I am a hospital social worker, redeployed to Cornwall Council’s Bed Bureau service. In an innovative response to the coronavirus (COVID-19) crisis, our team has been created to manage the different pathways for hospital discharges.
COVID-19 has changed life as we know it. For hospital social workers, this could not be truer. The beginning of the New Year heralded ‘business as usual’ with little attention paid to the impending pandemic that would sweep through our global community. I’m sure I’m not the first or last to admit I underestimated the impact this virus would have on both our personal and professional life. In my personal life, I have been plunged into home-schooling three young children alongside my role as a social worker. The psychological adjustment has been profound. But this a reality for many of my social work colleagues, highlighting the impact on both a micro and macro level in the lives of everyone.
Evolving ways of working in the face of crisis
BASW and Social Work England have issued statements in light of the quickly changing environment we are working within. Remaining focused on our social work values and ethics is essential to providing a service that is evolving daily following government guidelines issued regarding the hospital discharge service requirements. Focusing on the importance of discharging patients to increase capacity within hospitals, hospital social workers are part of a multi-disciplinary team primarily tasked with facilitating safe and timely discharge from acute and community hospital settings. There is no doubt, the role plays a key part in the fight against the threat COVID-19 poses to our communities. However, with access to wards being limited, hospital social workers are needing to become increasingly creative in working with individuals who are vulnerable.
Not being able to access the wards to talk to people accessing services directly has been particularly difficult. Face-to-face visits are integral to social work practice. With research indicating that 65% of communication is based on non-verbal interactions, it is essential that hospital social workers become more creative in the ways we assess patients.
As a social worker who values the role of relationship-based practice, I have found the changes challenging. Instead of visiting wards, meeting patients, reviewing notes and sometimes challenging clinical decisions, I am now making decisions about discharges following discussions with clinical staff and conversations with family members. With face-to-face contact being critical, this change is difficult for all parties involved. For people accessing services, they are finding themselves in a clinical environment with medical staff behind masks, scared of an invisible virus that poses a real threat their physical and emotional wellbeing and unable to be comforted by concerned family members. For medical staff, they are finding themselves potentially working without adequate personal protective equipment (PPE), receiving limited support from their usual hospital multidisciplinary team meeting (hospital MDT) and bearing the emotional toll of working during a pandemic. The role of a social worker has never been more critical in a hospital. For hospital social workers, we advocate for patients on a daily basis. From ensuring human rights are always observed to ensuring mental capacity assessments remain lawful. Often at the sharp end in clinical settings, we are managing people who are in crisis.
A new normal
The COVID-19 crisis has turned life upside down for everyone. It is unclear if things will return to normal or we as profession will have to find a new ‘normal’.
With health and social care becoming better integrated during the crisis, patient care has become more person-centred and led to less restrictive outcomes. The integration in Cornwall has enabled more people to be diverted away from hospital settings to remain safely in the community. Whilst it is important to recognise the challenges that working in crisis can place on both individuals, communities and organisations, change can often bring around positive change. Change that challenges the norm and creates new pathways to prevent unnecessary admissions. Change which protects our NHS from social admissions. Change which increases choice and availability of services in the community.
Whilst COVID-19 has interrupted the ‘business as normal’ approach, we must not miss this opportunity to learn and evolve both as practitioners and organisations.