Are integrated teams good for social workers?

Differences in culture, pay, terms and conditions, targets, ethos and jargon – all of these challenges are likely to be familiar to social workers with experience of integrated health and social care teams.

Fears around job security remain high for social workers in such teams. Does integration really work? And, more importantly, does it work for social workers?

Checklist: Does integration work for you?

Integration: Four things you need to think about

Terms and conditions

Social workers can be seconded into health teams, employed by health organisations or budgets might be pooled and a new organisation created, such as a community mental health trust.

In each case, social workers will face new contractual arrangements, which can cause anxiety. Confusion around the governance rules and professional supervision can also cause tension.

“In the best schemes all of this is crystal clear right at the start for every worker involved so they don’t need to worry about it,” says Nick Goodwin, senior fellow in health policy at the King’s Fund.

Helga Pile, UNISON’s national officer for social work, points out that employers have a duty to consult trade unions who can advise members about their rights. However, while TUPE protects pay, terms and conditions, she warns employers often try to negotiate “harmonisation” agreements further down the line.

Pile favours secondments, which mean social workers maintain their link to local authority structures, keep their professional independence and ability to challenge and offer greater security of employment should the integration fail.

Career progression

A recent online debate hosted by the College of Social Work’s mental health faculty showed many mental health social workers felt “frozen out” of key roles that helped shape how services were delivered.

Pile agrees that a key factor is the extent to which social care is represented within the partnership’s leadership and management structures.

“It can make a real difference as to whether social care professionals feel they are a beleaguered minority or properly respected and integrated.”

Governance

Within integrated teams there is often pressure to genericise roles and get different disciplines to take on tasks and responsibilities from each other.

Tensions often arise when staff are supervised by a different profession. Some integrated teams have separate professional and line management supervision – particularly in England where the new standards for social workers state they should be supervised by a qualified social worker.

Pile points out social workers have a professional duty to only undertake tasks they are qualified or competent to do. UNISON publishes a duty of care handbook, which helps members think about the pressures they might come under and how to act in the best interests of service users.

Job satisfaction

The Royal College of Nursing’s research on integrated teams in Scotland found that both the nurses and social workers interviewed preferred working in an integrated service than what existed before.

A social worker on Community Care’s CareSpace forum says that after having worked in four different integrated teams the benefits of better and simpler referral processes -“meaning you can find people face-to-face”- cannot be underestimated.

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