advocates from 18 advocacy providers across England, covering 33 local authority areas</td></tr><tr><td headers="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng227er11.s1.ref5" rid="niceng227er11.s1.ref5">Macadam 2013</a>
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</p>
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<p>Scoping review</p>
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<p>England</p>
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</td><td headers="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People who use social care services</td><td headers="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic scoping review and call for evidence with content analysis</td></tr><tr><td headers="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng227er11.s1.ref6" rid="niceng227er11.s1.ref6">Mercer 2020</a>
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</p>
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<p>Scoping review</p>
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<p>England</p>
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</td><td headers="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Independent advocacy services commissioned to provide advocacy to people accessing support/service through:
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<dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>i)</dt><dd><p class="no_top_margin">s117 aftercare (under the Mental Health Act)</p></dd></dl><dl class="bkr_refwrap"><dt>ii)</dt><dd><p class="no_top_margin">NHS CHC (adults)</p></dd></dl><dl class="bkr_refwrap"><dt>iii)</dt><dd><p class="no_top_margin">Children and Young People’s CC</p></dd></dl><dl class="bkr_refwrap"><dt>iv)</dt><dd><p class="no_top_margin">Personal Health Budgets;</p></dd></dl><dl class="bkr_refwrap"><dt>v)</dt><dd><p class="no_top_margin">Personal Wheelchair Budgets</p></dd></dl></dl></td><td headers="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic scoping exercise including data from: Freedom of information requests to identify what services were commissioned, by whom and to which groups; advocacy survey for advocates to identify what advocacy providers are delivering; semi-structured telephone interviews with Independent Advocacy providers; review of legislation and guidance to identify current provision and identify gaps</td></tr><tr><td headers="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng227er11.s1.ref7" rid="niceng227er11.s1.ref7">NDTi 2014b</a>
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</p>
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<p>Briefing note/Executive summary</p>
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<p>England</p>
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</td><td headers="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People living with disabilities</td><td headers="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Survey (with 200+ responses) and fieldwork at 4 sites; also mentions ‘mapping of the advocacy sector’</td></tr><tr><td headers="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng227er11.s1.ref8" rid="niceng227er11.s1.ref8">NDTi 2014c</a>
|
|
</p>
|
|
<p>Briefing note/Executive summary</p>
|
|
<p>England</p>
|
|
</td><td headers="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People living with disabilities</td><td headers="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Survey (with 200+ responses) and fieldwork at 4 sites; also mentions ‘mapping of the advocacy sector’</td></tr><tr><td headers="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng227er11.s1.ref9" rid="niceng227er11.s1.ref9">NDTi 2016a</a>
|
|
</p>
|
|
<p>Framework</p>
|
|
<p>England</p>
|
|
</td><td headers="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Providers and commissioners of independent advocacy</td><td headers="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Literature review (no details reported) and consultation with two self-advocacy groups</td></tr><tr><td headers="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng227er11.s1.ref10" rid="niceng227er11.s1.ref10">NDTi 2016b</a>
|
|
</p>
|
|
<p>Toolkit</p>
|
|
<p>England</p>
|
|
</td><td headers="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Providers and commissioners of independent advocacy</td><td headers="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Literature review (no details reported) and consultation with two self-advocacy groups</td></tr><tr><td headers="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng227er11.s1.ref11" rid="niceng227er11.s1.ref11">Newbigging 2012</a>
|
|
</p>
|
|
<p>Research report</p>
|
|
<p>England</p>
|
|
