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Hospital social work and discharge planning for older people: challenges of working in a clinical setting

Published online by Cambridge University Press:  20 August 2021

Deirdre Heenan Open the ORCID record for Deirdre Heenan [Opens in a new window]
Deirdre Heenan*
Affiliation:
School of Applied and Community Sciences, Ulster University, Coleraine, UK Email: da.heenan@ulster.ac.uk
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Abstract

Across the world acute hospitals are under unprecedented pressures due to shrinking budgets and increasing demand, against this backdrop they are also experiencing record levels of activity in Accident & Emergency and delayed transfers of care. Reducing pressure on hospitals by avoiding unnecessary admissions and delayed discharges has risen up the global policy agenda. However, reviews of strategies and policies have rarely involved discussions about the role that hospital social workers play in achieving timely hospital discharge. Yet discharge planning has become a, if not the, central function of these professionals. This paper presents the results of a small-scale exploratory study of hospital social work in an acute hospital in Northern Ireland. The findings reveal that the work of hospital social workers is characterised by increased bureaucracy, an emphasis on targets and a decrease in the time afforded to forming relationships with older people. Hospital social workers highlight concerns that the emphasis on discharge planning and pressures associated with the austerity agenda limits their capacity to provide other more traditional roles such as advocacy and counselling. It is argued that hospital social work should not be narrowly defined as ‘simply’ co-ordinating discharge plans. The tension that arises between expediting hospital discharge and advocating for older people and their families is also discussed.

Keywords

hospitalsocial workdischargeadvocacy
Type
Article
Information
Ageing & Society , Volume 43 , Issue 6 , June 2023 , pp. 1333 - 1350
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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