Professionals’ views of GP-style social work practices

The green paper on children and young people leaving care in England proposes to establish “social care practices” modelled on NHS-style GP practices. Graham Hopkins gathers opinions

So did you come into social work to open your own GP-style practice? In Care Matters: Transforming the Lives of Children and Young People the government proposes “a model of social care practices: small groups of social workers undertaking work with children in care commissioned by but independent of local authorities”.

These practices, says the green paper, should be similar to a GP practice – independent organisations, whether a voluntary or community sector organisation, a social enterprise or a private business. The practice would be registered with the Commission for Social Care Inspection and be responsible for employing social workers. The green paper says: “Each social worker would have the freedom to concentrate on the children in their care and would be accountable for their outcomes.

“While the local authority would still be responsible for care proceedings, once the child entered care formally they would be given a lead professional from a practice, charged with the task of being a consistent parental figure and advocate for the child.”

The idea has gained support but some are more critical. Carolyn Matthews, adoption and permanence team manager at Wigan
Council, says: “Is there an intention to create an elite group of custodians of society’s social conscience who are to be set apart from the management support mechanisms and the supervision expertise that guides and mentors us? How will further fragmentation assist children? I think they will feel overawed not assisted. The concept appals me.”

Fragmentation also concerns Sutton Council team manager Maureen Floyd: “Any practice will probably recruit social workers from councils. Social workers already criticise the lack of direct work with children, much of which is currently concentrated with looked-after children. To move this work out could reduce those opportunities further.”

The scepticism continues: “It introduces another person into the lives of young people without a clear remit and with little evidence that it would contribute to better outcomes overall,” says Andrew Cozens, strategic adviser for children’s services at the Improvement and Development Agency.

Chris Durkin, senior lecturer in social work, Northampton University, says: “When I reflect on the green paper, part of me
feels very angry because throughout my time in social work (over 25 years) this has always been an area of concern. Is anything going to change or is it going to be another initiative with a sackful of platitudes and no action?”

Others believe that major reforms will not work in social care because of the lack of staff and money. “The green paper sounds great on paper, but in practice will create change but not enough to significantly improve outcomes for looked after children. The reality is we will always lack appropriate resources and sufficient money to implement radical change,” says social worker Angie Jackson.

However, for some, the status quo is not good enough.

“Dismantling local authority social work is the only way to make it more effective,” argues Melanie Howes, social worker at Cornwall Council. “At the moment social workers are more like local government officers, bound by policies and procedures which, while wellmeant, do not allow a young person’s wishes to be heard effectively.”

But will it be liberating? “Direct work with children and young people in care does need a small bureaucracy to support it,” says Cafcass chief executive Anthony Douglas. “It needs it to find placements in a crisis when one breaks down out of hours, to raid other budgets to fund overspending care budgets, which would be hard for an independent practice to achieve if it is paid through a fixed contract price.”

Other potential pitfalls await. Independent trainer Linda Naylor says: “As someone who went from local authority social worker to running a private training business this transition is not straightforward. Learning business management skills is a new chore for most of us schooled in the local authority way of working.”

She continues: “Social workers going into business would have the same decisions to make and the same limited resources as  local authorities. Supervision and administrative arrangements would be difficult and costly to manage.”

That said, maybe a sector with structures in place and competitive edge, is all set? The chief executive officer of TACT, Kevin Williams, believes so. “Independent practices could work more flexibly and offer a real improvement in the delivery of social work practice,” he says. “The independent sector has improved foster care delivery and raised standards, and  independent practices could do the same.”

But previous attempts to transfer statutory work such as child protection to the voluntary sector have come to nothing, counters Douglas, as local authorities have the statutory responsibility for children in care and the only viable large-scale accountability framework.

“Independent social workers will always have a properly commissioned role to play supporting individual children in care, but they are the wrong group for independent practices to support.” So what’s the solution? “I favour the strengthening of the social worker and foster carers’ role, robust and focused mentoring support in schools, and further investment in advocacy and participation programmes,” suggests Cozens.

Douglas agrees: “Raise the standards of all local authorities to those of the very best. On the other hand, properly funded independent practices for children in need; now you’re talking! The big question there is: could they ever be properly funded?”

Arguments for GP-Style practices

● With social workers gaining more independence they should take on greater autonomy in decision making for children. Increased financial responsibility may provide the money and power to support their role.”
Maureen Floyd, team manager

● “A social care practice could allow workers to focus solely on looked after children. There is the opportunity to earn greater salaries and share in profits, and there is a financial incentive to move children on to permanency or return home.”
Alexandra Conroy-Harris, council lawyer

● “To the entrepreneurial social worker the care practice could be an attraction – offering an attractive and financially rewarding career. Independent fostering agencies tell us that for every 22 children in placement they get a £1m turnover.”
Ian Crosby, independent social worker and foster carer

● “The independent/voluntary sector has a good record in social work recruitment and retention and therefore could offer a more consistent social worker to young people.”
Kevin Williams, chief executive officer, TACT

Arguments against GP-style practices

● “Continuing professional development could be in jeopardy, as social work practices will have a focus upon profitability and could be disinclined to support training beyond the bare minimum.”
Maureen Floyd

● “There is a conflict of interest between having responsibility for the funds for the child, when profits will be dependent upon savings that can be made from that budget.“
Alexandra Conroy-Harris

● “The main need for looked-after children is continuity of social worker. Social workers leave the profession mainly due to overwork and stress and these proposals could make this worse not better. ”
Linda Naylor, independent trainer

● “This could set up direct conflict between the social worker acting for the local authority, who  child may perceive as being ‘against his parent’, and the independent practice social worker who is able to offer him tangible support.”
Maureen Floyd and Alexandra Conroy-Harris

Contact the author
Graham Hopkins

This article appeared in the 9 November issue under the headline “Do practices make perfect sense?”