Social work in a time of genocide: editor-in-chief editorial

A Note From the Editor-in-Chief

Health and Social Care Delivery Research (HSDR) Programme is part of the National Institute for Health and Care Research (NIHR). As such, it aims to contribute to the NIHR's mission of improving the health and wealth of the nation by funding evaluative research projects that have the potential to improve the quality, accessibility and organisation of health and social care services by providing useful outputs for decision-makers, staff, service users, academic, and public audiences. More information about the programme can be found on the NIHR website. A logic model is a visual way of showing how an activity, programme or intervention is expected to work and bring about the benefits and changes it intends to achieve. By summarising the core elements, a logic model can be used to support programme planning, implementation, and evaluation. NIHR logic models presentin a linear flow diagramthe key activities, outputs, outcomes and impacts of each funding programme as a series of logical steps.

ObjectiveTo make healthcare programmes more patient-centred and efficient in light of limited resources, it is crucial to ensure patient satisfaction. There is limited information on the overall level of satisfaction...

This article provides a timely intervention to debates and scholarship about the professional regulation of social work and social care. In Ireland, the recent commencement of the statutory regulation of social care by CORU – Ireland’s multi-professional health regulator – offers a watershed opportunity for learning. Social work has been separately regulated by CORU for over a decade, while the social care work register opened in November 2023. We conduct a comparative content analysis of the standards of proficiency for social work and for social care work. Albeit with different historical origins, regulation has now provided these professions with distinctive, as well as shared professional ‘benchmarks’, that may shape the trajectories of their future roles and training. We consider the approach CORU takes to regulation, in terms of the standards and how these differentiate or align the two professions. The novel contribution of the paper lies in its key findings. Namely, that: the format of the standards of proficiency framework itself warrants further consideration; insufficient attention is paid to empathy and emotions across standards; there is an absence of a considered approach to the influence of socio-economic factors on practice; there are variations in the emphasis placed on relational versus socio-political dimensions in practice; and finally, there are differences in the importance paid to ‘critical understanding’ across the standards. These areas particularly illuminate how CORU frames and interprets the nature of both professions. It is concluded that the standards of proficiency for both social care work and social work have much shared terrain, interspersed with infrequent but striking differences, indicative of the many commonalities and overlap in occupational spheres for both professions.

The Phenomenon of Conscience in Social Work

Considering the intermingling of problems in today’s multi-crisis environment, this text explores the possibilities of intertwining social work and pastoral care. In the search for effective approaches, we find dynamic patterns in the activities of the Royová (Roy) sisters. Their diaconal work is an important source for social work history illustrating how social work took the form of diaconal (charity) work with a rich pastoral reach at the time. Their activities represent a natural link between Christian anthropology and social work. This study mainly investigates the Christian (spiritual) basis of the social and charitable activities of the Royová sisters, the beginnings of the institutionalisation of social and charitable work in Slovakia and Serbia through the organisations founded by the Royová sisters, the Christian-social interpersonal contribution of the Roy sisters to the development of Slovak and European social work personified by their cooperation with several personalities of social and charitable work at the international, national, and local levels, and the contribution of the Roy sisters in the creation of women’s, volunteer, and international roots of social and charitable work in Slovakia and Europe. In their responses to the needs of their environment, we find significant stimuli for pastoral theology, which is supposed to respond to the needs of the multi-crisis environment of today.

