Social workers from other counties often comment upon the narrow understanding of social work that appears to exist in England. This perception could be due in part to the prominent statutory role social workers undertake within local authorities. This could help explain why the unique value contemporary social work practice contributes to people’s effective health and wellbeing sometimes gets lost.
Along with primary causes of disease, ill health and injury, addressing social factors is essential to effective health care and the overall health and wellbeing of individuals and communities. Research, meanwhile, continues to identify the social and economic determinants of health. Also, our broad professional knowledge, skills and holistic approach to the wellbeing of individuals and communities demonstrates our understanding of the physical, emotional and environmental factors involved in delivering effective health care.
Through our unique and multi-layered perspective, social work professionals intervene with the person in the context of their social environments and relationships. We recognise the impact on the health and wellbeing of individuals and families of a whole range of factors including social, cultural, economic, psychological, political and legal matters.
Social workers within the health system do two things. Firstly, they concern themselves with people who are vulnerable as a consequence of physical, emotional and situational difficulties – any or all of which may be temporary or on-going. Secondly, they engage with people to help maximise their recovery and enable medical and allied health practitioners to support them to achieve the best health and social outcomes.
Social issues are frequently complex and take up valuable time, often requiring on-going support to resolve. It makes sense to invest in social workers to provide this support. We are experts in building relationships to understand people’s complex needs, intervening to promote skills for independent living, and coordinating a range of support. We intervene with people across their lifespan with concerns arising from chronic illness and palliative care, acute trauma, mental health, infant and adult bereavement, suicide and carer stress. We also contribute advanced practice expertise in many areas including mental health, child abuse and neglect, safeguarding adults, brain injury, bereavement and loss, palliative care, research and policy.
Core and unique to the social work scope of practice - in any health setting - is undertaking comprehensive and evidence-based psycho-social assessment. These assessments range from targeted and brief specific-needs analysis, to a more comprehensive and holistic analysis of psycho-social factors and degrees of risk.
At an organisational level, social work provides significant value in reducing health service demand by facilitating individuals’ timely and seamless transition through the health and care system. This involves rigorous discharge planning, the establishment of strong, supportive, family and community networks and access to appropriate resources, all with the aim to prevent multiple readmissions.
Social work should be an area the health and care sector wants to invest in, above and beyond local authority investment. I hope that, as plans for greater integration of health and social care progress, principal decision makers will agree!
I know many social workers are engaging with the Law Commission’s current review of the Deprivation of Liberty Safeguards (DoLS). If you haven’t contributed I would strongly encourage you to do so now. I know how great the demands on your time are but this consultation is a truly valuable opportunity for us all to demonstrate our enthusiasm for leading and taking even greater responsibility in this area.
Personally, I believe the proposal by the Law Commission for an Approved Mental Capacity Professional (AMCP) is recognition of the wide regard in which Best Interest Assessors (BIAs) are held. The AMCP proposal reflects my belief that the future for social workers lies in recognised advanced accreditations and developing specialised skills. The AMCP role will require social workers to hold to account professionals across all health and care settings. In many ways this is nothing new – social workers are already taking the message of holistic person-centred care into the NHS. The proposal is an opportunity to further this vital work and be recognised properly for our contribution. The Law Commission’s consultation is open until 2 November 2015.
Finally, the National Institute for Health and Care Excellence (NICE) are recruiting members for one of their guideline committees on service models for ‘people with learning disabilities and behaviour that challenges’ and I would encourage social workers to apply.