Social Care Workers Research Articles

COVID-19 and Challenging Working Environments: Experiences of Black Sub-Saharan African (BSSA) Front-Line Health Care Professionals Amid of COVID-19 Pandemic in the English Midlands Region.

The impact of COVID-19 is challenging for many health and social care workers. The impact has been more felt by all ethnic groups, but during the course of its tenure, it has become more apparent that the black community has been affected more than others. They have been reported to suffer more fatalities from the pandemic compared to their white counterparts. Blacks are reported to make a significant percentage of health care workers. They are sometimes undervalued, lowly paid, with many on insecure contracts and experiencing professional inequality. This study sought to explore the challenges experienced by Black Sub-Saharan African (BSSA) front-line workers in health care during COVID-19 pandemic. The study utilised an explorative qualitative approach (EQA). Forty research participants were recruited for the study. Semi-structured interviews were used to collect data through online platforms which included Zoom, WhatsApp and Teams. A thematic approach was used to analyse data. Following data analysis, the research found that the research participants experienced undermining of expertise, lack of appreciation and unfair allocation of tasks and were overlooked for promotion and perceived as carriers of COVID-19. This group was over-represented in agency and self-employed roles. There is need for a strong government commitment to prevent discrimination through enacting a comprehensive legislation to support tackling the problem. Race equality training awareness needs to be rolled out into healthcare organisations and empower managers to deal with equality issues at work.

Penanaman Nilai-nilai Pendidikan Karakter Melalui Kegiatan Kepramukaan di Madrasah Tsanawiyah

Character education can be widely described as a school-based process to promote personal development in youth, through the development of virtue and moral values. This paper describes how scoutmasters of MTS Tribakti Al-Iklas 2 Anak Tuha Central Lampung have infused the character education values on scout activities at this school. This study uses qualitative methods, with a case study approach. The data were collected through observation, interview, and documentation. The collected data were then analysed descriptively by using three ways namely data reduction, data presentation, and conclusion or verification. The results show that the infusing of characer education through actualization model scouting activities in collaboration with teachers as well as block models that have been programmed at the beginning of the school year, such as camps and nature exploration. The characters that can be formed are patience, cooperation, responsibility, social care, courage, confidence, perseverance, creative, religious, patriotism, environmental awareness, independence, discipline and hard work. Terefore, it needs a collaboration scoutmasters of with parents student to to succeed the scouting program. For future research, it is recommended to to probe parent's role in supporting students' scouting activities.

Relational pedagogy in social care education: a model for relational justice

ABSTRACT Driven by a statutory obligation to protect the public, within the context of historical failings and institutional abuse, a process of professional regulation is transforming the profession of Social Care Work [SCW] in Ireland. Statutory registration requires Social Care Workers [SCWs] to demonstrate threshold-level proficiency standards, a challenge that has enlivened debates about theory, pedagogy, and practice. Although proficiency requirements are primarily instrumental and technical, focussing on case and risk-management, social justice is now central to the definition of SCW. However, there has been very little debate about what this entails for theory and practice and critical perspectives are marginal. In response, the value-based model of Relational Pedagogy, based on an ethic of care and relational justice , is proposed as a counterweight to the proficiency perspective by nurturing four inter-related sets of practices within social care education: (i) caring practices; (ii) critical practices; (iii); creative practices, and (iv) emancipatory practices.

Implementing a social work care coordination model for children and youth with special health care needs in a rural-urban health system

ABSTRACT This retrospective chart review examined care coordination among pediatric patients with varying levels of medical complexity who received care in a rural-urban health system. Care coordination utilization across patient acuity levels was examined for meaningful differences in frequency and duration of care coordination services. Results indicated that patients with more severe medical complexity had increased frequency and duration of care coordination services, as well as different patterns of care coordination activity utilization. This model of pediatric outpatient care coordination provides a flexible and highly targeted approach for stratification of care and services based on the needs of the individual patient.