</td><td headers="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People detained under the amended Mental Health Act 1983, who were eligible for support from IMHA services, including people with and without capacity and children under the age of 16</td><td headers="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Multiple methods (including literature review, 11 focus groups, shadow visits with IMHAs, expert panel review) to obtain information on IMHA services to develop draft quality indicators for IMHA services. Data from 8 case studies (NHS Trust areas) to understand experiences of qualifying service users and the commissioning and delivery of IMHA services and their relationship with mental health services</td></tr><tr><td headers="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng227er11.s1.ref12" rid="niceng227er11.s1.ref12">Ridley 2018</a>
|
|
</p>
|
|
<p>Review of 3 qualitative studies</p>
|
|
<p>England</p>
|
|
</td><td headers="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">African and African Caribbean men using mental health services; adults and children detained under the Mental Health Act 1983; children and young people receiving advocacy services</td><td headers="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparative analysis and synthesis of findings from 3 qualitative studies (including service user, advocate, professional and commissioner perspectives); data collected through focus groups and/or interviews</td></tr><tr><td headers="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng227er11.s1.ref13" rid="niceng227er11.s1.ref13">Roberts 2012</a>
|
|
</p>
|
|
<p>Survey</p>
|
|
<p>England</p>
|
|
</td><td headers="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People with learning disabilities</td><td headers="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3 surveys (responses from 78 local authority commissioners and 88 advocacy providers) and 3 case studies; provides information on, for example, funding and also discusses gaps in advocacy provision and barriers to accessing services</td></tr><tr><td headers="hd_h_niceng227er11.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng227er11.s1.ref14" rid="niceng227er11.s1.ref14">Turner 2012</a>
|
|
</p>
|
|
<p>Brief report</p>
|
|
<p>England</p>
|
|
</td><td headers="hd_h_niceng227er11.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People with learning disabilities</td><td headers="hd_h_niceng227er11.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2 surveys (responses from 78 local authority commissioners and 88 advocacy providers) and 3 case studies (no detailed methods reported); provides advice and suggestions on actions for commissioners and advocacy groups to provide robust evidence on the effectiveness and reach of advocacy services</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">CC: continuing care; IMHA: Independent Mental Health Advocate; NDTi: National Development Team for Inclusion; NHS CHC: National Health Service Continuing Healthcare; ODI: Office for Disability Issues.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng227er11appdtab1"><div id="niceng227er11.appd.tab1" class="table"><h3><span class="label">Table 8</span><span class="title">Excluded studies and reasons for their exclusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK588850/table/niceng227er11.appd.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng227er11.appd.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for Exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bauer, B., Wistow, G., Dixon, J., Knapp, M. (2013). Investing in Advocacy Interventions for Parents with Learning Disabilities: What is the Economic Argument?
|
|
Personal Social Services Research Unit. Available at: <a href="http://eprints.lse.ac.uk/51114/1/Investing%20in%20advocay.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://eprints<wbr style="display:inline-block"></wbr>​.lse.ac<wbr style="display:inline-block"></wbr>​.uk/51114/1/Investing%20in%20advocay<wbr style="display:inline-block"></wbr>​.pdf</a> [Accessed 16/02/2022]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chatfield, D., Lee, S., Cowley, J., Kitzinger, C., Kitzinger, J., Menon, D. (2018). Is there a broader role for independent mental capacity advocates in critical care? An exploratory study. Nursing in Critical Care, 23(2), 82–87. [<a href="https://pubmed.ncbi.nlm.nih.gov/28247553" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28247553</span></a>]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No key findings or recommendations relevant to Monitoring services and collecting data for quality improvement</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Davies, L., Townsley, R., Ward, L., Marriott
|
|
A. (2009). A framework for research on costs and benefits of independent advocacy, Office for Disability Issues. Available at <a href="https://www.bristol.ac.uk/media-library/sites/sps/migrated/documents/odiframework.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.bristol.ac<wbr style="display:inline-block"></wbr>​.uk/media-library/sites<wbr style="display:inline-block"></wbr>​/sps/migrated/documents<wbr style="display:inline-block"></wbr>​/odiframework.pdf</a> [Accessed 16/02/2022]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
