1. Black Belt Advocacy , Systemic Advocacy Themes
Statutory Advocacy always involves a 1 to 1 relationship where an independent advocate provides support to a person on a specific issue. This is mostly referred to as issue based advocacy – because the focus is usually given to supporting a person achieve specific outcomes (or represent them through a specific decision like in IMCA).
But not all advocacy takes place within the privileged and trusted space of a 1 to 1 relationship. Systemic advocacy describes the way advocacy organisations can deal with problems that are inherent in systems – or the way services are organised and delivered.
There are two ways you and your service can consider using systemic advocacy to change the way health and care services are delivered and improve the experiences of people who use them :
Themes
Advocacy services will support a number of people over a year. By looking at the types of support people are requesting help with, the advocacy service can collate these themes and raise them as issues that could be indicative of systemic problems
For instance, if over a 4 week period, 10 people complain about the lack of information during assessment process, this could suggest that there are inherent problems in the way the assessment process is being delivered. The individual advocates will be supporting each individual to raise their own personal concern and gain access to accessible information However systemic advocacy allows the service to raise this as an issue with the Local Authority assessment team to let them know that people are routinely experiencing problems.
Its almost as if the advocacy service are helping the health or care service improve their own systems through listening to the collective experience of people who use them. People do not need to be identified, rather it is the concerns that are being shared.
Listen to your experience
Another approach to employing systemic advocacy is to use your collective experience of what isn’t working.
Any good advocacy service will know what is going wrong in its area – where are the pressure points, what needs to change to
“By looking at the types of support people are requesting help with, the advocacy service can collate themes and raise them as issue that could be indicative of system wide problems”
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2. Black Belt Advocacy , Food for Thought
make things better for people who use services.
Advocates will come across grey practice that might raise concerns but not enough to justify a complaint or whistleblowing. Its these ‘opportunities for improvement’ that an advocacy service can highlight if they have the right relationship with the commissioner or service manager.
Use your knowledge that a particular team never refers to advocacy, or experience that a helpline caller is so abrupt the person would rather end the call then persevere talking to an unhelpful helpline. Remember the times when care home staff are too busy to help people finish their meal and feed it back to them so they can do something about it.
Starters to adopt systemic advocacy
We know that systemic advocacy is not something that happens all by itself. If you want to get better at systemic advocacy (or start!) have a think about the following activities:
Get a database or CRM system that allows your advocate to record issues, problems and outcomes. All advocacy services need an electronic system that can pull off data to show themes, trends that you can take action on. We love the advocacy purpose built
Set aside time. Build in time to review and analyse your data. This means a regular analysis of the themes people are raising or complaining and collating this into succinct themed issues to take to the commissioner.
Listen to your advocates. The Advocates will know where the pressure points are and where the unspoken concerns are. Listen to them and give them a voice to share these concerns early.
Don’t be afraid. Remember that advocates are magnificent rhinos. Use your charm to influence the people to take on board these concerns. Where the information falls on un-interested ears use your thick skins to complain and push for collective change. There are bodies like CQC and HealthWatch who have duties to respond to concerns so use these forums where appropriate
The goal is not to be a trouble maker but to offer insight into what is not working. Become an indispensable part of the Local Authority early warning sign that things might not be okay.