Moral Suffering in Frontline Social Care Workers: A Study of Moral Injury and Moral Distress

Introduction: Moral suffering (MS) is psycho-emotional harm derived from a conflict between one’s circumstances and one’s deeply held moral values. It includes the constructs of moral distress (MD) and moral injury (MI) and is characterized by constraints or mandates preventing the perceived morally correct event. Evidence has demonstrated the application of MS in helping professions, and research has linked MS to a deterioration of mental health, self-identity, worldview, and job-performance. Aims: In this study, we examined the relationship between MD, MI, burnout, and external/internal constraints in Frontline Social Care Workers (FSCWs) in the UK. Methods: We employed a quantitative, cross-sectional correlational design, recruiting 119 FSCWs (female = 91.6%, tenure 1–2 years = 27.4%) using convenience sampling. Participants completed an online survey including the Moral Injury Events Scale and the Copenhagen Burnout Inventory. Measures for MD, external constraints (stress, time, and resources), and internal constraints (psychological safety and preparedness) were informed by previous research. Results: Participants reported a significant prevalence of moderate-to-high MD (25.4%), MI (33.3%), and burnout (64.9%), and we found significant relationships between the constructs and dimensions. Constraints were significant predictors of MS (explaining 35.3% of MD variance and 30.1% of MI variance), with stress, time, and psychological safety making the strongest contributions. Conclusions: FSCWs can be examined as a unitary population experiencing morally challenging circumstances that may result in MS and burnout. Improved MS measures, increased awareness, and policy shifts are necessary to redefine the paradigm of work-related distress, taking systemic constraints and the potential for moral harm into account.

Going DEEP: an evaluation of a social pedagogy-informed approach to evidence-enriched practice in social care

Social care workers benefit from multiple types of evidence to enhance citizen well-being, support their own well-being and improve social care services. Building capacity within social care to find, collect and use different forms of evidence is an international concern. The Developing Evidence Enriched Practice (DEEP) programme in Wales is informed by the values and aims of social pedagogy. It aspires to enhance both the generation and use of evidence in social care. To learn about what works in the programme, we conducted an evaluation based on contribution analysis that explored programme impacts between 2020 and 2023. Based on a co-produced theory of change the evaluation drew on exemplar cases, questionnaire responses, documentary evidence, process data and unsolicited feedback. There was evidence that the DEEP programme contributed to people better valuing and gaining a better understanding of different forms of evidence. Citizen voice could become more central in decision-making, and there were examples of practice, policy and research being informed by diverse evidence. Many people who attended the DEEP learning course enhanced their confidence and skills by using the DEEP approach and said that they would put their learning into practice. It was harder to evidence longer-term impacts and the sustainability of the approach. These findings suggest that there can be merit in developing capacity-building programmes informed by social pedagogy. Such programmes can be characterised as relational, holistic, practice-focused, multifaceted, contextualised and co-produced with intended beneficiaries.

The ALLIANCE collaboratively explored a human rights-based approach to digital health and social care, ensuring that citizens are protected from exclusions and exacerbated inequalities. 

A human rights-based approach to the use of digital technologies in health and care, creating a good practice template to allow people to choose, try and practice digital technologies which supports their health, care and wellbeing as well as having access and control of their data.
 Creating an international understanding of a human rights-based approach empowers individuals and increases their awareness of the benefits of digital technology in supporting their own health and care. For professionals involved in service design and delivery, the adoption of the principles will make improved services, which are accessible, with a heightened awareness of some of the factors that can widen/exacerbate inequalities.
 We believe that an adoption of these five principles for a human rights-based approach to digital health and social care will lead to a more equitable, meaningful use of technology, with benefits for citizens as well as policy makers and service providers.
 We engaged with a range of individuals and stakeholders through online workshops and a survey. We talked to people who used digital services, those who provided services and support workers who engaged with digitally excluded groups. Based on their feedback, we refined the principles:
 1.People at the centre
 2.Digital where it is best suited
 3.Digital choice
 4.Digital inclusion not just widening access
 5.Access and control of digital data.
 After developing the five principles, we wanted to extend this beyond theory, to identify practice-based examples where these principles are already at the heart of services. We produced a series of case studies, sharing learning and effectively highlighting the positive impact digital technologies can have on supporting self management, promoting independence and assisting unpaid carers. We also held events where we invited organisations that champion this approach.
 We work closely with Scottish Government, Digital Health and Care Directorate to ensure a human rights approach is embedded in Scottish policy.
 The principles support the ethos of the Scottish Approach to Service Design and underpins developments/ progression of services e.g. Scottish Care Technologist
 Our next steps include launching our Scottish Social Services Council (SSSC) Open Badge, offered as a recognition/award to people working in social care for doing further learning and development, on Digital Human Rights Principles. We will continue to map and share good practice as it progresses and develops and strive for it to be imbedded across all industry.
 We would like delegates to feel inspired by this approach and to share our vision. To come away with an appetite to apply it practically in the design, delivery, and evaluation of their digital services and to want to raise awareness of it.
 The international appreciation and endorsement of a human rights-based approach to digital health and social care would lead to the creation of accessible, personalised and goal-orientated care.

