Page Section: Centre Content Column
Advocacy Guidelines
Year: 2005
Publication Date: 24 March 2005
Page Number: 1433
Title: Advocacy Guidelines for the Nationwide
Advocacy Service
Notice Text: Advocacy Guidelines for the
Nationwide Advocacy Service Pursuant to section 28 (1) of the
Health and Disability Commissioner Act 1994 ("the Act"), I, Annette
King, Minister of Health, hereby approve the following guidelines
made by the Health and Disability Commissioner.
Dated at Wellington this 15th day of March 2005. ANNETTE KING,
Minister of Health.
Gazetted publication.
Governing Guidelines
Advocacy Practice Guidelines
Management Practice Guidelines
1. Empowerment Principle
The concept of rights is inherently linked to the empowerment
principle. Advocacy is committed to the belief that consumers
already have skills and experience on which to draw to assist them
in resolving their concerns. Advocates are required to be a strong
voice for those consumers who have limited ability to
self-advocate, or who are likely to be experiencing institutional
discrimination. A consumer-centred and flexible focus with access
to a continuum of empowering strategies is required to ensure the
most appropriate approach for each consumer. Working in an
empowering way is based on the belief that it is better to equip
and support consumers to solve their own problems than to take over
their problems and fix them on their behalf. The empowerment
principle supports the consumer to resolve the current issue with
assistance, and to learn skills and knowledge to develop confidence
to self-advocate if and when similar issues arise in the
future.
2. Low-Level Resolution
The intention of the Act and the Code of Health and Disability
Services Consumers' Rights ("the Code") is to promote resolution of
complaints at the lowest appropriate level. Often the quickest and
most satisfactory way of dealing with grievances is for the
consumer to deal directly with the actual provider of the service.
The nationwide advocacy service established under the Act is
therefore fundamental to this aim of low-level resolution.
3.
Code of Practice
Advocacy service providers and advocates shall comply with the
Code as if they were providers for the purposes of the Code, except
where such compliance is inconsistent with these guidelines.
4.
Interpretation of and Comment on Rights
Advocacy service organisations and individual advocates shall
refer any request for interpretation of the Code to the
Commissioner.
Advocacy service organisations and individual advocates shall
not offer opinions about the interpretation of the Code or other
rights except to refer consumers, providers or media to any
relevant decisions or statements by the courts, Human Rights Review
Tribunal or the Commissioner and to assist consumers or providers
to understand those decisions and statements.
5. Quality
It is important that the quality and effectiveness of the
advocacy service is monitored and evaluated regularly and that
improvements to the service are made on the basis of feedback from
consumers, complainants, providers and advocates.
Advocacy Practice Guidelines
6.
Empowered
Consumers Consumers remain in control and take responsibility
for their issues, concerns and rights. Advocates, through
empowerment advocacy and encouragement, assist all consumers and
other complainants to act on their own behalf. If the consumer is
unable to act on his or her own behalf or it is culturally
inappropriate for the consumer to speak on his or her own behalf
and requests the advocate to do so, the advocate may accept
instructions to act or assist on behalf of the consumer.
7. Protecting
the Wider Body of Consumers
Advocates may have concerns about a provider's practice or any
other matter that relates to the rights of health consumers or
disability consumers or both (whether in relation to a particular
consumer, a group of consumers or consumers generally).
These concerns may have arisen through an advocate working with
a consumer who is unwilling or unable to complain, or from trends
identified by the advocate in the course of his or her work, or
from concerns raised by others in the community. The concerns can
relate to an individual provider's practice, a group of providers'
practice, and/or systems and processes used by the provider/s, or a
combination of provider practice and the systems and processes
being used. When concerns are not confined to a specific provider's
practice or a specific system or process, it is sometimes referred
to as being a "systemic" concern.
In order to protect the wider body of consumers and ensure the
proper accountability of providers, an advocacy service may contact
providers directly about the concerns raised, or draw the matter
directly to the Commissioner's attention.
The advocacy service can contact the provider directly in the
first instance when concerns can be appropriately resolved at a low
level. The service manager shall notify the Director of Advocacy of
all direct contacts about systemic and non?systemic concerns made
by advocates, in the absence of a formal complaint.
An advocate shall refer systemic and non-systemic concerns that
cannot be dealt with appropriately with low level resolution
directly to the Health and Disability Commissioner. A referral
shall also be made where the concern has been raised previously by
the advocacy service, and the provider has not responded or taken
appropriate action.
8.
Priorities
Persons who are least able to self-advocate, and those persons
whose welfare is most at risk and who do not have an appropriate
support person, are the priority for all inquiry and complaint
advocacy services to consumers. Those considered as having their
welfare most at risk are likely to be consumers who may experience
two or more of the following:
- Very little social contact
- little or no family support
- difficulty in communicating and being understood
- living in a situation where physical, emotional, mental or
financial abuse by an informal or formal caregiver is threatened or
has occurred
- mental illness and/or drug or alcohol addictions that may
impede their ability to reason and/or be understood or taken
seriously.
It is important for advocates to establish, build and maintain
positive working relationships with informal and formal
providers/caregivers where the consumer whose welfare is most at
risk is required to use the ongoing services of the provider or
caregiver.
9. Consumer
Interdependence
When working with consumers, advocates assist and encourage them
to develop their own support networks. This enables them to remain
in control and take responsibility for their own issues, concerns
and rights. Ongoing support networks may include family, extended
family, friends and neighbours, other consumers, paid professionals
or advocacy groups to meet their ongoing advocacy needs and to
assist in the resolution of their issues. Health and disability
consumer advocacy may be used in conjunction with a consumer's
network of support people.