Self-report questionnaires can enable health and social care organisations to understand better a person’s views about their health and well-being, allowing them to provide effective, safe, individualised integrated care. Outcomes are the results from care and/or treatments people have received whilst in clinical or other care settings. Some outcomes, such as symptoms, quality of life and aspects of physical, mental, and social functioning can only be captured directly from the person themselves. These are called patient-reported outcomes (PROs) in healthcare settings, and this information is usually collected using electronic questionnaires that allow us to assess and measure these issues of individual importance. PROs can deliver person-centred care through individualised clinical assessments to support disease/treatment monitoring leading to improved patient–clinician communication which aids shared decision-making. At an organisational level, PROs are used to monitor provider performance, inform policy, and guide quality improvement. PROs in social care could be used similarly, to promote choice and autonomy, to ensure care meets a person’s goals for their health and wellbeing. At a service level, these self-report questionnaires could help identify unmet need and guarantee that measures of quality emphasise person-centred outcomes. PROs offer an opportunity to support effective integrated care in settings where individuals, particularly those with multiple long-term conditions, might receive both health and social care services. The National Institute for Health and Care Research Applied Research Collaborative West Midlands (NIHR ARC WM) leads a programme of research exploring the use and implementation of PROs in integrated care. A Priority Setting Group was established comprising people with lived experience of health and social care(n=3), experts in health, social care and PROs methodology (n=4) and representatives from a charity to support independent living (n=2), who identified the need to undertake a scoping review to explore the evidence on the use of PROs in adult social care. The scoping review, which included searches of 6 databases (years 2010-2023), identified 159 articles reporting on the international use of 216 PRO measures in social or integrated care. PROs were primarily used as research tools, but 5% studies reported PROs as part of an intervention; 23.9% papers focused on PROs use with participants in long-term residential care, with less published evidence of PROs use for those receiving supported living services (5.7%) and social day care services (3.1%). Only 3 articles (1.9%) referred to PROs in the context of the provision of integrated health and social services. The review highlighted a lack of coherence in purpose of use and poor reporting of implementation factors that could optimise PROs use to achieve potential identified benefits in these populations. Findings informed a mixed methods study (qualitative interviews and structured survey), designed in consultation with the NIHR ARC WM Public Advisory Group (n=18), to explore current and potential use of PROs in integrated care settings, involving persons with lived experience, carers and professionals across health, social care, voluntary and charitable organisations. Results will inform guidance on key considerations to optimise PROs use in integrated care.

Issue Health and social services cause significant environmental impacts. In Finland, national steering towards environmentally sustainable health and social care has been lacking. Description of the problem A multidisciplinary research project (EKO SOTE 2022-2023) was designed to investigate aims and steering mechanisms for environmentally sustainable social and health care in Finland. The project aimed to propose national steering and monitoring mechanisms for stronger environmental sustainability within the sector. Data for the proposal was collected from literature, review of national legislation, interviews, surveys, and co-development events. The project also aimed to calculate the carbon footprint of Finnish health and social care with the EEIO model ENVIMAT. Results It was estimated that health and social care contributed to 6.5% of Finland’s national carbon footprint in 2019, of which the share of health care was 4.2%. The new goal ‘Social and health care is carbon neutral and minimizes the environmental burden by 2035’ was proposed to be incorporated in the national strategic steering. Wellbeing service counties (WSC) as public care providers were suggested to be included as responsible actors in the Finnish Climate Act. National networks and targeted project funding for WSCs were found important. Three sets of indicators were designed for monitoring environmental sustainability: minimum indicators for all WSCs for national monitoring, voluntary indicators for regional monitoring, and indicators for advanced regions to pioneer best practices. Lessons According to the informants, national steering for environmentally sustainable health and social care is urgently needed. The national goal should be ambitious, wide-ranging, and feasible, and cover environmental aspects broadly. The steering requires multiple mechanisms: normative, strategic, informational, and economic. WSCs should be empowered to develop suitable means to achieve the national goal. Key messages • The project provided an ambitious, feasible, and comprehensive national goal and steering model for reducing the environmental impact of health and social care in Finland. • Collaborative efforts and joint steering model could advance environmental sustainability in health and social care.