Expansion of Integrated Care in Brazil: the experience of reorganizing the healthcare network in Santana de Parnaíba.

During 2018/2019, the State Department of Health of São Paulo in partnership with the International Center for Integrated Care delivered an integrated care pilot project- Transforming Together. The aim was to co-design and deliver a more integrated system in the North Coast Region and to build the capability of key players in the region and state to sustain the change. The demonstrator project generated knowledge transfer in 2020/2021 through an InterAmerican Development Bank webinar and publications to encourage other municipalities to develop integrated care networks. With their acquired knowledge and experience, a team of local consultants have spread the change methodology to another region.
 In 2022 a new integrated care project was launched in Santana de Parnaíba-SP, a municipality in the metropolitan region of São Paulo with around 145,000 inhabitants, an HDI of 0.814 and GDP per capita of 12.500 dollars. Primary and secondary care services are already strong, referring patients to the regional network only for tertiary services, and a new hospital is scheduled to open in 2023. The project aims to fully integrate this hospital within the healthcare network and with other sectors.
 The work plan, co-designed with the municipality, has three workstreams aligned to provision of services and care for the population: a diagnostic phase; technical support for managers; and a ‘train the trainers’ educational programme to build workforce competencies for integrated care. For the diagnostic phase, municipal services were visited, health and social care service data was analyzed and a novel Day of Care Survey applied to understand the current hospital inpatient profile. Workshops with managers from different sectors explored the concepts of integrated care, supported them to map local care pathways and to self assess the maturity of their network using the Scirocco self-assessment instrument. After agreeing the educational programme outline and selecting participants, learning cycles began in July 2022. Six thematic sessions focus on: Integrated Care and Innovation; Management and Assistance Models; Leadership; Participatory Policies; Effective Work Processes; and Governance. The sessions include masterclasses by international experts via videoconference.
 
 By November 2022, more than 100 health and social care workers have participated. They have had the opportunity to deepen their knowledge on integrated care, strengthen relationships with colleagues from other services/sectors, understanding the importance of working together between all the actors involved in the care of a person to improve their health and well-being. Managers have a growing understanding of how to tackle the main barriers to people centered integrated care, and how working together across sectors is still deficient. Scirocco tool scores reflected knowledge, certainty and readiness for integrated care.
 This initiative highlights how implementation can be transferred successfully from one context to another.
 By using international expertise to build local knowledge and leadership, we have demonstrated a methodology that builds capability for integrated care in the Brazilian system and a support programme that is transferable to different regions in São Paulo state. Scale up of the Transforming Together integrated approach across all states is necessary to strengthen the Brazilian public health system.

Broken psychological contracts in health and social care during COVID-19 among nursing professionals.

