A report on advocacy services in the NHS in London says they are suffering from 'precarious short-term funding', a lack of pay and little formal training.

The report comes as the Kings Fund today launches a new£1m programme to step up health advocacy for black and ethnic communities.

With support from NHS London regional office, the millennium grant will be spent on developing quality standards, accredited training and a new network for advocates.

Many advocates said GPs were indifferent or hostile towards them.

Some said barriers they faced with GPs reflected 'wider inequalities in service delivery at a primary care level'.

One provider concluded that this was 'actually racism: institutional racism that needs to be addressed, because GPs are serving the community in a very non-appropriate manner'.

The report concludes that advocacy plays a vital part in giving people from minority ethnic communities fair access to the NHS services and ensures the development of culturally sensitive services.