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A day in the life of a hospital social worker in acute settings

Posted by: , Posted on: - Categories: Integration, Knowledge and skills, Viewpoint

My first ever job as a qualified  social worker was in a large inner city teaching hospital. It  was an excellent start to my career. It was fast paced, demanding and a great opportunity to develop skills and confidence working in a multi-disciplinary team. So I am very pleased to welcome hospital based social worker Rhiannon Hudd from Wiltshire Social Care as my guest blogger this week.

Social work in hospital settings is busy, rewarding and requires us to take a holistic approach to ensuring a person's health and care needs are met as effectively as possible, in the midst of a system set up to treat conditions with the greatest efficiency. ‎So, no pressure there then! Thanks to Rhiannon for providing her reflections.

Having spent my final placement as a social work student in an acute hospital environment, to then return as an agency employee and later, level 2 ASYE, I feel I now have a comprehensive understanding of how social workers and health professionals can be integrated within multidisciplinary teams.


hospital11As a student, when I was told where my final placement would be, I recall thinking: ‘A hospital? I didn’t know they had social workers in hospitals!’ Now, almost three years down the line, this continues to be a common reaction when I describe my work setting to people.


As a hospital based social worker working in acute settings, it takes considerable efforts to build rapport with health colleagues in order to maintain effective working relationships. After all, these are the individuals we rely on for the evidence to build into our assessments.


During my time as a student, I recall referring to social and medical theory on various occasions. Today, as a fully-fledged practitioner in acute environments, I reflect this theory in my practice on a daily basis, even if it is not always at the forefront of my thinking.


The role of social workers in acute hospital settings, in my opinion, cannot be easily summarised. The nature of these environments means our work often goes above and beyond what is typically expected. For example:


  • working to achieve a safe discharge plan that is considered the ‘best outcome’ for the service user
  • taking into consideration their views and wishes
  • balancing complex family dynamics often at point of crisis
  • upholding our roles and values in advocating best interests and wishes of the service user.

All this in busy environments that can place vulnerable people at risk of becoming institutionalised. It is a huge challenge. To then add the expectation that we must have all the above in place by the time acute medical teams deem individuals ‘medically fit for discharge’ makes things tricky!


We must also consider the requirements of daily practice which include:


  • timely assessment writing
  • completing evidence based mental capacity assessments
  • working with multiple professionals, families and community based colleagues to maintain support networks enabling safe and sustainable discharge for the service user.

In an environment where professional judgement should be challenged on a daily basis, but where it may seem ‘easier’ to accept the medical team’s authority without question, it remains paramount that our passion for supporting the service user remains the focus of our assessments.


We must strive to uphold the values, principles and duties of social work to make sure service users do not lose their voice within the complex and fast changing environment of acute health and social care.


Despite the constant pressure, ongoing challenges, difficult conversations and complex cases, ultimately, I feel blessed. I feel blessed to be in a role that brings a network of support to individuals that need it most and I feel pride every time I hear the words ‘I don’t know how you do that job’.


As a hospital social worker I feel we are the ‘gel’ that holds together and coordinates a large support network within the complex task of discharge planning. We are the signposts, the advocates, the mediators and the professionals tasked with upholding legal frameworks.


Social work is a vital and forever changing profession. I feel proud to continue supporting individuals to the best of my creativity and knowledge, at a time when the challenges facing me, my colleagues and those we seek to help, are even greater than ever.

Rhiannon Hudd is a social worker at Wiltshire Social Care, Brunel Treatment Centre, Great Western Hospital in Swindon

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  1. Comment by Trevor Fossey posted on

    Where are the service users in the comment "We are the 'gel' that holds together... the advocates, the mediators, and the professionals..."? The service should be 'patient centred', with the patient/service users being empowered?
    The Power of Information initiative launched by the Government in June 2012 gave a commitment that all service users in Health and Social Care would have online access to their own records/data - GP Health has complied, with all citizens now having access to their own record but Social Care still has a culture of not empowering individual users by providing online access.
    I have online access to both my Financial health and GP Health records - why does Social Care feel that is inappropriate to provide similar online access to my Social Care? The culture needs to change?

  2. Comment by Tim posted on

    Bit picky mate.
    I think the respect for the service user is inherent in the presentation, which covered most of the ground in a succinct way
    You could have made an addition of your important point of online access, rather than a complaint about 'where is the service user...'
    Online is important, but biased towards a section of the population, it's hardly person centered for the average 80 year old, and other sections of the population ! etc

  3. Comment by Jan posted on

    All I can say is we do the best we can, especially in difficult circumstances

  4. Comment by Widaad posted on

    I'm a medical social worker in Mauritius and yes! we all do the work in the same way. Bringing a smile on the face of any client and be patient centred is very important. Here in Mauritius I work in the mental health care centre and relatives tend to dump patients with psychiatric problems in that hospital due to lack of carers available to help handle them, low income, lack of specialised institionslised care centres for patients with psychiatric illness. Also as a medical social worker I'm having to do all my tasks myself because there's no assisting staffs to help out. I'm on the verge of burn out. I listen to about 7 cases per day 5 follow ups squeezing 3 new cases with lots of phone calls to take on more cases and pressure by the head of the institution to see more cases within a short time. I wish that I was a member of the uk social work association so I could get some help some tips. Social work is huge work in a hospital. Doctors n nurses alone can't do much without the medical social workers. There are only 8 of us in my country Mauritius now. We tend to practically dance around wards the whole day the whole time even after working hours sometimes. I have to do the monthly statistics myself. I get lots of troubles to stick to my daily plan of work because every day there are new additions to my main tasks list. Meetings Court Cases training sessions lectures unexpected meetings. So being vulnerable to burn outs is one of the disadvantage of being a medical social worker who tends to be a perfectionist in every way. I wish any medical social worker in any hospital even around the world helps me out.


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