https://lynromeo.blog.gov.uk/2015/06/19/our-primary-concern-is-care-that-works-for-the-whole-person/

Our primary concern is care that works for the whole person

As our newly elected ministers settle into their respective portfolios, I’ve been reflecting on my priorities as Chief Social Worker for Adults. Top of the list for me is the need for social work to be positioned and embedded at the heart of adult social care.

The Care Act and accompanying guidance delivered in the last parliament have already provided the framework within which this can happen. As I visit local authorities across the country I am witnessing the reinvigoration of our practice as it moves from away from a purely process led care management approach. Social workers are focusing on seeing the person first; their strengths, assets and the outcomes they want, rather than starting with what's wrong and considering which formal services can fix things. As brokers within the health and care system, we can work alongside people as individuals and their carers, co-producing the care and support that will improve their lives and wellbeing.

doctor-tools-clipart-6nTXoLEiBThe new deal for general practice announced by the Secretary of State for Health Jeremy Hunt provides another opportunity to demonstrate the value we can bring to multi-disciplinary teams. If GPs really do spend a fifth of their time dealing with patients’ social problems (debt, isolation, unemployment etc.) but around 50 percent have no contact with social care providers, then this space is one where we can really make a difference.

By picking up on the social, relational and environmental issues in the right way at the right time, we can make sure people are connected to the appropriate support within the context of community based solutions. Social work input here can enable people to connect with others to reduce their isolation and improve opportunities to do something worthwhile. This in turn helps reduce their reliance on primary care services, A&E and the development of more serious conditions later.

Excellent social work emphasises the use of professional judgement; it puts a focus on prevention and co-production where the person is active rather than passive in identifying what matters to them and how best outcomes can be achieved. Our practice is well positioned to empower people in this way and help them make independent decisions about how they live. A holistic, whole family based approach gives us this opportunity and insight. We are able, in even the most complex personal circumstances, to critically analyse and undertake thorough risk assessments, where we balance positive risk taking with sound safeguarding practice.

This is about rebalancing the focus of care and support with an explicit need to promote well-being, prevention and solutions people can shape themselves within their social networks and communities. This social connectivity is positively associated with reduced illness and death rates. This is why it is imperative we promote a community strengths based approach to working with individuals, families and communities.

In adult settings, social workers are highly skilled at engaging with the people they work with - people with dementia, autism and those approaching end of life. Collectively, we are changing the culture from institutionalised, conditions based approaches to those where we support the whole person in the context of their community. An essential part of this is working collaboratively with other professionals, especially GPs, nurses and allied health professionals. Not only that, we must demonstrate our adaptability to rise to the challenge of the population’s ever changing needs against the backdrop of societal trends which continue to evolve and diversify.

The focus on improving out of hospital care and improving primary care services offers an opportunity for professional social work to make a real contribution well beyond the usual statutory local authority responsibilities. To be part of an enhanced general practice offer is therefore an exciting opportunity for us.

Social workers as part of primary care teams can really support GPs and other health professionals to focus on a person’s wider needs. By raising awareness of the social context within which a person lives, we can make positive contributions to improving responses to their health and well-being.

In a recent visit to Bury local authority, I heard the story of a social worker who identified loneliness and alcohol misuse in a woman who had been through rehabilitation services six times. By working with her to identify social and supportive connections with others, she was able to avoid the periods of isolation which led to previous debilitating falls. It’s a simple example, but one that made a real difference to the life of this woman and reduced her reliance on NHS services.

People using primary care can really benefit from the added value social workers can bring. I hope in the coming year we can successfully make the case for investing in social work as part of that offer.

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