Recurring concern
Inadequate formal patient advocacy support for people with complex care needs
First reported 27 Feb 2018•Latest report 16 May 2022
What this concern includes
Includes failures of formal or designated patient-advocacy arrangements for people with complex care needs, including failure to identify advocacy needs, appoint or provide an advocate, support communication with care providers, filter or explain distressing information, manage complex care correspondence and appointments, and prevent care arrangements from placing an unreasonable advocacy burden on the patient or family.
Not included
- Excludes ordinary family involvement, family communication or family participation in care decisions where no patient-advocacy support deficiency is identified.
- Excludes statutory advocacy systems, such as an Independent Mental Capacity Advocate or Independent Mental Health Advocate, when the assertion is specifically about that named statutory process.
- Excludes generic communication, appointment, care-coordination or documentation failures unless they directly leave a patient without required advocacy support.
- Excludes disagreements about treatment or care where the patient has access to appropriate advocacy and the advocacy arrangement itself is not deficient.
- Excludes generic family support or informal advocacy where no formal or designated patient-advocacy need or system failure is asserted.
- Reports
- 2
- Individual concerns
- 2
- Date range
- 2018–2022
- Stated actions
- 3
Distinct published reports
A report can raise multiple concerns
First to latest report issue date
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
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Concerns raised1
Overreliance on family members to advocate for the patient
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Communicate with service users and families, including families in care planning, to establish a shared understanding of risk management.
Stated by Sheffield Health Partnership University NHS Foundation Trust -
Action
Ensure complex clinical decisions consider multidisciplinary risk information and service-user and family views, with decisions clearly recorded.
Stated by Sheffield Health Partnership University NHS Foundation Trust
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Concerns raised1
Lack of a formal patient advocate system for patients needing support with distressing treatment news and complex care arrangements
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Register the advocacy matter with commissioners.
Stated by Norfolk and Suffolk NHS Foundation Trust
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
Commissioners, rather than the Trust, are responsible for commissioning advocacy services; access otherwise depends on consent or statutory frameworks.
Stated by Norfolk and Suffolk NHS Foundation Trust
Data last updated 7 September 2026