Opinion: Service users do not want care navigators

The sixties song Please Don’t Let Me Be Misunderstood could have been written with social work in mind. The message from research has been that the public does not understand what it is. They are likely to confuse it with the benefits system. Physiotherapy, yes. Nursing, of course – even optometry commands some comprehension. But social work remains somewhere, most say, they would really rather not go.

Yet the signs are that social work occupies a special place in many service users’ hearts, not least those facing the worst deprivation and exclusion. A clearer picture is emerging from the evidence in the current review of Social Work Roles and Practice in England being led by the General Social Care Council. Social work thinkers and leaders will do well to take careful note of what service users have to say.

But service users draw a sharp distinction between what they see as “good” and “bad” social work. For them, bad social work means mechanical “care management”, operating in large impersonal and bureaucratic organisations, which largely seem to be concerned with assessing people out of support, rather than providing it. Such social work boils down to a hugely complex and costly rationing system. Sadly this has been the prevailing direction of travel of statutory social work since Margaret Thatcher’s day.

On the other hand, what service users particularly value about social work – what makes for good social work in their view – is its inherently social approach; the relationship they can have with the practitioner and the positive personal qualities they associate with social workers. These include warmth, respect, being non-judgemental, listening, treating people with equality, being trustworthy, open and honest, reliable and communicating well.

Service users like the way that social work addresses both their emotional and practical issues, which are often interlinked and inextricable. They value social work practitioners who give them time to sort things out, support them to work out their own agendas, are available and accessible, offer ongoing support, are responsive, reliable and deliver, who have a good level of knowledge and expertise, as well as valuing service users’ own expertise.

They appreciate the wide range of support social workers can offer, including counselling and advice, advocacy and information. Service users also value the variety of approaches used by staff, including work with individuals and families, groups and communities and the breadth of tasks they are prepared to take on.

In fact what consultations with service users are increasingly showing is that service users value the kind of social work that practitioners want to do, first went into the profession to practice, but too often aren’t allowed to do by their statutory employers.Service users and practitioners both want social work underpinned by values of social justice and liberation.

There are some big messages for government here. Government has not always been the greatest fan of social work. Perhaps more important, it still isn’t clear that it fully understands it. The white paper, Our Health, Our Care, Our Say, which is the closest thing we have to a blueprint for future primary health and social care, is coy about social work. There are few mentions and little clarity. But it looks as though policymakers are going for a model of social work practitioner as navigator.

This could be a big mistake. It would be little more than social worker as assessor and referral agent – the sort of social work that’s least popular with service users. It says nothing about social work’s own vital role as a source of support in its own right. This is what service users highlight as social work’s great potential strength. This could offer social work a truly positive future – at least as far as service users are concerned.

Peter Beresford is professor of social policy at Brunel University and long-term mental health service user

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