By Annette Bauer
In the social care area, advocacy refers to an intervention that informs service users of their rights and choices and supports them in resolving issues that have a great impact on their lives. Research at PSSRU funded by the NIHR School for Social Care Research investigated some of the costs and outcomes of advocacy provided to parents with learning disabilities who were at risk of losing their children into care. Parents with learning disabilities are a group affected by multiple disadvantages and experience a higher risk of not receiving the support they need and may, as a result, lose their children into care. On the basis of seventeen case studies and some additional project-level information we explored some of the costs and outcomes linked to advocacy. We attached economic values to outcomes based on data from the literature.
Last month the ‘Confidential Inquiry into premature deaths of people with learning disabilities’ published by the Norah Fry Research Centre reaffirmed previously found deficits in the care provided to people with learning disabilities. Among their recommendations the researchers find that effective advocacy can help to ensure this group gets the appropriate quality of care. Advocacy has been declared a potentially important driver of the personalisation of health and social services but it is also recognised that data to support this are scarce and better evidence on effectiveness and cost-effectiveness is required¹ ². The policy debate comes at a time of financial hardship for third sector organisations providing advocacy, with some local projects at risk of being (or already) closed down.
Our tentative findings suggest that savings to the public sector could exceed the estimated costs of the intervention due to reduced child safeguarding activities, reduced mental distress and improved access to early interventions. In addition, there were expected long-term benefits linked to child development outcomes such as improved school performance that were harder to quantify. Our empirical conclusions are only tentative indications of economic impact based on a limited set of information gathered in a short time; our research aims to inform the current debate and the priorities and design of further (larger scale) research.
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¹HM Government (2012) Caring for our future: reforming care and support, Social care White Paper, London.
²Rappaport J, Manthorpe J, Moriarty J, Hussein S and Collins J (2005) Advocacy and people with learning disabilities in the UK: How can local funders find value for money?, Journal of Intellectual Disabilities, 9, 219-319.