Introduction: In the forthcoming extensive reform of social and health care in Finland these services will be fully integrated at all levels of care. One of the most challenging target groups of the reform are patients making much use of both social and health care services, i.e. ‘high needs patients’. This paper introduces a study addressing the problems identified by care professionals working in the field in implementing integrated care pathways for this patient group. The study is part of a research project entitled ‘Successful Integration in Health and Social Care’, coordinated by the University of Eastern Finland and funded by the Foundation for Municipal Development (KAKS). The research question of the sub-study presented here is: What are the pitfalls in implementing integration in the care pathways for high needs patients? Theory/Methods: The study draws on the theoretical approaches to care pathways (Campbell et al. 1998; Rosstad et al. 2013), integration of health and social care (Nolte & McKee 2008; Valentijn 2015); integration models (Sampalli et al. 2012; Grembowski 2015); development of care services for people with multimorbidity (Rijken et al. 2016); and collaboration among health and social care professionals (e.g. D’Amour 2005; Schepman et al. 2015). The data was gathered in Finland in spring 2016 from participants on the Better Everyday Life project. Twenty-two teams of composed of various care professionals (altogether 130 people) representing primary, specialized and social care conducted a problem analysis of the development challenges in pathways for high needs patients. The professionals used the LEAN-based ‘fishbone tool’ for analyzing the pathways. The data were analyzed by two researchers using content analysis and the ATLAS.ti qualitative data analysis software. Results: Four main categories of problems in the care pathways were identified: helpless professionals, tired patients, insufficient coordination of care between the ‘silos’ of health and social care and lack of support from management. Professionals often find patients with multiple needs burdensome and that they lack the capacity to solve their problems. The only way to deal with them is to pass them on to another professional or care provider. Patients suffer from fragmentation of services: they get lost in the jungle of separate services and wear themselves out. Nobody in the care system is responsible overall for a patient needing services from several separate actors. Management is unaware of the problems at the operative level and does not give enough support for the care professionals to improve the pathways through collaboration. Discussions and Conclusions: (comprising key findings) Successful implementation of care pathways for high needs patients requires multi-professional and inter-organizational collaboration beyond professional, organizational and sectoral silos. Lessons learned: Thorough consideration of state-of-the-art of care pathways by grassroots professionals is a fruitful starting point for development work. Limitations: The findings are based on a small-scale study in the health and social care context of a single country. However, the challenges of integrated care pathways may be quite similar in other European countries. Suggestions for future research: In addition to listening to grassroots professionals, high needs patients themselves as well as managers should be involved in the study.

Social work is often defined as a practical field with limited theoretical contributions as opposed to sociology that is perceived as theoretical. As a consequence, social work’s own researchers often tend to search outside their profession to find its scientific basis. Hence, social work’s own theoretical contributions have often been overlooked, diminished or even perceived as non-existent. In this article, we turn to one of social work’s founding mothers, Mary Richmond (1861–1928) and one of her most important texts, What is Social Case Work? (1922). Our aim is to show the theoretical contribution of her text, and thereby to highlight certain theoretical developments within social work itself. Through a hermeneutically close reading, we challenge some traditional and dominant interpretations positioning Richmond’s texts within pathological and individualistic perspectives. We demonstrate how the two key concepts ‘personality’ and ‘man and his environment’, together with the model of social case work, reflect a dynamic view of social interactions in which the individual is inextricably bound together with its social surroundings.