EY (2017). Society’s return on investment (SROI) in older people’s cancer advocacy services. Available at: <a href="https://opaal.org.uk/?s=Society%27s+return+on+investment+%28SROI%29+in+older+people%E2%80%99s+cancer+advocacy+services" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://opaal<wbr style="display:inline-block"></wbr>​.org.uk<wbr style="display:inline-block"></wbr>​/?s=Society%27s+return+on+investment+<wbr style="display:inline-block"></wbr>​%28SROI<wbr style="display:inline-block"></wbr>​%29+in+older+people<wbr style="display:inline-block"></wbr>​%E2%80%99s+cancer+advocacy+services</a> [Accessed 16/02/2022]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Feeney, M., Evers, C., Agpalo, D., Cone, L., Fleisher, J., Schroeder, K. (2020). Utilizing patient advocates in Parkinson’s disease: A proposed framework for patient engagement and the modern metrics that can determine its success. Health Expectations, 23, 722–730. [<a href="/pmc/articles/PMC7495075/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7495075</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32363785" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32363785</span></a>]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-UK based (International)</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Harflett, N., Turner, S., Bown, H., National Development Team for Inclusion (2015). The impact of personalisation on the lives of the most isolated people with learning disabilities. A review of the evidence. Available at: <a href="https://www.ndti.org.uk/assets/files/Isolation_and_personalisation_evidence_review_final_02_06_15.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/Isolation<wbr style="display:inline-block"></wbr>​_and_personalisation<wbr style="display:inline-block"></wbr>​_evidence_review_final_02_06_15<wbr style="display:inline-block"></wbr>​.pdf</a> [Accessed 06/04/2021]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No key findings or recommendations relevant to Monitoring services and collecting data for quality improvement</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Healthwatch (2015). Independent Complaints Advocacy: Standards to support the commissioning, delivery and monitoring of the service. Available at: <a href="https://www.healthwatch.co.uk/sites/healthwatch.co.uk/files/healthwatch_advocacy_standards_10022015.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.healthwatch<wbr style="display:inline-block"></wbr>​.co.uk/sites/healthwatch<wbr style="display:inline-block"></wbr>​.co.uk/files/healthwatch<wbr style="display:inline-block"></wbr>​_advocacy_standards_10022015<wbr style="display:inline-block"></wbr>​.pdf</a> [Accessed 16/02/2022]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kilinç, S.
|
|
Erdem, H., Healer, R., Cole, J. (2020). Finding meaning and purpose: a framework for the self-management of neurological conditions. Disability and Rehabilitation, 44(2), 219–230. [<a href="https://pubmed.ncbi.nlm.nih.gov/32406762" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32406762</span></a>]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
National Development Team for Inclusion (2012). Reasonably Adjusted?
|
|
Mental Health Services and Support for People with Autism and People with Learning Disabilities. Available at: <a href="https://www.ndti.org.uk/assets/files/Reasonably-adjusted_2020-12-30-150637.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/Reasonably-adjusted<wbr style="display:inline-block"></wbr>​_2020-12-30-150637.pdf</a> [Accessed 06/04/2021]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No key findings or recommendations relevant to Monitoring services and collecting data for quality improvement</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
National Development Team for Inclusion (2014). The impact of advocacy for people who use social care services: a review of the evidence, NDTi Insights. Available at: <a href="https://www.ndti.org.uk/assets/files/Insights_19_Impact_of_Advocacy_FINAL.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/Insights<wbr style="display:inline-block"></wbr>​_19_Impact_of_Advocacy_FINAL.pdf</a> [Accessed 11/02/2022]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No key findings or recommendations relevant to any scope area</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
National Development Team for Inclusion (2020). Valuing voices: Protecting rights through the pandemic and beyond. Available at: <a href="https://www.ndti.org.uk/assets/files/Valuing_voices_-_Protection_rights_through_the_pandemic_and_beyond_Oct_2020.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/Valuing<wbr style="display:inline-block"></wbr>​_voices_-_Protection<wbr style="display:inline-block"></wbr>​_rights_through_the<wbr style="display:inline-block"></wbr>​_pandemic_and_beyond_Oct_2020.pdf</a> [Accessed 07/04/2021]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No key findings or recommendations relevant to Monitoring services and collecting data for quality improvement</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
