The missing piece in the integration jigsaw? Evidence for the social work role in integrated care for adults

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Bailey, D. ORCID: 0000-0001-5823-7746, Kemp, L. and Parkes, Y. ORCID: 0000-0002-5928-6133, 2019. The missing piece in the integration jigsaw? Evidence for the social work role in integrated care for adults. Nottingham: Nottingham Trent University.

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Abstract

There is wide agreement that the integration of social care and health is the way forward with past and present government initiatives such as the creation of Care Delivery Groups (CDGs), the Better Care Fund and move to Integrated Care Systems enabling social care and health to work collaboratively together to prevent individuals being admitted to hospital so that they can be better cared for in their own homes.

As we await the forthcoming green paper on Social Care in England, we continue to know little about whether and how adult social work contributes (the means) to the effectiveness (the end) of integrated services with health, particularly for those aged 65 and over. This gap in knowledge and importantly evidence of what works, has led to funding initiatives such as the Better Care Fund being short lived. In order to be confident that the investment of public funds will deliver best value we need a more systematic approach that teases out the benefits and drawbacks of integration in a way that more easily allows comparison between different ways of delivering integrated care.

The Care Act (2014) continues to provide the legislative framework for adult social care in England and the social work role in relation to assessment and delivery of personalised care. Social workers by virtue of their value base are less risk averse than healthcare colleagues, enabling people to have more control of their decision making through personalised care approaches. In comparison with other areas of social work for example with children and families or in mental health services integration of adult social work with older people has received comparatively less attention. This needs to change if we are to realise the ambitions as articulated by Simon Stevens Chief Executive of NHS England – “to identify cohorts of people in our population, who need a pro-active, person centred response to their needs and risks, who need to be put in as much control of their lives, care and treatment as possible”.

This synthesis aims to examine the evidence that is available about social work with adults aged 65 and over in integrated teams and services in order to answer three questions:

1. What are the types of research methods are being used to investigate the social work contribution to integrated working with adults and what are the strengths and limitations of these?
2. What if anything can we learn from the studies about how social workers contribute in ways that make a difference; from the perspective of other professionals and from service users and carers?
3. What if anything can we learn about the skills and capabilities that these social work contributions draw on and are these skills and capabilities in any way more ‘specialised’ in integrated care than perhaps in other social work settings?

In total the synthesis consisted of 35 sources of evidence that reflected a high level of diversity in respect of the methods they employed, their robustness and their focus. The synthesis while useful as an exercise in drawing together these somewhat disparate sources, reveals an overall limitation in terms of research that provides robust evidence of the social work contribution to integrated working with older adults, what this looks like as well as how it is achieved. This testifies to the need for commissioning of further research on the adult social care role in integrated care and the key questions needing answers regarding its effectiveness. Until such time as this evidence is available, social work curricula at qualifying and post qualifying levels will struggle to equip social workers to contribute to service integration effectively and we risk continuing to commission services based on limited understanding of what works.

Item Type:

Research report for external body

Creators:

Bailey, D., Kemp, L. and Parkes, Y.

Publisher:

Nottingham Trent University

Place of Publication:

Nottingham

Date:

1 December 2019

Identifiers: