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Thursday, 08 December 2016

Engage: It is more essential than ever celebrate the role of hospital social work

Written by Dr Ruth Allen

BASW CEO Dr Ruth Allen marks national Hospital Social Work Day 2016...

Some of my most formative and rewarding work experiences have been in hospital settings, specifically on mental health wards. And some of the most skilled and inspirational social workers I have had the privilege to work with have been hospital social workers. 

I want to dedicate this blog to a sadly missed ex-colleague of mine; Martin Wrench. Martin was a social worker and skilled therapist at the (also now sadly missed) Henderson Hospital therapeutic community for people who had attracted the label 'personality disordered'.  Martin was exemplary in his compassion and in his dedication to bridging the gap between clinical therapeutic perspectives and the complications and richness of people as a whole; their trauma, resilience and humanity. 

But as Martin and I would often discuss, working in a hospital setting is often a challenging role that requires multiple skills and an ability to constantly and relentlessly translate across boundaries - and often across resistances and blocks in the system. Working as a social worker or social work manager in hospitals has also been the source of some of my greatest frustrations. And that is, in fact, one of the reasons I believe hospital social work is so important. 

Often our role is to broker care and find costed solutions for community support in order for people to leave hospital. In adult social care, this has become tougher and tougher for individuals, families and staff as funding is pared back. It is more essential than ever that we celebrate and describe to our health colleagues and the public what our role is in this and why a fair settlement for social care resourcing is so important. 

But hospital social work often is - and should be - about even more than this. It offers a vital professional perspective and skilled way of working with people that both protects and empowers. We work in hospitals to support our health colleagues to meet the needs and expectations of Inpatients (and other users of hospital based services) and to ensure assessments and support cover social and family considerations.  But we are also an essential part of ensuring people in hospital are recognised as people, for all they are and all they think and feel, throughout their stay. 

Everyone in hospital is more than the sum of their (sick and healthy) parts. But the institution can reduce and dehumanise people just to their broken bits in the eyes of professionals if we don't consciously focus on the fact these are people with rights and expectations, pasts and futures, likes and dislikes, and levels of capacity to make specific decisions. Most Inpatients also have people who care about them who want to be involved. We try to see the world through the Inpatient's eyes and the eyes of their loved ones. 

So, our job as a hospital social worker is to see 'Mrs Jones, ex-civil servant, loving and creative mother, pianist, traveller, twice divorced, now happily a partner to John, suffering from early stages of dementia, in hospital after a fall and desperate to get home to John and the dog'. She is not 'the confused hip with pressure sore risk' in bed 24, passive and deteriorating. 

Maybe this is something of a caricature, maybe it seems a bit old fashioned - but my recent experience in mental health hospitals tells me these risks remain. On Hospital Social Work day 2016, let's remember - and celebrate - social work's role, past and present, in humanising clinical environments, safeguarding people's rights, smoothing and steering transitions between home and hospital and out again, supporting successful discharge and rehabilitation, translating medical jargon and processes into meaningful information for the person and their family, upholding people's rights to be safe and to receive the treatment and care they need, and to continue to be themselves. 

This is the stuff that makes for quality of experience and which underpins the success of treatment. Social workers are key to helping people participate in and take control of their own recovery, making clinical support more likely to be effective, supporting informed Inpatient decision making, increasing uptake of full programmes of treatment to increase the chance of success, and resolving social issues which may be preventing recovery. Social workers also help people say no - and use the Mental Capacity legislation of all four countries of the UK to support people's rights to do this. 

All of this can endear us to our health colleagues - and can make us seem like flies in the NHS-issue ointment. We should be proud of this and celebrate our successes.  It's our burden, our pleasure and our privilege to be - or have been - hospital social workers.


About The Author

Dr Ruth Allen is CEO of the British Association of Social Workers (BASW). Prior to this she was Chair of The College of Social Work’s Mental Health Faculty, Director of Social Work at South West London and St Georges' Mental Health NHS Trust and Head of Social Care for Hertfordshire Partnership NHS Trust. Dr Allen holds a Master's degree in Social Work, with distinction, from the University of Sussex and a Professional Doctorate in Education, also awarded by the University of Sussex.

Ruth was writing on the BASW Blog which you can follow here: https://www.basw.co.uk/news/england-blog/