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APPG inquiry: Fears over welfare of ‘lost’ patients as cuts bite on social work in hospitals

Brain injury patients are at risk of ending up on the streets or entering the criminal justice system once they leave hospital because over-stretched social care departments are struggling to support them, a Senior Social Worker warned.

The concern was one of a range raised by hospital-based social workers giving evidence to MPs on adult social care at the third session of the All Party Parliamentary Group on Social Work’s inquiry into the state of the profession.

Their testimonials underline findings from BASW’s State of Social Work survey last year highlighting the severe pressures facing the profession.
Addressing MPs in Westminster, the hospital social worker said: “In terms of social work and social services departments, it is our impression they are struggling hugely. Getting a social worker allocated [to a patient] is a major event.”

The Senior Social Worker, employed at a specialist hospital unit for supporting brain injured people, said social services departments found it difficult to understand the needs of such patients.

“What we are finding is that with brain injured clients they do not fit neatly into local authority social service provision. They can be able, but be cognitively damaged. They cannot self-care or organise their lives without significant support, but they can get out and about. It can be a huge risk factor if they are not cared for adequately.”
The social worker warned there were “strong links” with the criminal justice system when the social welfare needs of brain injury survivors were not met.

“If they are not provided with enough support they can slide into the criminal justice system very easily. Social services should play a large part in preventing that.
“People with a brain injury typically suffer from social isolation. They lose friends. They can’t make new ones. They can be quite lost out there. With the severe cut-backs in day care resources it can put survivors in further isolation. I think we are probably losing people to the streets who otherwise wouldn’t be there.”

Another social worker giving evidence, who works in a hospital ward, said the needs of transplant outpatients were often not understood by Disability Living Allowance Medical Assessment Officers who commission services. 

“They don’t understand the day-to-day things they have to go through. A liver transplant patient for example can one day function very well [but] the next day you might be talking a different language. So you give them a document like the Disability Living Allowance and they just physically can’t do it. We are being encouraged to steer people to the Citizens Advice Bureau. But there are long waiting lists and a lot of people physically can’t get there. So they keep coming back to us.”

Asked by the parliamentary group’s Acting Chair Mike Wood what one thing the Government could do to improve things, both social workers called for senior social care managers to be involved in the planning and allocation of resources at a local level.

One said: “We have some excellent social services and health services but they are so challenged by resources and it is hard to argue with people who don’t understand. The budget holders need to be the people who understand the problem.

“If frontline services in the acute sector are going to save lives and treat major trauma, it is essential that there are care pathways for survivors, going right through from suitable health to social care provision.”

The other social worker told MPs: “Whenever there is a crisis, we always seem to find money for doctors and nurses, but we don’t get the same focus on the work that social workers put in.

“I think social workers at senior service level should be involved. We need someone at that senior level to say what is available in the community and to give cohesive care as well as health care for patients.”