Previous articleNext article No AccessGroup Composition as an Element of Social Group Work PracticeWilliam ShalinskyWilliam Shalinsky Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Social Service Review Volume 43, Number 1Mar., 1969 Article DOIhttps://doi.org/10.1086/642327 Views: 64Total views on this site Citations: 6Citations are reported from Crossref Copyright 1969 The University of ChicagoPDF download Crossref reports the following articles citing this article:Laura MacLeod Act Before You Think: Using Instinct Not Intellect in Groups, Social Work with Groups 39, no.2-32-3 (Apr 2016): 208–220.https://doi.org/10.1080/01609513.2015.1048418Faye Mishna The Application of Self Psychology to Therapeutic Camps, Psychoanalytic Social Work 12, no.11 (Mar 2005): 51–71.https://doi.org/10.1300/J032v12n01_05Faye Mishna, Joseph Michalski, Richard Cummings Camps as Social Work Interventions: Returning to Our Roots, Social Work With Groups 24, no.3-43-4 (Nov 2002): 153–171.https://doi.org/10.1300/J009v24n03_11Geoffrey Channon A Selective Bibliography, Australian Social Work 26, no.22 (Jan 1973): 43–51.https://doi.org/10.1080/03124077308549397 James K. Whittaker Models of Group Development: Implications for Social Group Work Practice, Social Service Review 44, no.33 (Sep 2015): 308–322.https://doi.org/10.1086/642580Beryce W. MacLennan, Naomi Levy The Group Psychotherapy Literature 1969, International Journal of Group Psychotherapy 20, no.33 (Oct 2015): 380–411.https://doi.org/10.1080/00207284.1970.11491773

Protecting vulnerability. An international comparison of social workers as street-level bureaucrats during the COVID-19 lockdown

The supervision of social auxiliary workers has received little attention, both in research and supervision practice. Social auxiliary workers are trained and qualified to support the services of qualified social workers. Yet, despite their importance in social welfare service delivery, social auxiliary workers are seen as the stepchild to social workers and are often neglected in terms of receiving supervision for their professional duties. This article explores how social auxiliary workers experience supervision to guide their daily activities. Although there are a few studies on the supervision experiences of social auxiliary workers in South Africa, there are no previous studies focused on the Northern Cape province. This article is based on a qualitative study that used an exploratory and descriptive research design. Semi-structured interviews were used to gather data from six social auxiliary workers in the John Taolo Gaetsewe District of the Northern Cape. Using Tesch’s eight steps of analysis, the findings reveal the inconsistent use of the role and function of supervision in developing the capacity and training of social auxiliary workers and the implications of ineffective supervision. A key recommendation is that social auxiliary workers should have mandatory, structured and supportive supervision to uphold the professional purpose of employing social auxiliary workers in the context of social service delivery to vulnerable populations.

Ethical Dilemmas in Applying Second-Wave Information Technology to Social Work Practice

BackgroundThe increasing prevalence of Alzheimer’s disease (AD) will substantially impact health and social care systems worldwide. In this study, we aimed to estimate the real‐world use and cost of health and social care services in a large cohort of AD patients in the United Kingdom.MethodWe conducted a retrospective cohort study using Discover‐NOW, a real‐world database containing linked primary and secondary care electronic health records of people living in North‐West London, England. A total of 18,116 patients diagnosed with AD were followed from first observed AD diagnosis to end of patient follow up, within the time window from 1 January 2010 to 31 December 2021. The baseline prevalence of 33 comorbidities, survival duration, health and social care resource utilisation and total direct health and social care costs (in 2019 terms) were estimated.ResultOf 18,116 patients with AD, 8,970 (50%) used social care after diagnosis. Most patients using social care were female (65% vs 62% in the general AD population) and were a similar age at diagnosis (median 82 years) compared to those who did not. Of the patients with social care utilisation, 5,248 (59%) resided in care homes and 2,636 (29%) received domiciliary care at home. Annual direct social and health care costs for each patient receiving social care were £25,664 and £6,248 respectively, constituting an annual total cost of £31,912. Median survival from time of AD diagnosis was 4.9 years in the general AD population and 1.9 years after care home admission. Patients who entered care homes, entered at a median age of 85 years and had higher baseline prevalence of stroke (11% vs 7%), chronic kidney disease (40% vs 35%), and atrial fibrillation (17% vs 13%) than the general AD population.ConclusionIn AD patients who used social care, social care costs were >4 times other healthcare costs. Slowing or delaying the requirement for social care would have a major impact on reducing the societal and economic burden of AD on patients and society.