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Abstract

The Care Act 2014 and Mental Health Act 1983/2007 place a duty on UK councils to provide an independent advocate for a baby, child or young person who has substantial difficulties being involved in their own healthcare or who may not have an appropriate person to represent them. In addition to this, independent advocates may be used in healthcare situations where babies, children and young people cannot agree with their parents or healthcare professionals over a healthcare decision, or where it is not appropriate for their parents or carers to represent them. Independent advocates provide information and an opportunity for children and young people to express their wishes and concerns about healthcare, with the reassurance that the advocates are independent from their healthcare providers and that these discussions will not impact the care they receive. Furthermore, the independent advocate develops a trusting relationship with the child or young person, empowering them to make decisions, and acts as an objective supporter. However, independent advocates can be obtained from a range of providers, with individual advocates having different competencies and experience, and there may be variation in practice and quality of support. The aim of this review is to determine how children and young people can be best represented by independent advocates.

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