In this study we are interested about the reasons why nurses leave their occupation as a nurse and what is the role of the COVID-19 pandemic behind this decision. Our focus is in registered and auxiliary nurses working in all fields of health and social care. The research, which this abstract is based, investigates why nursing professionals are leaving their occupation and how the health care as working environment should be developed in order to secure enough enthusiastic professionals to the field. Theoretical background leans on the concept of psychological contract which we using to describe the relationship between employer and employee referring to an individual´s beliefs about the terms and conditions of a mutual exchange agreement.
 Psychological contract exchange is based on the perceptions of employee and employer rather than what is explicitly agreed and written down. The studies of the psychological contract have emphasized to breach of the contract meaning the situation where another contract party has failed to fulfill the expectations and obligations of the other party. Psychological contract breach cause dissatisfaction towards to work, impairs commitment to the organization and affects to the employee´s mental well-being and retention to work. In this study we examine situation where the psychological contracts breach has already led to leave work in health and social care. Explicit research question is: Why nurses leave their nursing position and how the COVID-19 has influenced to this decision?
 Our data consists of 36 stories wrote by registered and auxiliary nurses telling why they have left their nursing position and it was collected in Autumn 2021 via textual data collection tool “Penna” which is maintaining by Finnish Social Science Data Archive (FSD). Written request was intentionally very open and gave respondents freedom to describe their thoughts why they have left the nursing position. Altogether there were 310 stories but in here, we decided to concentrate to stories (n=36) where the COVID-19 was mentioned to be the final reason to leave the field. Based on preliminary findings, it seems that psychological contract was breached many ways during the COVID-19. For example, nurses were strongly disappointed how the work was organized during the crisis (leadership issues, working environment). They felt that their self-determination was broken especially considering the vaccination policy. In these stories, the writers emphasize the workload and lack of appreciation.
 This study highlighted that there were critical perspectives towards health and social care working conditions that the COVID-19 made even worse. This means that the was negativity and feeling of unappreciation and the COVID-19 somehow enabled to final decision. This is appearing as increase in workload and nurses were not able to have their normal and entitled vacations. Based on preliminary findings, it seems that psychological contract breached.
 Study indicates that we need to recognize the factors that are breaching the psychological contracts in order to develop and plan health and social care as well as nursing profession. This should be considered in all levels: individual, leadership and management as we

Integration knowledge and -skills for providing person centred care, A Personalised Integrated Care Approach

Introduction/Background: Do you also see citizens’ complex needs are nowadays often poorly met by the current services from single organizations which are mainly focused on providing single component care? Citizens’ complex needs are characterized by support questions in several interrelated domains of daily life. A need for support consists therefore of several interacting components: also called a complex care need (MRC, 2008). Citizens want to feel supported in being able to participate as optimally as possible in society with the highest possible quality of life, at the lowest possible cost (triple aim) and with more meaning for care providers (quadruple aim). Dynamic micro networks might be part of the solution of providing integrated healthcare and social care services (Schrijvers, 2016).
 Why a workshop? Knowledge and skills for providing care in dynamic networks are lacking among almost all parties involved: care providers, informal carers, managers, administrators, supervisors and financers. Dynamic partnerships in which healthcare services are provided in an integrated and personalized manner will increase in significance (Nies & Minkman, 2015). Earlier in over fifty research projects in practice involving healthcare and social care organisations and citizens in neighbourhoods in The Netherlands, we worked on answering questions for creating, organising, financing and delivering personalised care to citizens. However, most professionals have good ideas about how to deliver integrated and personalized care. Exchange of knowledge, expertise and experiences of all attendees is central in this workshop.
 Who is it for? Everybody working in healthcare and social care who wants to share her or his ideas on providing integrated care for enabling personalized care.
 What are you going to do?
 Workshop, 60 minutes (55 minutes audience interaction time), with group work and pitches;
 a.Opening and short introduction (5”)
 b.Short presentation about our findings (5”)
 c.Discussion in groups: Interaction between participants aiming at discussing the perspectives of micro level, meso level, macro level of dynamic networks in integrated care research, in four groups: (30”):
 1.How can we achieve co-creation and collaboration with clients, informal carers and various professionals in dynamic networking?
 2.How can we organize and manage dynamic networks for providing integrated personalised care?
 3.How do we structure accountability and financing of dynamic networks for providing integrated personalised care?
 4.How policy can we design policy facilitating dynamic micro network care on regional, national and European level?
 d.Pitches and Conclusions and general reflections (15”)
 How are you going to engage with the audience? Everybody is an expert in her or his own (working)situation. In small groups of 4-6 persons we will discuss one of the four questions mentioned above. We challenge everyone to share their own experiences and ideas.
 How are you going to summarize the take home messages? We end up with lessons learned and sum these up in take home messages. Attendees are invited to write these down and take these with them.