National Development Team for Inclusion (2020). Valuing voices in Wales: Protecting rights through the pandemic and beyond. Available at: <a href="https://www.dewiscil.org.uk/news/valuing-voices-in-wales-report" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.dewiscil<wbr style="display:inline-block"></wbr>​.org.uk/news/valuing-voices-in-wales-report</a> [Accessed 07/04/2021]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No key findings or recommendations relevant to Monitoring services and collecting data for quality improvement</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
National Development Team for Inclusion. (2018). The Advocacy Charter (Poster). Available at: <a href="https://www.ndti.org.uk/assets/files/Advocacy-Charter-A3.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/Advocacy-Charter-A3.pdf</a> [Accessed 16/02/2022]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
National Development Team for Inclusion. (2018). The Easy Read Advocacy Charter (Poster). Available at: <a href="https://www.ndti.org.uk/assets/files/The-Advocacy-Charter-Easy-Read.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.ndti.org<wbr style="display:inline-block"></wbr>​.uk/assets/files/The-Advocacy-Charter-Easy-Read.pdf</a> [Accessed 16/02/2022]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
National Development Team for Inclusion. (2018/2019). The Quality Performance Mark Advocacy standards. Assessment Workbook Quality Performance Mark. A National Development Team for Inclusion programme
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
National Development Team for Inclusion and Empowerment Matters CIC. (2014) Advocacy Quality Performance Mark (QPM). Recognising Quality in independent advocacy. Code of Practice 2014
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Newbigging, K., Ridley, J., McKeown, M., Machin, K., Poursanidou, D., Able, L., et al. (2012). The Right to Be Heard: Review of the Quality of Independent mental Health Advocate (IMHA) Services in England, University of Central Lancashire. Available at: <a href="https://www.firah.org/upload/notices3/2012/uclan.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.firah.org<wbr style="display:inline-block"></wbr>​/upload/notices3/2012/uclan.pdf</a> [Accessed 13/05/2021]
|
|
</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No key findings or recommendations relevant to Monitoring services and collecting data for quality improvement</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Newbigging, K., Ridley, J., McKeown, M., Machin, K., Sadd, J., Machin, K., et al. (2015). Independent Mental Health Advocacy – The Right to Be Heard: Context, Values and Good Practice. Jessica Kingsley Publishers: London, UK.
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is a book/book-chapter.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Newbigging, K., McKeown, M., French
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B. (2011). Mental health advocacy and African and Caribbean men: Good practice principles and organizational models for delivery. Health Expectations, 16(1), 80–104. [<a href="/pmc/articles/PMC5060645/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5060645</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21645185" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21645185</span></a>]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No key findings or recommendations relevant to Monitoring services and collecting data for quality improvement</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Older People’s Advocacy Alliance (2014). Every Step of the Way. 13 stories illustrating the difference independent advocacy support makes to older people affected by cancer. available at: <a href="https://opaal.org.uk/app/uploads/2015/09/Advocacy-Stories.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://opaal<wbr style="display:inline-block"></wbr>​.org.uk<wbr style="display:inline-block"></wbr>​/app/uploads/2015/09/Advocacy-Stories<wbr style="display:inline-block"></wbr>​.pdf</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Older People’s Advocacy Alliance (2016). Facing Cancer Together. Demonstrating the power of independent advocacy. Available at: <a href="https://opaal.org.uk/app/uploads/2016/12/Facing-Cancer-Together.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://opaal<wbr style="display:inline-block"></wbr>​.org.uk<wbr style="display:inline-block"></wbr>​/app/uploads/2016/12<wbr style="display:inline-block"></wbr>​/Facing-Cancer-Together.pdf</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Older People’s Advocacy Alliance (2017). Time: Our Gift to You – why cancer advocacy volunteers support their peers. Available at: <a href="https://opaal.org.uk/app/uploads/2017/02/Time-our-gift-to-you.