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Involvement and choice - you will be involved as much as you want and are able to be

Speaking to patients

Services only work when the people who use them are equal partners in the care process.

We will take into account peoples history and culture, particularly around communication and access, and respect.

The service will protect your rights, as well as those of other people, and will protect you and others from harm wherever possible.

We will always try to make sure that people are involved as much as they want and are able to be, and have choices wherever possible.

We want to support you to make informed choices through:

  • taking part in planning your own care and understanding the care, treatment and support choices you have

  • consider the range of options and then you can make your choice to achieve your shared goals 

  • having information to help you make informed choices and decisions about things like psychological therapy and medication

  • being involved in working out what circumstances make your health worse, and using advance decisions if you want to, to say what you would like to happen

  • having family and carers involved in decisions about your care when appropriate

 

Sometimes your ability to make decisions and understand the impact of them can fluctuate.  We will take this into account and ask you questions or your thoughts at different times of the day or in different stages of your life.  This is really important that we give you the opportunity to really think through decisions even when you might be unwell.  If you are not able to make decisions, we will help to protect and empower you.

For local Advocacy services, please see below under 'Advocacy'

“You have the right to make choices about your NHS care and to information to support these choices. The options available to you will develop over time and depend on your individual needs.” “You have the right to be involved in discussions and decisions about your healthcare, and to be given information to enable you to do this.”NHS Constitution

  • Taking account of differences in and barriers to effective communication including making provision for languages other than English.

  • Being aware that everyone's communication ability varies depending on physical and mental health and many other factors

  • Respecting your rights to privacy and confidentiality

  • Promoting equality, recognising respecting and valuing diversity

  • Applying principles of person-centred approaches in assessment, care planning, review and discharge

  • Telling you about the risks and benefits of any intervention or treatment, including the potential side effects of any medication

  • Identifying any networks of support you have

  • Protecting your interests where your capacity to make decisions is impaired

  • Offering opportunities for Self Directed Support, such as Direct Payments, Individual Budgets etc. where these apply, or signposting to agencies that can help

  • Listening to what care you do and do not want, including any Advance Directive or Statement of Wishes you make

  • Working within safeguarding procedures

 

We also comply with any legislation in this area, such as the Mental Health Act Code of Practice 2008 which says:

‘Patients must be given the opportunity to be involved, as far as is practicable in the circumstances, in planning, developing and reviewing their own treatment and care to help ensure that it is delivered in a way that is as appropriate and effective for them as possible. The involvement of carers, family members and other people who have an interest in the patient’s welfare should be encouraged (unless there are particular reasons to the contrary) and their views taken seriously.’   

We want to make sure you can access the information you need.         

  • If you need information in another language, click on the buttons at the bottom of the front page to translate the whole site, or contact us for a leaflet translation

  • If you prefer Easy Read, click here

  • If you need a care plan or other form translating, let us know

  • If you need the text larger to be able to read it better, click on the text size at the very top of the page - the bigger the letter A you click on, the bigger the text will get

Mental Capacity

Every day we make decisions about lots of things in our lives. The ability to make these decisions is called mental capacity. People may have difficulty making decisions some or all of the time. This could be because they have:

  • a learning disability
  • dementia
  • a mental health problem
  • a brain injury
  • had a stroke

 

If we are concerned that you may not have the capacity to make major decisions about your health and welfare (including personal care), property and financial affairs, or where you live, we will assess your capacity to make these decisions. If you are unable to make some decisions, the Mental Capacity Act says:

  • you should have as much help as possible to make your own decisions
  • people should assess if you can make a particular decision
  • even if you cannot make a complicated decision for yourself, this does not mean that you cannot make more straightforward decisions
  • even if someone has to make a decision on your behalf you must still be involved in this as much as possible
  • anyone making a decision on your behalf must do so in your best interests

 

The Mental Capacity Act (2005) provides a framework to protect and empower vulnerable people who are not able to make their own decisions. See below for a brief guide to the main provisions of the Act.

Service Users/Patients

Please click here for a booklet Making decisions: who decides when you can't?

Carers

Please click here to find out about Carers and the Mental Capacity Act and a booklet Making decisions: a guide for familiy, friends, and unpaid carers. Carers and advocates will normally be involved in planning care, and in any reviews.

Advocacy is a way of giving people a voice

There are different models of advocacy:

  1. Self-advocacy: this is where people speak for and represent themselves, with some support
  2. Peer advocacy: where the advocate has common ground with the person being represented, such as shared experience
  3. Volunteer Citizen advocacy: Unpaid volunteers who represent the persons views
  4. Professional Advocacy: A paid trained advocate who provides advice and support


If you need someone to help you have a voice in discussions, you might want to think about having an advocate. You can bring a friend, family member or carer, or use a volunteer or paid advocate.
You can access different types of advocacy support, this may depend on where you live or what you need help with.

