Experiences of social workers in primary care in Ireland

A Systematic Review of Social Work in General Practice: Opportunities and Challenges

PURPOSE

This study identified the nature of social work practice in primary health care and described the reported patient outcomes, benefits, challenges, and enablers of social work in general practice [GP] settings.

METHOD

A systematic literature review applying the Prisma framework was conducted.

RESULTS

A total of 26 studies met the inclusion criteria. Social work practice in GP assists in delivering positive health outcomes for patients, improved patient care, offers value for money, and supports interdisciplinary teams. Identified challenges include funding impediments, organizational barriers, and a lack of understanding of and undervaluing the social work role.

DISCUSSION AND CONCLUSIONS

The review outlined the benefits of social work practice in GP practices; however, these must be further evidenced. Funding for social workers in primary health care was identified as a challenge when it was lacking, and as an enabler when it was available. Further research to evidence the patient outcomes and overall benefits, the fiscal value of social work and funding pathways in primary health care is recommended.

Perceptions towards integrated care through the narrative of practicing social workers and psychologists in PHC: a cross-case analysis

Purpose

In a collective effort to build a patient-centered and coordinated health care system, social workers and psychologists are being progressively introduced to primary health care (PHC) settings worldwide. The present study aims to explore the current status of integration through the narrative of social workers and psychologists in PHC settings in Kazakhstan.

Design/methodology/approach

In this paper purposive snowball sampling was utilized to recruit social workers and psychologists who work, or used to work, in PHC settings since the onset of integration in Nur-Sultan for participation in an in-depth interview. A semistructured interview guide was based on normalization process theory (NPT). Interviews were conducted via video conference, in Russian language, lasted no more than 50 min, and transcribed verbatim. Cross-case analysis of eight cases was performed using NPT constructs.

Findings

Cross-case analysis included findings from the interviews from five social workers and three psychologists. Four major constructs of implementation process from NPT were reflected in the findings: coherence (believes integration improves patient care, functions within integrated care), cognitive participation (individual changes to role performance, mechanisms of work), collective action (status of support from stakeholders, cooperation within a multidisciplinary team) and reflective monitoring (existing mechanisms for monitoring the integration).

Research limitations/implications

Despite organizational integration, there is a lack of successful clinical integration of social workers and psychologists in PHC settings of Kazakhstan, which is manifested by a lack of understanding of responsibilities and functions of these mental health care specialists. Consensus was reached by all participants that both social workers and psychologists are valuable assets in a multidisciplinary team.

Originality/value

The present study contributes to the current knowledge of integrated PHC service delivery by addressing the status of integrated care in Kazakhstan from interviews with key stakeholders in social work and mental health. Moving forward, improvements are needed to (1) establish the monitoring mechanism to evaluate the status of integration, (2) enhance effective collaboration within multidisciplinary teams in PHC settings and (3) increase awareness among medical workers and community members on mental health issues and the available support offered by social workers and psychologists to promote quality of life in a holistic, integrated manner.

The DNA of Social Work as a Partner in Primary Health Care

There is a strong focus on primary health care (PHC), as rooted in a commitment to social justice and equity, to reduce social inequalities in health. Within PHC, interprofessional collaboration is emphasized to achieve these objectives. Social workers are a renewed partner within these collaborations, as principles of social justice and human rights are the core of this profession. However, it is unknown if and how social work implements these principles in primary health care settings. This systematic literature review examined the existing literature on the role of social work in primary health care settings on themes of social justice. Our results emphasize how valuable the presence of social workers in primary health care is because of their broad perspective on health. At the same time, we also reveal a few points of concern, as their focus on social justice remains rather individual. This review suggests the strengthening of a social justice based approach in primary health care, which is an issue that should be shared with other healthcare professionals. We discuss implications for practice, research and policy.

Collaboration between general practitioners and social workers: a scoping review

OBJECTIVES

Aim of the study is to present an overview of collaboration structures and processes between general practitioners and social workers, the target groups addressed as well the quality of available scientific literature.