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://opaal<wbr style="display:inline-block"></wbr>​.org.uk<wbr style="display:inline-block"></wbr>​/app/uploads/2017/02<wbr style="display:inline-block"></wbr>​/Time-our-gift-to-you.pdf</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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SERIO (2021). The Veterans’ Advocacy People: Final Evaluation Report and Social Return on Investment Analysis, The Advocacy People. Available at: <a href="https://www.vfrhub.com/wp-content/uploads/2021/01/898ed6_d72d832632234777aa1b5b68e8c314e6.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.vfrhub.com<wbr style="display:inline-block"></wbr>​/wp-content/uploads<wbr style="display:inline-block"></wbr>​/2021/01/898ed6_d72d832632234777aa1b5b68e8c314e6.pdf</a> [Accessed 06/04/2021]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No key findings or recommendations relevant to Monitoring services and collecting data for quality improvement</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Social Care Institute for Excellence, University of Central Lancashire (2015). At a glance 68: Understanding Independent Mental Health Advocacy (IMHA) for people who use services. Available at: <a href="https://www.scie.org.uk/independent-mental-health-advocacy/resources-for-users/understanding/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.scie.org<wbr style="display:inline-block"></wbr>​.uk/independent-mental-health-advocacy<wbr style="display:inline-block"></wbr>​/resources-for-users<wbr style="display:inline-block"></wbr>​/understanding/</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Social Care Institute for Excellence, University of Central Lancashire (2015). At a glance 68: Understanding Independent Mental Health Advocacy (IMHA) for people who use services, easy read version. Available at: <a href="https://www.scie.org.uk/independent-mental-health-advocacy/resources-for-users/understanding/easy-read/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.scie.org<wbr style="display:inline-block"></wbr>​.uk/independent-mental-health-advocacy<wbr style="display:inline-block"></wbr>​/resources-for-users<wbr style="display:inline-block"></wbr>​/understanding<wbr style="display:inline-block"></wbr>​/easy-read/</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Social Care Institute for Excellence, University of Central Lancashire (2014). At a glance 67: Understanding Independent Mental Health Advocacy (IMHA) for mental health staff. Available at: <a href="https://www.scie.org.uk/independent-mental-health-advocacy/resources-for-staff/understanding/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.scie.org<wbr style="display:inline-block"></wbr>​.uk/independent-mental-health-advocacy<wbr style="display:inline-block"></wbr>​/resources-for-staff<wbr style="display:inline-block"></wbr>​/understanding/</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Social Care Institute for Excellence and University of Central Lancashire (2015). Flowchart for Open Access IMHA. Available at: <a href="https://www.scie.org.uk/independent-mental-health-advocacy/resources-for-staff/improving-access/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.scie.org<wbr style="display:inline-block"></wbr>​.uk/independent-mental-health-advocacy<wbr style="display:inline-block"></wbr>​/resources-for-staff<wbr style="display:inline-block"></wbr>​/improving-access/</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Social Care Institute for Excellence, University of Central Lancashire (2015). Improving access to Independent Mental Health Advocacy for providers of mental health services. Available at: <a href="https://www.scie.org.uk/independent-mental-health-advocacy/resources-for-staff/improving-access/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.scie.org<wbr style="display:inline-block"></wbr>​.uk/independent-mental-health-advocacy<wbr style="display:inline-block"></wbr>​/resources-for-staff<wbr style="display:inline-block"></wbr>​/improving-access/</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Social Care Institute for Excellence, University of Central Lancashire (2015). Improving equality of access to Independent Mental Health Advocacy (IMHA): a briefing for providers. Available at: <a href="https://www.scie.org.uk/independent-mental-health-advocacy/improving-equality-of-access/briefing/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.scie.org<wbr style="display:inline-block"></wbr>​.uk/independent-mental-health-advocacy<wbr style="display:inline-block"></wbr>​/improving-equality-of-access/briefing/</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Social Care Institute for Excellence and University of Central Lancashire (2015). Improving equality of access to Independent Mental Health Advocacy (IMHA): a report for providers. Available at: <a href="https://www.scie.org.uk/independent-mental-health-advocacy/improving-equality-of-access/report/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.scie.org<wbr style="display:inline-block"></wbr>​.uk/independent-mental-health-advocacy<wbr