Collaboration has a remarkable impact to resilience of people working in disability services

Background: In the shadow of COVID-19-pandemic the shortage of social services’ and health care workers resilience of workers is an important paradigm to consider. Occupational wellbeing consists of many factors like work community, collaboration, solidarity, occupational health care, flexibility, salary, and different compensations. Collaboration and good possibilities to influence in work allow better occupational wellbeing and resilience.
 For e.g., housing services for persons with disabilities, collaboration may be one thing which can affect the whole community. COVID-19-pandemic’s lockdown measures combined with shortage of employees, collaboration with different partners may be a key factor that supports surviving and resilience of clients and workers. The study is part of “Building the future based on experiences during COVID-19” -project funded by the European Social Fund.
 Aim: The aim of the research was to find out how respondents feel the coronavirus epidemic has affected work, the workplace, and the work community and what new practices have been introduced in the workplace in areas such as the way services are organized. The survey and interviews examined the changes in the everyday lives of people with disabilities as observed by the workers and managers. Also of interest are the measures and methods adopted in the services to prevent coronavirus infections and communication between customers and workers during the coronavirus epidemic.
 Methods: Study methods used are survey for people working in services for the persons with disabilities and thematic interviews for managers working in service housing, or group housing for persons with disabilities. The survey results were analyzed by descriptive, quantitative analyze and interviews were analyzed by thematic, qualitative analyze. 
 Results: Collaboration is an valuable asset of workplaces. The resilience and wellbeing among/of workers, customers, managers and the whole community can be supported by emphasizing collaboration culture in organizations. E.g. customers may get better access to COVID-19 testing or different daytime activities in a lockdown situation. Workers and managers can benefit e. g. colleagues’ collective aid. Without collaboration the situation may be that organization, workers, managers, and customers have been on their own in COVID-19 era.
 Conclusions: Collaboration is valuable to customers, workers, and managers. In paradigm of collaboration there is inequality between customers, workers, and managers. The amount of collaboration between different organizations may vary. Further research is needed for tackling problems such as inequality and shortage of social services and health care workers and people working in services for the persons with disabilities. One solution may be collaboration with e.g. social and health care sector, third sector and local vocational schools. Research which considers workers and managers own opinion, voice and institutional problems may also be one part of solution because it gives different views to the problem. 
 Keywords: Workers, managers, disability services, persons with disabilities, Finland, COVID-19

‘You’re only a care worker’. Exploring the status of adult social care work through the intersection of HRM innovation and job quality

This paper examines the intersection between job quality and innovation by exploring policy-led innovation aimed at delivering high-quality adult social care jobs that attract and retain much-needed skilled workers. Through qualitative enquiry, we examine workforce policy’s emphasis on training, development and career progression, key elements of job quality, to create higher-skilled, higher-status roles. Drawing on focus groups and interviews with care providers and care workers in Wales (UK), we question the likely success of policy-led innovation given first its ineffective delivery and second its failure to address broader aspects of job quality. Policy thus fails both to institutionalise skilled roles in care work and to raise the status of the care worker occupation. We contribute to emerging HRM and interdisciplinary theory and policy debates about the complex nature of innovation activities and their outcomes for job quality in care work within a sector typified by low-quality jobs. We illustrate the different ways in which job quality and innovation interact and how both can be constrained by one another as a function of environmental antecedents.

