Alternatives to Litigation: Patient Advocacy: PALS, ICAS, etc.

• Introduction
• The GMC and other Professional Bodies
• NHS Complaints
• Patient Advocacy: PALS, ICAS, etc.
  • PALS: Patient Advice and Liaison Service
  • ICAS: Independent Complaints Advocacy Service
  • Northern Ireland, Scotland, and Wales
  • Where Can I Get More Information?
• Public Inquiries
• Regulatory Bodies

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ICAS: Independent Complaints Advocacy Service

What Is ICAS?

Under the Health and Social Care Act of 2001, the NHS is required to provide access to fully independent Patient Advocacy (you can read the Act by following the link at the end of this section).  This law ensures that patients who have a complaint against the NHS are empowered to pursue their concerns with advice and support.  Following the abolition of Community Health Councils (CHCs - see above), responsibility for independent Patient Advocacy has been passed on to the Independent Complaints Advocacy Service (ICAS).

Who Provides ICAS?

The actual bodies that provide ICAS vary throughout England.  In due course, this service will be commissioned by regional Patient & Public Involvement (PPI) Forums (for further information on PPI Forums, see our Regulatory Bodies page).  As an interim measure, however, the Department of Health has awarded contracts for the provision of ICAS for nine separate regions of England.  These contracts took effect on 1st September 2003.

In most - but not all - areas, the contract for the provision of ICASs has been awarded to the Citizens Advice Bureau (CAB).  You can find out which ICAS has responsibility for your region by referring to the table at the end of this section, which includes all necessary contact details.

What Can ICAS Do for Me?

The primary role of ICASs is to help patients pursue complaints arising from NHS treatment (see our separate page on NHS Complaints).

ICASs are - as the 'I' in their name suggests - independent of the NHS.  Their job is to take on the "patient's friend" role that used to be provided by CHCs.  This means that they are "on your side".  Unless your complaint against the NHS has no prospect of success (in which case, they should tell you as much, and explain their reasoning), they are there to provide whatever support you require.  If you consult your local ICAS about an NHS complaint then, depending on the circumstances of your particular case, the kind of assistance that can be provided might include:

• Advice about how the NHS Complaints Procedure works, and what options are available to you;
• Someone to support you in raising concerns, and someone to follow them up on your behalf;
• Help with writing letters and filling in forms;
• Assistance with understanding any replies you receive, and advice on what you might do next;
• Someone to arrange meetings to talk through worries with the clinician(s) about whom you have complained, or those who oversee their work; and
• Someone to accompany you to any hearings/interviews you are asked to attend.

ICASs are there to provide as much or as little support as you feel you need.  Some people simply want some initial, impartial advice, and are happy to pursue their own complaint from that point.  Others appreciate comprehensive assistance throughout the process of their complaint.  Whatever level of service you need, your local ICAS will help you on a free and confidential basis.

As we explain in our separate page on NHS Complaints, you are not allowed to seek advice from solicitors (like us) if you are pursuing the NHS Complaints Procedure.  Because of this rule, ICASs should provide your best source of support and advice.

Independent Specialist Advocacy

In a few key specialist areas - especially in Mental Health - there is already an established network of independent advocacy service providers.  Organisations such as these were in place long before the abolition of CHCs, and it is not suggested that ICASs should take over from them, when it comes to the provision of specialist advocacy.

It is envisaged that, in due course, more advocacy networks with areas of particular specialism - e.g. children's health, healthcare in the elderly, etc. - will develop.  This would mean that, in future, certain complainants would have access to support from people with special expertise in the particular type of care to which their complaint relates.  Because it would not be possible to provide a service like this on a local level, national or regional agencies would be needed.  For this reason, such services would be provided as an alternative to - rather than instead of - local ICASs.