Independent Mental Capacity Advocate (IMCA)

The Mental Capacity Act 2005 introduced the role of the Independent Mental Capacity Advocate (IMCA).

IMCAs are a legal safeguard for people who lack the capacity, and who do not have family or friends to support them, to make specific important decisions about:

  • Serious medical treatment
  • Change of accommodation
  • Care reviews
  • In adult protection cases, an IMCA may be appointed even where family members or others are available to be consulted (Safeguarding)

The IMCA role is to support and represent the person in the decision-making process. IMCA’s make sure that the Mental Capacity Act 2005 is being followed.

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IMCA Referral Form Eng

IMCA leaflet Eng&Welsh


Serious Medical Treatment

An IMCA must be instructed and consulted when:

  • an NHS body is proposing to provide, withold or stop serious medical treatment

Change of Accommodation

An IMCA must be instructed and consulted when:

  • an NHS body is proposing to place/move a person in hospital for longer than 28 days
  • an NHS body or local authority is proposing to arrange/change accommodation in a care home for more than 8 weeks

Care Reviews

The Mental Capacity Act 2005 clearly places a power on Health and Social Care professionals to instruct an IMCA during:

  • Care Reviews for people in accommodation arranged by the local authority
  • Reviews undertaken by the NHS for people receiving Continuing Healthcare
  • Care Plan reviews taking place for inpatients


The regulations set out in the Mental Capacity Act 2005, specify that local authorities and the NHS have powers to instruct an IMCA during the adult safeguarding process; even where family members or others are available to be consulted.

If the following requirements have been met:

  • Safeguarding measures are being put in place in relation to the protection of vulnerable adults from abuse*
  • a person who may have been abused*
  • a person who has been neglected*
  • a person who is alleged to be the abuser*

*where the person lacks capacity

…the NHS or local authority have the power to instruct an IMCA.


The Deprivation of Liberty Safeguards (DoLS) give additional rights and responsibilities to an IMCA, other than those assigned to them by the Mental Capacity Act 2005. Chapter 3 of the DOLs Code of Practice provides a detailed list of those rights and responsibilities.

The Deprivation of Liberty Safeguards (DoLS) is included in the Mental Capacity Act 2005 and came into force on 1 April 2009. The safeguards are designed to protect the interests of vulnerable people and to:

  • Ensure they can be given the care they need in the least restrictive regimes
  • prevent arbitrary decisions that deprive people of their liberty
  • provide safeguards for people
  • provide them with rights of challenge against unlawful detention
  • avoid unnecessary bureaucracy.

The Mental Capacity Act DoLS apply to anyone:

  • aged 18 and over
  • who has a mental disorder, such as dementia or a significant learning disability
  • who lacks the capacity to give informed consent to the arrangements made for their care and/or treatment
  • for whom deprivation of liberty (within the meaning of Article 5 of the European Convention on Human Rights) is considered, after independent assessment, to be necessary in their best interests and to protect them from harm.
  • The safeguards cover patients in hospitals, and people in care homes registered under the Care Standards Act 2000, whether placed under public or private arrangements.

An IMCA must be instructed and consulted when:

  • 39 A
    The supervisory body receives an application to deprive someone of their liberty and the relevant person has no appropriate family or friends to consult with for a Best Interest Assessment
  • 39 C
    There is a gap between the relevant persons representative leaving and the appointment of another
  • 39 D
    A person has an unpaid representative and either they or their representative asks for the support of an IMCA The supervisory body believes that without the help of an advocate the relevant person or their representative would be unable to exercise their rights.

If you would like any more information about ICMA and Dols please contact us on:

Advocacy Services North East Wales(Flintshire & Wrexham) 01352 759175

Conwy And Denbighshire Mental Health Advocacy Service (Conwy, Denbighshire, Gwynedd and Ynys Môn) 01745 816501

Mental Health Advocacy Scheme (Gwynedd and Anglesey) 01248 670450