The impact of routines on emotional and behavioural difficulties in children and on parental anxiety during COVID-19

BackgroundThe Covid-19 pandemic and related public health measures, including lockdowns and school closures, have impacted on mental health of children.Aims and hypothesisWe hypothesised that there would be an association between maintaining a routine during lockdown and both lower emotional and behavioural difficulties in children and lower parental anxiety. Routine was taken as keeping to the same basic activities such as mealtimes and bedtimes. We also hypothesised that children of ‘keyworker’ parents would have fewer emotional and behavioural symptoms due to having maintained more normal routines. The key reason was that children of keyworkers still attended school or nursery and parents would have been getting up and coming home at the same times as pre-Covid. Keyworker status was defined as those whose work was essential to Covid-19 response, including work in health and social care and other key sectors.MethodsWe used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to explore associations between maintaining a routine, and emotional and behavioural difficulties in children, using linear regression models. All eligible ALSPAC-G2 participants were sent the survey and the responders are representative of the eligible G2 population. We included measures of parental anxiety. We separately explored associations with having a keyworker parent. We used the Carey Infant Temperament Questionnaire and the Revised Rutter Parent Scale for Preschool Children to establish levels of emotional and behavioural difficulties. The measures were chosen to match previous waves in multi-generations in ALSPAC where they had been shown to be predictive of later mental health in children. The scales measure emotional and behavioural problems.ResultsTwo hundred eighty-nine parents completed questionnaires about their 411 children. Keeping a routine was associated with emotional and behavioural difficulty scores 5.0 points lower (95% CI −10.0 to −0.1), p = 0.045 than not keeping a routine. Parents who reported keeping a routine had anxiety scores 4.3 points lower (95% CI −7.5 to −1.1), p = 0.009 than those who did not. Children of keyworkers tended to have lower emotional and behavioural difficulty scores [−3.1 (95%CI −6.26 to 0.08), p = 0.056] than children of non-keyworkers. All models were adjusted for relevant potential confounders.ConclusionMaintaining a routine may be beneficial for both child emotional wellbeing and parental anxiety, although it is also possible that lower parental anxiety levels made maintaining a routine easier. Being the child of a keyworker parent during lockdown may have been protective for child emotional wellbeing.

Time off work following psychological injury among health and social care workers: a population-based retrospective cohort study in New South Wales, Australia

ObjectiveThis study aimed to determine the disability duration and burden of compensated time loss in the health and social care (HSC) sector following psychological injury.MethodsA retrospective cohort study was conducted...

Professionals Evaluating Clients' Suitability for Digital Health and Social Care: Scoping Review of Assessment Instruments.

Increased digital health and social care services are generally considered to improve people's access to services. However, not everyone can equally access and use these resources. Health and social care professionals should assess clients' suitability for digital solutions, but to succeed, they need information about what to evaluate and how. This scoping review aimed to identify evaluation tools that professionals can use when assessing clients' suitability for digital health and social care. We summarized the dimensions and the practical usefulness of the instruments. The MEDLINE (Ovid), CINAHL, Web of Science, and ASSIA databases were searched in February 2023 following the Joanna Briggs Institute's Manual for Evidence Synthesis. Studies were included if they focused on health and social care clients and professionals, examined clients' suitability for using digital health or social care, and applied related assessment methods in the direct client work of professionals. Studies focusing primarily on instruments intended for research use without clear applicability to professionals' practical contexts were excluded. Details of the eligible studies were extracted, and qualitative content analysis according to the research objectives was performed. A total of 19 articles introducing 12 different assessment instruments intended for the health care context were included in the review. No instruments were found for evaluating the suitability for digital social care. The instruments contained 60 dimensions of the client's suitability for digital health, which reflected four perspectives: (1) skill-based suitability, (2) suitability based on general ability to maintain health, (3) suitability based on attitude and experience, and (4) suitability based on practical matters. The described practical usefulness of the instruments included professionals' possibility to (1) identify clients most in need of education and support, (2) direct and recommend the right clients for the right digital services, (3) ensure that clients can use digital health, (4) improve effectiveness and maximize the provision of digital health, (5) develop and redesign services, and (6) empower clients. Based on the diverse assessment instruments available and the dimensions they measure, there seems to be no comprehensive evaluation tool for assessing clients' prerequisites to use digital solutions. It is important to further develop comprehensive screening tools applicable to professionals' busy work (both in health and social care) with defined threshold values for suitability.