Specialist advocacy and representation is available for people with mental health problems who have substantial difficulty in being involved in their own care. This includes people who qualify under the Mental Health Act (IMHA service) and/or the Mental Capacity Act (IMCA service).  Click here to read about Advocacy Services in Derbyshire and Derby City

Contact:

  • If you live in Derbyshire -  Derbyshire Mind, Tel: 01332 623732. Click here for more information

  • If you live in Derby City - ONE Advocacy Derby, Tel: 01332 228748. Click here for more information
     

Independent Community Advocacy

Independent Community Advocacy is a new requirement on Local authorities.  If you are likely to have substantial difficulty in being involved in your care and if you do not have an appropriate person to support you the Local Authority has a duty to arrange independent advocacy.

  • If you live in Derbyshire -  Derbyshire Independent Community Advocacy Service, Tel: 01332 623732. Click here for more information

  • If you live in Derby City - ONE Advocacy Derby, Tel: 01332 228748. Click here for more information 

 

imca

Independent Mental Health Advocacy Service(IMHA)

From the 1st April 2009, changes in the law meant that some patients have a legal entitlement to the specialist help of an IMHA.  The service is available to anyone who is detained under the Mental Health Act

IMHA's help people to understand and exercise their rights in relation to the Mental Health Act, this can include representing them and speaking on their behalf in a variety of settings including ward rounds, CPA meetings and tribunals.  The Mental Health Act Code of Practice provides further information on the role, rights and responsibilities of the IMHA's. 

Advocates offer independent support to help people express their views and wishes in relation to the mental health services they are using or wishing to access. 

Click here to find out more about Derbyshire County IMHA Service
Contact details: Derbyshire Mind, Derby West Business Centre, Ashbourne Road, Mackworth, Derby, DE22 4NB.  Tel. 01332 345966. email enquiries@derbyshiremind.org.uk

Click here to find out more about Derby City IMHA Service
Contact details: ONE Advocacy, Stuart House, Green Lane, Derby,  DE1 1RS. Tel: 01332 228748.

 

What is an advance decision?

The term advance decision (previously known as an 'advance directive', or a 'living will'). means a statement explaining what medical treatment the individual would not want in the future, should that individual 'lack capacity' as defined by the Mental Capacity Act 2005.

It can relate to all future treatment, not just that which may be immediately life-saving.

An advance decision is legally binding in England and Wales. Except in the case where the individual decides to refuse life-saving treatment, it does not have to be written down, although most are and a written document is less likely to be challenged.

Carers and relatives

If the person you care for is aged 18 or older and has mental capacity they can appoint a personal welfare lasting power of attorney (LPA). The person who is given power of attorney (the 'attorney') will be able to make decisions about future medical treatment on their behalf if the person doesn't have the mental capacity to make the decision.

If the person you care for wishes to refuse medical treatment in the future, they should make their wishes known by making an 'advance decision'. This is made when the person still has capacity and is used if they're not able to make the decision themselves at the time of the proposed medical treatment.

If the person you're looking after makes an advance decision, you can't override it unless the LPA was made later and specifies that you have the power to do so.

What should be in an advance decision?

The code of practice in the Mental Capacity Act provides a checklist of information to be included in any written statement. The statement should include:

  • Full details of the person who is making the statement, including their date of birth, home address and any distinguishing features (so that an unconscious person, for example, could be identified).
  • The name and address of their general practitioner (GP).
  • Whether the GP has a copy of the statement.
  • Something to say that the decision is intended to have effect if the person lacks the capacity to make treatment decisions.
  • A clear statement of the decision, specifying the treatment to be refused and the circumstances in which the decision should be used or which will trigger a particular course of action.
  • The date the document was written and, if appropriate, the date it was reviewed.
  • The person’s signature. If the person can't write, they must give authority to somebody else to sign on their behalf in their presence.
  • A signature from a witness to the above (You may wish to seek legal advice about this)

For more information    

 

Your Care

 We want to help you to make informed choices through:

  • Understanding your care, treatment and support choices

  • Being a partner in decisions about your care

  • Having information to help you make choices and decisions about things like medication

  • Being involved in working out what makes your health worse or better, and using advance statements or advance decisions if you want to, to say what you would like to happen

  • Your family and carers being involved in your care when they need to be (when you’re happy with this)

 

Read more about how you can be involved in the Your Care booklet