DESIGN

A scoping review following the guidelines of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews).

INCLUDED SOURCES AND ARTICLES

According to a pre-published protocol, three databases (PubMed, Web of Science, DZI SoLit) were searched using the participant-concept-context framework. The searches were performed on 21 January 2021 and on 10 August 2021. Literature written in English and German since the year 2000 was included. Two independent researchers screened all abstracts for collaboration between general practitioners and social workers. Articles selected were analysed regarding structures, processes, outcomes, effectiveness and patient target groups.

RESULTS

A total of 72 articles from 17 countries were identified. Collaborative structures and their routine differ markedly between healthcare systems: 36 publications present collaboration structures and 33 articles allow an insight into the processual routines. For all quantitative studies, a level of evidence was assigned. Various measurements are used to determine the effectiveness of collaborations, for example, hospital admissions and professionals' job satisfaction. Case management as person-centred care for defined patient groups is a central aspect of all identified collaborations between general practitioners and social workers.

CONCLUSION

This scoping review showed evidence for benefits on behalf of patients, professionals and healthcare systems by collaborations between general practitioners and social workers, yet more rigorous research is needed to better understand the impact of these collaborations.

TRIAL REGISTRATION NUMBER

www.osf.io/w673q.

Perspectives on social workers from within an integrated setting

Purpose

This research explores community professionals' opinions concerning social worker's roles and statutory functions. It explores the perspectives of professionals and their 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 multidisciplinary team structures; and perceptions regarding the challenges of cultural and contextual drivers of social work practice.

Design/methodology/approach

This study adopts an interpretivist paradigm and social constructionist epistemology in that there are multiple realities to be understood and different perspectives and perceptions to be explored. This study adopted a data collection approach of thematic analysis of semi-structured interviews.

Setting and participants

Social workers and nurses working within an integrated social care and health NHS trust.

Methods

Six respondents volunteered for interviews in 2017. Data were coded as follows using a multistage approach: (1) coding of comments into general categories (e.g. culture, models of practice), (2) coding of subcategories within main categories (e.g. values, knowledge and skills), (3) cross-sectional analysis to identify themes cutting across categories and (4) mapping of categories/subcategories to corresponding comparable research for comparison.

Findings

Most interviewees (5) were social workers, with one from the nursing field. Respondents provided comments that fell under four overarching themes: cultural theme, the impact of economic austerity, organisational structures and the political drivers of integration.

Originality/value

This study contributes to the evidence regarding the role of social workers within integrated health and adult social care organisations (as opposed to mental health social work) and also contributes to the evidence around social work in times of austerity.

The Public–Private Mix in Primary Care Development: The Case of Ireland

In 2001, Ireland announced a Primary Care Strategy that has led to the implementation of primary care centers (PCCs) throughout the country. This article examines the nature and extent of private and public sector involvement in establishing the PCC network since 2001. The study is based on a PCC dataset constructed using unpublished data obtained from Ireland’s Health Service Executive (HSE). The dataset includes the date when PCCs became operational and their mode of delivery: public procurement, private lease, or public–private partnership. The results show that 140 PCCs have or will become operational by the end of 2019: 35% (49 PCCs) are public, 55% (77) are leases with private landlords, and 10% (14) are public–private partnerships. Before 2009, PCCs were delivered by traditional public procurement, but since 2009, private delivery methods have been prioritized. In conclusion, the PCC network has been increasingly implemented by relying on the private sector. This results in a more commercialized network subject to financial risks associated with public–private partnerships.

Interprofessional collaboration and integration as experienced by social workers in health care

Interprofessional collaboration in health care is gaining popularity. This secondary analysis focuses on social workers' experiences on interprofessional teams. The data revealed that social workers perceived overall collaboration as positive. However, concerns were made apparent regarding not having the opportunity to work to full scope and a lack of understanding of social work ideology from other professionals. Both factors seem to impede integration of and collaboration with social workers on health care teams. This study confirms the need to encourage and support health care providers to more fully understand the foundation, role, and efficacy of social work on interprofessional teams.