Evidence-informed practice in NHS settings

Research shows the importance of practitioners being evidence-informed with learning that supports self-efficacy and emotional resilience.  

The Research in Practice Partner network has members from across health and social care. In this conversation with a Link Officer – Katy Cleece, Lancashire and South Cumbria NHS Foundation Trust – and Louise Jonstone, Research in Practice Partner Engagement Officer, they reflect on the similarities and differences of working in the NHS and local authority settings. How supervision is critical to supporting practice and the benefits of accessing resources.  

‘What is different about being a social care practitioner in an NHS Trust setting?’

Ultimately in the NHS Trust, we're not doing statutory social work. The role is different, and we occupy quite different spaces.

For us in Lancashire and South Cumbria, it's a massive patch and it might be that you're in a team or an office where there's no other social worker, so it can be quite health dominated. Maintaining those social work values can be quite difficult at times.

We have 260 social workers and there is a strong commitment to continuing professional development (CPD). We have social work and research meetings, a social work research conference, an annual conference for World Social Work Day. So, we have opportunities to come together, as social workers united in our values and profession. But it can be isolating, especially if you're the one social worker.

Then in terms of keeping up your social work practice – I think we have more opportunities in the Trust for relationship-based practice.

Depending on where you are, we have specialist knowledge and social work roles. Such as perinatal, or the mental health inpatient wards, which is about supporting people to come out of hospitals. So, there's a lot of drawing on legislation. Some of our social workers are in therapy roles, or mental health practitioner roles. So, you are doing therapeutic intervention, which is good because that relationship-based practice is a big part of social work.

Differences between NHS Trust and local authorities

It can sometimes feel like there’s a disconnect with how our colleagues in the local authority perceive us. Sometimes there is a view of the Trust as a ‘bright light’, but the reality is more complex. I love working for this trust, there are lots of positives. But we are still busy managing important and high-risk work.

Our local authority colleagues often come through different routes – apprenticeships, or your traditional university pathway. For people who join an NHS Trust and haven't had much time in the local authority, confidence around legal literacy can be lower. So, things like the Mental Health Act 1983, the Care Act 2014 is embedded in statutory social work. While processes might change, that foundational knowledge matters. If you’ve worked in local authority settings, you’ve had the chance to apply and embed it. For people that have come straight or quite early into the Trust, if they haven't had opportunities to practise and use it, that gap is real.

Another challenge is the medical model. Social workers in multidisciplinary teams with generally psychiatry led need to find their voice. Social work is rooted in social justice, in being that fearless advocate for people who might otherwise go unheard. It’s about respectfully challenging and navigating opposing ideologies.

Multi-disciplinary working

‘I recently saw a LinkedIn post from someone considering moving from a local authority to a Trust because they thought it would be “easier”’

This is misconception. The timescales are different, but every setting has its pressures. I’ve worked in adult community, the NHS, and Children’s Services. I can appreciate that all three have massive pressures – just different ones – I guess that's a lack of understanding.

Our workforce tends to be more experienced, but knowledge gaps remain. Many people don’t really know what social workers in NHS Trusts do. And nationally, there’s inconsistency: some local authorities won’t accept NHS social workers as Approved Mental Health Professionals. That creates barriers and tension, though solutions are emerging.

There are a lot of pressures in Children's Services. It can be very fast paced, with high caseload numbers. If you've got a child that needs removing, you've got to do that the same day.

In Adults’ Services, things can feel slower, but it’s quite complex – the Court of Protection work, for example, is time-consuming. Mental health can add a lot of urgency or high-risk situations demanding immediate action, whether that’s requesting a Mental Health Act assessment or arranging discharge plans for someone in hospital.

‘Do social workers work across services or work across children's and adults, or is everybody working separately?’

Most work happens separately. In Children’s Services, it depends on the local model. For example, in Lancashire, we use a family safeguarding model, which includes adult practitioners – but not usually social workers – unless they happen to be working as mental health practitioners. These teams tend to handle everything from high-end child in need cases through child protection, court proceedings, and removal.

