An Exploration of the Role of Social Workers Within an Integrated Setting

Phillipowsky, Darryl James (2018) An Exploration of the Role of Social Workers Within an Integrated Setting. PhD thesis, University of Worcester.

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Abstract

This qualitative study has been undertaken to address a literature gap relating to the efforts to integrate health and adult social care within England at a time of austerity. This study adopted an interpretivist paradigm utilising a social constructionist epistemology in that there are multiple realities to be understood and different perspectives and perceptions to be explored. This interpretivist study explored the impact of social work within an integrated organisation from the perceptions of the practitioners: social workers, occupational therapists and nurses.

Free-text data from 41 survey respondents were subject to thematic analysis. Subsequently a further 6 interview respondents were also subject to thematic analysis. 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. 5 interviewees were social workers (83%) with 1 nurse participant (17%). These respondents provided comments that the author developed into four overarching themes: first, culture – cultural biases and clashes of professional 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 outlining/organising/ structuring integrated care within a health organisation. Fourth, political: the political drivers of integration.

This study highlights areas of concern specifically for social workers as well as for integrated social care and health, uncovering a number of themes that exist across the integration journey. While most of the comments were negative, analysis reveals concerns shared by substantial 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 integrated care. The findings and recommendations are therefore pertinent to many health and social care organisations looking to integrate in the future.

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