Nonphysical Suffering: An Under-Resourced and Key Role for Hospice and Palliative Care Social Workers

This article highlights recent research findings that have significance for hospice and palliative care social work in Canada, and for the field of hospice and palliative care more broadly. A 2020 discourse analysis study examined the experiences of 24 interdisciplinary palliative care clinicians across Canada in their work with patients’ nonphysical suffering. Nonphysical suffering is suffering that may be emotional, psychological, social, spiritual and/or existential in nature. The study found an absence of specialist social workers on hospice and palliative care teams or limited time for specialist social workers to address patients’ nonphysical suffering due to high caseloads and complex practical needs. While the study recognizes social workers have expertise in supporting patients’ nonphysical suffering, a competency and skill that has not been sufficiently captured in the existing literature, the systemic barriers they face in providing care may leave patients’ needs unmet. The study also highlights the unique pressure social workers may feel to relieve patients’ nonphysical suffering due to the psychosocial focus of their role. The need for specialist social workers to be included and adequately resourced on hospice and palliative care teams across diverse settings in Canada is evident.

Tools to accelerate anti-racist supervision practices in social work practicum-based education settings

ABSTRACT Due to recent racial injustices in the United States and globally, there is an urgent need for curricular reform in social work education. The profession requires creative tools, techniques and methods that provide strategies for how to dismantle structural racism embedded in the work of both social care systems and social work education and training. The education of social work students offers a vital window of opportunity to equip the next generation to dismantle systems of oppression and engage in justice-oriented action. The authors provide resources to support practicum-based educators in the implementation of anti-racist supervision practices with social work students. Tools and strategies including vocabulary, key terms, skill building and reflection that can guide the development of foundational knowledge for engagement in justice oriented social work practice.

The Impact of COVID-19 on Social Care and Social Work in the UK: A Scoping Review

Abstract Prior to the COVID pandemic, staffing levels, staff turnover and vacancies in adult social care and social work within the UK were a major concern, with staff experiencing high workloads, burnout, stress and poor morale. The paucity of published evidence in a rapidly evolving contemporary situation indicated the suitability of a scoping review. Systematic searching produced evidence published between 1 December 2019 and 9 May 2023. Out of ninety-seven articles retrieved, the final analysis included thirty nine articles. To report the review findings clearly and accessibly, the analysis used the Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework. Abundant evidence emerged on psychological distress and the impact of COVID-19 on the working environment for social care and social workers, but a paucity of psychosocial resilience, supporting social care managers, Personal Assistants and moral injury. Social care needs and the statutory duties of social work are likely to become even more intense. The COVID pandemic magnified a chronic lack of funding, staffing, support and regard for adult social care, with no future planning compared to the NHS. This legacy and backlogs of social care assessment and service delivery are of concern despite the proposed actions of the Adult Social Care Reform Act in England.

