The perceptions regarding social workers from within an integrated trust in an age of austerity

The purpose of this paper is to explore community professionals’: opinions concerning social worker’s roles and statutory functions; understanding of collaborative and cooperative work; experiences of professional support; opinions on the aspects of anti-oppressive practices in social work; views on social work identity within multi-disciplinary team structures; exploring perceptions regarding the challenges of cultural; and contextual drivers of social work practice.

Design: thematic analysis of free-text data from a survey. Setting and participants: social workers, occupational therapists and nurses working within an integrated Health and Social Care NHS Trust. Main outcome measures: free-text coded and categorised by theme. Overarching themes are identified incorporating comment categories. Methods: 41 respondents (of n=600 survey respondents) provided free-text comments. Data were coded using a multistage approach: coding of comments into general categories (e.g. resources, budgets); coding of subcategories within main categories (e.g. s75 agreement, staffing levels); cross-sectional analysis to identify themes cutting across categories; and mapping of categories/subcategories to corresponding comparable research for comparison.

Most free-text respondents (51 per cent) were from social workers, with 32 per cent from occupational therapists and 17 per cent from nurses. These respondents provided comments that the authors developed into four overarching themes: first, culture – cultural biases and clashes of culture within an integrated care organisation which result in a negative experience for professionals and confusion for service users and/or carers. A lack of shared socialisation and the development of a shared culture. Second, austerity: the impact of economic austerity. Third, organisation: conceptual confusion in respect of defining/organising/structuring integrated care within a health organisation. Fourth, political: the political drivers of integration.

This study presents specific areas of concern for social workers and for integrated social care and health as a whole, revealing a number of themes present across the integration journey. While the majority of comments were negative, analysis reveals concerns shared by significant numbers of respondents: conceptual confusion in respect of organising integrated care within a health organisation, a lack of shared socialisation and the development of a shared culture within the integrated organisation, and the impact of economic austerity on integration.