Experiences of advocacy services in Bath and North East Somerset

This work was intended to help inform understanding of how the current advocacy provision was working in practice and to feed into future planning and recommissioning activity.

The initial focus was on exploring whether Healthwatch could support the collection of face‑to‑face feedback from individuals following advocacy sessions, while recognising the sensitivities involved and the practical constraints of advocacy delivery.

Approach taken

Healthwatch worked with commissioners and liaised directly with the current advocacy provider to understand how advocacy is delivered across different settings and what opportunities there might be to gather feedback safely and appropriately.

Discussions with the provider highlighted the varied nature of advocacy delivery. In some settings, such as mental health units, advocates may see multiple people through drop‑in services, while in other settings, such as care homes, visits may involve one or more individuals depending on circumstances. Advocates were clear that the focus of their work is on responding to individual need, which can make structured or additional engagement activity challenging alongside core casework.

Given these realities, Healthwatch supported feedback gathering primarily through an advocacy survey, rather than direct face‑to‑face engagement. This approach aimed to balance the desire to capture user experience with the need to avoid disruption to advocacy delivery or placing additional pressure on individuals at what can already be a stressful time.

Alongside the survey, Healthwatch explored with the provider whether there might be opportunities to speak with individuals, carers or next of kin who wished to share their experiences in more depth, and kept this option open where people felt comfortable and consent could be appropriately managed.

What the feedback gathered

Feedback received through the survey was generally positive about advocacy provision and highlighted the value advocates bring, particularly in supporting people through complex processes where rights, decision‑making and legal frameworks are involved.

Respondents described advocacy as helping to:

• Support people to understand information and processes
• Ensure individuals’ rights are upheld
• Give people a voice when they may not otherwise feel able to speak up
• Build confidence and reassurance during assessments, reviews and complaints processes

There was clear appreciation for the professionalism, responsiveness and consistency of advocates, with several respondents noting the importance of building relationships over time.

Feedback also identified areas for improvement, including:

• The need for more accessible information, such as easy‑read materials to support people to remember and reflect after advocacy sessions.
• Capacity pressures within the service, with some respondents feeling advocates were stretched.
• Challenges in accessing advocacy in certain circumstances, particularly for people who are out of area or require more specialist forms of advocacy.
• Practical barriers around meeting in confidential and appropriate spaces, especially within mental health settings where risk and space constraints need to be managed.

Overall, most respondents felt they achieved the outcomes they were hoping for, or something close to this, although some feedback reflected mixed experiences where system‑level constraints limited what advocacy could realistically achieve.

Constraints and learning

As with the digital engagement work, this piece of activity was carried out within a number of constraints. Advocacy work is, by its nature, highly individual and often time‑sensitive, which limits opportunities for additional engagement activity such as focus groups or extended follow‑up conversations.

Timescales, capacity pressures and the need to prioritise advocacy delivery meant that feedback gathering remained fairly light‑touch. While there was interest in exploring more in‑depth qualitative engagement, this was not fully developed during this period.

There is learning here for future engagement. Where deeper insight from people using advocacy services is desired, this may need to be planned earlier, resourced appropriately and designed in a way that fits around advocacy practice rather than alongside it.

Added value of Healthwatch involvement

Healthwatch’s role supported the collection and consolidation of feedback in a way that was proportionate and sensitive to the context of advocacy work. Acting as an independent body helped create space for honest feedback, including both positive experiences and areas where people felt the system could work better.

This activity provides evidence of engagement linked to the co‑production element of the contract, while also highlighting practical considerations and learning that can inform future work, particularly in the context of recommissioning and service development.