Newly integrated health and social care organisations can expect
to see a deterioration in staff morale and a rise in anxiety and
stress among the workforce, researchers for the Institute for
Applied Health and Social Policy at King’s College London have
found, writes Lauren Revans.
The findings of an independent evaluation of mental health
services in Somerset following the creation of the Somerset
Partnership NHS and Social Care Trust in April 1999 can be seen as
a sign of what lies ahead for the government’s new care trusts, the
first four of which came into being last week.
Although findings from the UK’s first combined mental health and
social care provider reveal benefits of integration for service
users, any such benefits for the workforce are far less
Questions also remain as to whether the benefits to service
users could have been delivered without the transfer of social care
staff to NHS employment.
According to the findings, in the first two years staff
complained of increased workloads and “increased level of emotional
exhaustion”, more bureaucracy and a reduction in therapeutic
contact time, decreased job satisfaction, and rising pressure on
Social workers, who were transferred from Somerset council,
reported that they did not have the same levels of contact with
colleagues in the social services department as they had
previously, and that they felt service users no longer saw them as
“independent enough” because of their relationship with their
There were also concerns about working in a team where they were
a minority discipline, and about the loss of informal peer
supervision and the implications of that for newly qualified social
workers “who had never had the formative experiences of working in
a social services setting”.
However, the report acknowledges that the trust had,
nonetheless, come through the transfer of employment of most social
care staff “without any major personnel problems or service
Although staff reported improvements in relationships between
social care staff and health colleagues on both a formal and
informal basis, the report finds that “cultural differences”
“There was evidence in some areas that although relationships
were developing, the underlying affiliation to a health or social
care background continued to exist,” it says.
The Somerset Partnership NHS and Social Care Trust provides
secondary mental health services for children, adolescents, adults
and older adults within Somerset. About 130 of the 1,300 staff
employed at its creation were transferred from the council.