A diversionary tactic? Social work in an emergency assessment unit.

Paul Bywaters and colleagues consider staff responses to a project in which a full-time social worker was seconded to an emergency assessment unit and associated admissions ward in a large teaching hospital. Perhaps the most acute
point of tension between NHS hospital trusts and social services departments (SSD) in recent years has been the belief that social services’ failure to provide speedy access to domiciliary and residential social care has resulted in ‘blocked’ beds. Enforced joint planning, particularly around ‘winter pressures’, has generated increased understanding by NHS managers of the constraints on SSD budgets – but better understanding does not meet performance targets or national service framework (NSF) standards. Hence the plethora, in recent years, of local initiatives designed to prevent unnecessary hospital admissions, to speed discharge or enhance rehabilitation – for example, rapid response, hospital at home, admissions and assessment wards, intensive discharge services, intermediate care.