Improving Treatment Adherence in Patients with Sickle Cell Disease

BACKGROUND: Crizanlizumab is approved for treatment of sickle cell disease (SCD) patients with frequent pain crises and hospital admissions. Here, we address systemic factors that have led to sub-optimal adherence to monthly crizanlizumab infusions at our institution. Due to 340B status limitation, the drug was originally offered at a site affiliated to our hospital with little SCD team presence. In 2020, UW hospital (primary site of SCD care) acquired 340B status, but transferring crizanlizumab infusions to UW hospital was not prioritized. In 2022, our institution's crizanlizumab adherence was 22% 1. Patients receiving crizanlizumab were interviewed to identify adherence barriers. Top barriers included location (44%), scheduling (44%), and low knowledge about the medication (67%). A detailed analysis with SCD team input revealed barriers such as restriction on opioids for day treatment, scheduling delays after hospital admissions, onerous paper orders process, different EMRs, and poor communication/coordination between sites (Fig 1). METHODS: The hospital leadership was appraised of these barriers in a series of meetings by the SCD team and approval to administer crizanlizumab at UW hospital infusion center was granted. UW health pharmacy and infusion staff planned a transition phase with 5 patients transitioned each month between March-April 2023. Crizanlizumab orders were updated in the EMR, and infusion nursing staff received training about the drug. Smart phrases were created for patient education in after visit summaries (AVS). Day treatment with IV fluids and pain management was offered with infusions. SCD care coordinator and social worker helped with scheduling, transport, and childcare. Providers aimed to discuss treatment goals and pros/cons during visits. Goal was set to assess adherence at months 3 and 12 after implementation. Average rate of adherence was defined as percent of prescribed treatments taken by the patient over a specified time period. In case of hospitalization, adherence was defined as rescheduling and receiving the treatment. We aimed to improve adherence to 50% at 3 months and 75% at 12 months if crizanlizumab FDA approval is maintained. RESULTS: By mid-July 2023, 11 patients were transitioned to UW Hospital for crizanlizumab infusions. 10/11 patients received the drug during this period (1 patient taken off due to pregnancy). The average adherence rate increased from 22% to 71% at 3 months, exceeding the original goal. 5/10 patients had an adherence rate of 75% or more. Additionally, 70% received at least one visit from the SCD social worker (SW) during treatment and 70% saw their provider concurrently with at least one visit. All patients received day treatment with supportive IVFs and/or pain medications during the infusion visit (Fig. 2). Only 2/10 patients had 25% or less adherence which occurred due to scheduling errors that will be addressed moving forward. DISCUSSION: Our study aims to address both intentional and unintentional barriers to crizanlizumab adherence that included infusion location, scheduling, and patient education. Our team advocated for the transition of infusions to the main hospital where they receive all other SCD care. This provided patients with direct access to their SCD team during infusions. Care coordinator and social work involvement helped consolidate treatment-related orders to one EMR, standardize nursing and patient education, organize scheduling, and address social barriers. The adherence rate increased from 22% to 71% at 3 months after implementation. Although the current approval of crizanlizumab is under review, we believe the barriers addressed in this project can be extended to current SCD treatments and upcoming novel therapies. Splitting care sites due to insurance and logistical reasons can create barriers for this vulnerable population due to complex care coordination and psychosocial needs. The rapid improvement in crizanlizumab adherence displayed here is a testament to the impact of having a dedicated SCD team at one leading site to advocate for and address the unique barriers to healthcare experienced by people with SCD. Sources 1. Nixon G, Fallon M, Fulcer K, Curran W, Nazeef M, Pradhan R. How can infusion therapy adherence by improved in Sickle Cell Disease. American Society of Health-System Pharmacists; Dec. 2022. Las Vegas, NV.

A53Simulation equipment - What do you have? What do you do with it?

Educators and workforce planners appreciate that clinical skills development and simulation-based learning are key strategic responses to safe and effective service provision and a sustainable workforce. However, some simulation-based experiences require simulators costing tens of thousands of pounds. In order to promote a ‘Once for Scotland’ approach, collaboration is essential to encourage sustainability by enabling sharing of equipment, training materials, processes, procedures and faculty between boards. Although there have been other scoping exercises [1], we believe that this the first to take place at a national level. This scoping exercise aimed to: Establish what equipment is available in the territorial health boards; Clarify the types of skills-based courses being run across NHS Scotland; Connect and encourage collaboration between simulation providers Information was gathered via Teams discussions and questionnaires. The responses were collated into Excel spreadsheets. These have been linked into an application to present the data in a more user-friendly manner online ( Interactive map of simulation resources in Scotland Responses reveal that: All health boards in Scotland have invested in simulation-based learning. There is pioneering work with the establishment of medical and surgical bootcamps as well as national pharmacy simulation. Additional work needs to be carried out to ensure that resources are invested wisely to areas of greatest need and that resources are shared within and between health boards. It is clear where abundant simulation activities are taking place, as well as where there are gaps in equipment and faculty. Distribution of the information gathered will reduce duplication of effort, increase collaboration and encourage the sharing of equipment between health and social care workers across Scotland. It is hoped that this scoping project will support the creation of new relationships between people, not just for their mutual benefit, but for the benefit of the people of Scotland. The results are a first step to providing a detailed inventory of the resources available to help ensure best value for money. We hope to see an increase in the sharing of equipment across Scotland similar to the use of the NES surgical cut suit which was purchased by the Scottish Centre for Simulation and Clinical Human Factors and recently used by the simulation team at NHS Lothian to provide a multi-professional immersive paediatric training session. The plan is to update this database on a regular basis and to widen the results to incorporate all health boards as well as universities. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.