There are also separate teams for lower-level cases. These used to be managed by social workers, but now they’re often staffed by family wellbeing practitioners. You’ll also find dedicated fostering and adoption teams, and separate Children in Our Care (CIOC) teams.

In Adults’ Services, you typically have adult community teams that work with any adult, regardless of age or presenting need. There may also be separate safeguarding teams that collaborate with the police on enquiries, as well as mental health teams. However, both adult community and mental health teams often deal with similar issues, just within different structures.

Accessing evidence-informed resources to support practitioners

‘Evidence-informed resources would seem to me to be critical in supporting practitioners. What are your thoughts on that?’

In the NHS, we have academic journal access, which is a real advantage compared to colleagues in local authorities who generally don’t. However, building research capacity among social workers is challenging. Many see research as overly academic and feel blocked by it because social work is such a vocational profession – and time is always limited.

When you open an academic journal, you’re faced with pages of methodology and results full of numbers. Honestly, as someone doing a master’s in research, I find that daunting. Numbers aren’t typically part of the social work skillset, so taking time out to engage with that can feel overwhelming. Plus, you often must do your own independent searches.

That’s why resources like Research in Practice are so valuable. You can search for something – say, ‘child removal’ – and instantly find relevant courses and articles. The platform is user-friendly, visually engaging, and gives you quick, digestible summaries. You can read something in minutes and then follow links for deeper learning if you want. I recently completed training on contact for children after removal from birth families, which was excellent. That these resources are available is a huge benefit.

Training can be expensive, and local authorities and NHS Trusts often don’t have the budget. So, having an organisation-wide subscription that gives all professionals access is a game-changer.

‘Working in an NHS setting, does that lend more weight to it?’

It absolutely does help. We should be relying on evidence-based practice. Healthcare tends to do this well – it’s embedded, and they often have strong research and development teams. But in social work and local authorities, we’re still battling to get people to see that evidence-based practice matters. It’s not just about intuition or relationship-based work.

Having access to Research in Practice really helps bridge that gap and makes research accessible in a way that academics just don’t. It also gives practitioners confidence and a basis for that professional challenge:

‘This is what we know from research. It's not just me telling you’.

Research in Practice has podcasts that people can listen when they're out and about. They don't need to sit and take time. People also have different learning styles and different interests – the variety is useful and anything that gets those messages across is valuable.

The voice of lived experience

‘What topics are most relevant?’

Well in the NHS legal literacy is really helpful. But more broadly, trauma-informed practice and cultural awareness. People can think ‘we're culturally aware’ and then something will come up if we get that voice of lived experience that's direct.

For example, I worked with the Deaf village with a social worker colleague. She did some research engagement, and there are loads of barriers for Deaf people. I was also talking to a research manager for another Trust and about how inaccessible patient information sheets are. Because it's written in words and British Sign language isn't English.

Whether it's blogs or online training etc. people engage with it well when there's people with lived experience that are giving their voice.

The value of supervision

‘So, thinking about supervision – do most of your managers oversee multidisciplinary teams where there’s a mix of professions? And is that an area where additional support would be helpful?’

For me, supervision is fundamental to keeping the workforce well. How can we call it safe practice if we’re not reflecting on what’s happened? The challenge is that when things get busy, supervision often drops off. But when people don’t have supervision, stress levels rise – that's when people go off sick.

I’m a practice educator, and in the NHS, whoever your team manager is usually provides your supervision. So, it could be a social worker supervising nurses, occupational therapists, or therapists – although therapists often have their own supervision. But if you’re a social worker and your team leader is a nurse, then a nurse does your supervision. Social Work England suggests that if you’re not managed by a social worker, you should still have professional social work supervision. We haven’t got that right yet because there’s a shortage of social worker team managers.

Peer supervision is absolutely okay. But the reality is that some people lack confidence in delivering supervision, so they don’t come forward. Others say they are too busy. The biggest barrier is that some clinical teams don’t recognise that supervision should happen. So, it’s a real challenge to release people for supervision, let alone to offer it. There are huge pressures around this.

For me, maintaining our social work identity means insisting on professional social work supervision. I’ve always advocated for that.