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Social work adds value to integration

Posted by: , Posted on: - Categories: Consultation and engagement, Education and training, Integration

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.

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’
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’

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.

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  1. Comment by Andrew S Hatton posted on

    Social Work is also significant in work with ALL offenders.

    In Scotland the former Scottish probation services have long been fully integrated within Social Work Departments.

    I am unsure of the current situation in Northern Ireland.

    In England and Wales until about 1998 Probation Officers training was fully integrated with that of social workers with those planning to follow careers in one or other agency frequently undertaking some of their practical training within a social work or probation agency even though that was where they ultimately intended to work. To this day the pre entry social workers training is considered by the Ministry of Justice fully suitable for those who are employed as probation officers, though sadly pre entry probation officer training does not make those who qualify acceptable to Local Authority Social Work Departments.

    With Social Work Departments, usually but not exclusively called Social Services - qualified social workers continue to be the lead workers engaged with offenders under the age of eighteen years - the youngest can be convicted at ten. They also work extensively with mentally disordered offenders both within psychiatric and special hospitals and in the community.

    Yet the chief social worker for England has omitted to mention the word offender or criminal in her over view of social work.

    She also failed to mention the Children and Family Court Advisory and Support Service who undertake work on behalf of the Family Courts with those involved in contentious adoption & care hearings where Local Authorities’ recommendations to the courts maybe challenged by families and guardians of children and where divorced or separated parents are in dispute over the arrangement of their children. Such work was once undertaken mostly by employees of former probation services by workers initially employed as probation officers.

    The nation loses out by splitting probation and social work training and no longer recognising the vital part social work plays in work with many if not most criminals under court ordered supervision or parole.

  2. Comment by Lyn Romeo posted on

    My blog was focused on social work in health so was not intended as a fully comprehensive overview. I agree that social work practice is key to working with young offenders and in the family courts. This is an area that the Chief Social Worker for Children and Families leads on and I will pass on your comments.

    The social work that is done in forensic mental health services is invaluable and I am speaking at their conference in the autumn - I will make sure I blog on this then.

    Thanks for your comments.

    • Replies to Lyn Romeo>

      Comment by Andrew S Hatton posted on

      The crucial fact about the discipline of 'social work' is that whilst necessarily specialist work exists any social worker needs to constantly be wary of the fact that ALL social work overlaps and for example forensic social work - as it seems latterly termed is not only relevant with those charged or convicted of crimes but to those who commit what could be charged or convicted were it ever brought to the attention of prosecuting authorities, rather than remain 'hidden' with family and social groups.

      Thus folk working in probation or - I think bizarrely under the auspices of the Department of Health - in Youth Offending teams need to be constantly alert to all the other aspects of social work, say care of the elderly and disabled, which was what I believed was the driving force behind the instigation of multi - disciplinary Social Service Departments in LAs in England & Wales.

      So I presume that it is as important to those who lead the management of UK Social Workers in Local and Health Authorities or any other work such as CAFCASS, that there are significant client facing people in the twenty two Probation agencies in England and Wales, both the Community Rehabilitation Companies and the National Probation Service who have a well grounded training in generic social work, due to the overlaps AND shared underlying principles.

      I thought it was those shared underlying principles that Lyn Romero was referring to when she differentiated in the lower value she suspects is placed on social work in the UK than in North America.

      Some of the pioneers of our international discipline are indeed North American, such as Biestek and Hollis whereas some of the originators were also European like Octavia Hill & Frederic Rainer and those who inspired him from the temperance movement. So it is understandable that we make international comparisons.

      Readers maybe interested to learn more of the international dimension that is reflected in an English Language but largely Dutch Academic funded "History of Social Work" website. It is sad there are no UK Institutions associated with it - I would be interested to know if there are any similar UK or USA ventures, it seems worthwhile - I see Elizabeth Fry from our £5 note is duly commemorated very early on!

  3. Comment by Mrs Helen Dennis-Parsons posted on

    Shoesmith (Baby Peter) evidently never read even half-way of these "practices".
    I have experience of Social Care on temporary but all too frequent occasions;
    the spectrum of "humanity" compassion and actual interaction didn't come any
    where near the aforegoing. As with most things in life, there were lovely, helpful


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