10. Role of
Advocates
An advocate provides information, facilitates, and makes it as
easy as possible for the consumer to pursue and resolve his or her
concerns and issues with advocacy support. An advocate provides
assistance to consumers to pursue a complaint through any informal
or formal procedures, including proceedings before a health
professional body.
An advocate assists a consumer to gain knowledge, and offers
skill training to assist the consumer to develop confidence to
represent herself/himself. This is so that the consumer is
supported to resolve the current issue with assistance and to
resolve future issues, where possible, using the skills and
knowledge gained through working alongside an advocate.
When assisting a consumer, advocates shall not offer opinions as
to whether there has been a breach of the Code. The advocate
represents or assists the consumer to resolve issues. While
advocates may need to obtain information about a consumer's
concerns, they shall not investigate or adjudicate on issues
raised, nor act as an impartial mediator.
If resolution is not achieved, the advocate shall, if requested
by the consumer, assist the consumer in finding an appropriate
forum where issues raised may be mediated or complaints may be
investigated. This can involve the advocate in supporting a
consumer through the Health and Disability Commissioner complaint
processes and/or the Director of Proceedings processes.
11. Advocates' Role with
Providers
Advocacy services and advocates support consumers who believe
their rights under the Code have been breached. Advocates convey
the consumer's issues, concerns and/or complaints, not their own.
Advocates are on the side of the consumer and may present some
challenging situations to the provider, but this does not prevent
them from being fair, considerate and professional in all their
dealings with providers.
Advocates do not offer an opinion as to whether there has been a
breach of the Code, nor are they impartial mediators, investigators
or adjudicators. Advocates give free presentations to provider
group, on advocacy services, the Health and Disability Commissioner
role, the Code, and the complaints processes available to
consumers. Presentations should, where possible, be in a format
appropriate to the needs of the audience.
12. Confidentiality
Advocacy services and advocates shall not make statements to the
media, or in presentations, or in personal communications that
identify individual consumers or providers, nor comment whether
specific actions by providers, either real or hypothetical, are or
would be in breach of the Code. Advocates shall comply with the
Advocacy Service Organisation's media policy, which upholds this
guideline.
Management Practice Guidelines
13. Consumers' Needs and
Accessibility
Subject to the priorities imposed in Guideline 8 of these
guidelines, advocacy service providers and advocates shall take
positive steps to ensure that they are able to meet the needs of
any particular person or groups of persons for whom they have
contracted with the Director of Advocacy to provide services.
Advocacy service providers shall therefore take positive steps to
ensure advocacy services are equally accessible to all groups of
consumers.
Specialist nationwide advocacy services may be contracted with
the Director of Advocacy to provide consumers with specialised
advocacy. Advocates shall inform consumers of the availability of
such nationwide advocacy services and any existing specialised
community support groups.
14. Advocate Support
Advocacy service providers shall ensure that appropriate support
systems are in place for individual advocates. This may include
induction, training, performance management, peer supervision via
support and review, risk management procedures, physical safety and
appropriate specialist support.
15.
Relationship of the Service Provider to Consumer
Advocacy service providers, rather than individual advocates,
are contracted to provide services to the consumer. Consumers shall
be advised that the advocate is providing the service as an
employee of the advocacy service provider.
16. Referrals
to Other Agencies
Advocacy service providers shall establish and maintain
effective links with relevant agencies, including community groups,
and refer consumers to those agencies as and when appropriate.
17. Information Systems
The collection, accurate recording and transfer of information
pertaining to the services provided by advocacy organisations,
including trends in consumer issues, assists in the efficient and
effective management of advocacy services. It provides valuable
information as to the present and future needs of consumers and the
need for any improvements to the service.
Reporting requirements in line with contractual obligations
shall be facilitated by the use of information systems approved by
the Health and Disability Commissioner.
18. Publicity
and Promotion
The integrity (principles and professionalism) of the advocacy
service is maintained by ensuring consistency in all publicity
provided about the Health and Disability Commissioners' Advocacy
Service. The Health and Disability Commissioner will provide all
generic promotional and educational material, about the Code and
the role of the Commissioner, directed to consumers and providers.
Promotional and educational material will, where possible, be in
accessible formats for consumers. Any specific promotional and
educational information produced by individual advocacy service
providers will be sent to the Director of Advocacy, prior to
publication, for comment. Formal public speaking engagements and
papers for publication by advocacy service providers and individual
advocates will be notified in advance to the Director of Advocacy
for comment.
Explanatory Note
The first Health and Disability Commissioner's Advocacy Service
Guidelines were approved in 1996. The Minister of Health approved
the revised and updated guidelines on 24 February 2005 following a
comprehensive consultation process where opportunities for comment
were extended to a wide range of people and organisations that
included representatives of health consumers, disability services
consumers, health care providers, disability services providers and
professional bodies.
The revised guidelines reflect the development and maturity of
the nationwide advocacy service and have taken into account the
responses received during the consultation process. The new
guidelines also clarify the distinction between governing,
management and advocacy practice guidelines.
Free copies of the guidelines will be available to the public on
the Health and Disability Commissioners' web site
http://www.hdc.org.nz or directly from the Health and Disability
Commissioner, the Director of Advocacy or from any of the three
advocacy organisations providing Health and Disability
Commissioner's advocacy services by phone (0800 11 22 33) or email
requests (hdc@hdc.org.nz).