style="display:inline-block"></wbr>​/improving-equality-of-access/report/</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Social Care Institute for Excellence, University of Central Lancashire (2015). Commissioning Independent Mental Health Advocacy (IMHA) services in England: 10 top tips for commissioners. <a href="https://www.scie.org.uk/independent-mental-health-advocacy/measuring-effectiveness-and-commissioning/10-top-tips.asp" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.scie.org<wbr style="display:inline-block"></wbr>​.uk/independent-mental-health-advocacy<wbr style="display:inline-block"></wbr>​/measuring-effectiveness-and-commissioning/10-top-tips.asp</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Social Care Institute for Excellence, University of Central Lancashire (2015). What does a good IMHA service look like? (Self-assessment tool) Available at: <a href="https://www.scie.org.uk/independent-mental-health-advocacy/measuring-effectiveness-and-commissioning/what-good-imha-service-looks-like/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.scie.org<wbr style="display:inline-block"></wbr>​.uk/independent-mental-health-advocacy<wbr style="display:inline-block"></wbr>​/measuring-effectiveness-and-commissioning<wbr style="display:inline-block"></wbr>​/what-good-imha-service-looks-like/</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Social Care Institute for Excellence, University of Central Lancashire (2015). Making a difference: measuring the impact of Independent Mental Health Advocacy (IMHA). Available at: <a href="https://www.scie.org.uk/independent-mental-health-advocacy/measuring-effectiveness-and-commissioning/impact/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.scie.org<wbr style="display:inline-block"></wbr>​.uk/independent-mental-health-advocacy<wbr style="display:inline-block"></wbr>​/measuring-effectiveness-and-commissioning/impact/</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Strong, S. (2012). User-led organisation leadership of support planning and brokerage. The International Journal of Leadership in Public Services, 8(2), 83–89.
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Taylor & Francis Production Disability and Rehabilitation (IDRE). My Life Tool (self-management tool): <a href="http://www.mylifetool.co.uk" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">www<wbr style="display:inline-block"></wbr>​.mylifetool.co.uk</a>
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Teeside University (2015/2016). UTREG Online Module Specification. Advocacy - Evolution, Equality and Equity. Unpublished
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Townsley, R., Marriott, A., Ward, L. (2009). Access to independent advocacy: an evidence review, Office for Disability Issues. Available at: <a href="http://www.bristol.ac.uk/media-library/sites/sps/migrated/documents/iar-exec-summary-standard.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.bristol.ac<wbr style="display:inline-block"></wbr>​.uk/media-library/sites<wbr style="display:inline-block"></wbr>​/sps/migrated/documents<wbr style="display:inline-block"></wbr>​/iar-exec-summary-standard.pdf</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not published in the last 10 years</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Turner, S., Giraud-Saunders, A. (2014). Personal health budgets: Including people with learning disabilities, Think Local act Personal. Available at: <a href="https://www.thinklocalactpersonal.org.uk/_assets/Reports/TLAPIncludingLD.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.thinklocalactpersonal<wbr style="display:inline-block"></wbr>​.org.uk<wbr style="display:inline-block"></wbr>​/_assets/Reports/TLAPIncludingLD.pdf</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication is based on case-studies.</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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VoiceAbility (2021). STOMP and STAMP: Stopping the over medication of children, young people and adults with a learning disability, autism or both.
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr><tr><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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VoiceAbility (2021). Preventing over-medication: STOMP top tips for advocates: How you can help to stop the over-medication of people with a learning disability, autism or both. Available at: <a href="https://www.voiceability.org/assets/download/STOMP-2021B.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.voiceability<wbr style="display:inline-block"></wbr>​.org/assets/download/STOMP-2021B.pdf</a> [Accessed 16/02/2022]
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</td><td headers="hd_h_niceng227er11.appd.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication has no evidence base</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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