Covid-19: Impact on Social Work

David Simmonds Excerpts

Wednesday 23rd March 2022 Westminster Hall

[David Simmonds (Ruislip, Northwood and Pinner) (Con)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I add my congratulations to the hon. Member for Lancaster and Fleetwood (Cat Smith) on securing the debate. Like her, I have had the opportunity over many years in the world of local government, to see the transformative benefits that social workers can bring to the lives of many of our most vulnerable people. Those are children in the care system, adults with learning disabilities and people facing difficulties in old age, where the professionalism, attention to detail and the care provided by local authorities across the country have enabled people to live the best life they possibly can in the circumstances they face.

The topic of today’s debate makes clear that the pandemic has tested not just the professionalism of our social workers, but our care system’s capacity to respond. We will all have seen amazing examples of how social workers and those connected to them have stepped up to the plate. The local authorities that serve my constituency—the London Borough of Hillingdon and the London Borough of Harrow—both played key roles in the community. Social workers identified the needs of individuals and harnessed support from volunteers, charitable and community organisations, to ensure that, where there were limits to what the state could do to provide for people in a time of acute need, others were able to step in.

I will give the example of H4All, a charitable organisation in Hillingdon that brought together the efforts of several organisations, supported by a local authority that recognised that social workers would be able to do their best work if they were effectively supported. For example, with libraries closed, library staff were redeployed to man call centres for people who needed to raise a concern about someone they knew, a family member, or who were supporting someone and needed to arrange delivery of medication.

They were able to use staff who were redeployed, so that social workers could concentrate on things that only they could do, such as assessments of need to enable people to progress in their care packages, the preparation of people to be discharged from hospital, and acute work in children’s services, such as child protection for those known to be at risk, who might otherwise have missed the opportunity of a regular visit from a professional to ensure they were safe and thriving in their placement. One of my neighbours, a foster carer, was supported through the process of fostering a baby who was placed with her. Social workers were able to continue ensuring that system for supporting the needs of the most vulnerable, despite all the pressures of covid.

In the context of the debate about the future of social work, covid has given us the opportunity, not just in social work but in many parts of our system, to learn lessons and identify what we can do better, based on how covid tested the operation of the system. As the co-chair of the all-party parliamentary group for social work, I am conscious that, along with other professional organisations, social workers are taking a key interest in how the profession will develop and sit in the context of the care system, of which it is a crucial part.

That is not a new debate. I commend the Department for Education for seeking, through the fast-track programme, to identify ways in which people who want to become social workers could develop their professional standards. They are able to pursue a programme, facilitated by placements in different types of organisations, with different aspects of the social work profession. Having sat in on some of those training sessions, I was fascinated to see how social workers saw things in a different light, through talking to people who managed cases other than the ones they might commonly come across in their day jobs. They were able to support each other to develop their professional judgment. The proposed re-tendering of that programme, although an important part of the system, needs to ensure that it continues to support social workers in developing the highest professional standards, and does not lose the focus it has brought to the system.

Some of those issues are consistent across all parts of the social work profession. We heard, for example, about caseloads, which remain a challenge for social workers whether they are dealing with adults with learning disabilities, very elderly people, or children who are in need for whatever reason. The context of regulation for children’s social workers is different from that of adult social workers, and that also remains a challenge. The work of the Care Quality Commission is perhaps beginning to diverge from the work of Ofsted, so the regulatory framework for the social work profession is becoming more and more diverse, reflecting the fact that the clients that social workers serve are different.

It is worth reflecting on some of the pandemic lessons. We have seen, for example, a move away from significant numbers of family support workers in children’s services, as well as occupational therapists in supporting elderly people, and in the role of youth workers, which was referred to earlier. Perhaps we need to reflect on the structures that we expect from our local authorities and that our regulatory framework drives. Perhaps there should be a greater degree of local flexibility to bring together those different but allied professions so that they focus on the needs of the most vulnerable.

Local authorities will do that for a variety of reasons. I recall Hackney Council’s so-called pod model bringing together youth workers, therapists and social workers. By the time that other local authorities had adopted that model, Hackney had given up on it because it felt it was not working any more, so there is sometimes a risk that, when tested, new ideas prove to be not as effective as we would like. However, we should see the deployment particularly of folks such as family support workers in a way that can really help the social work profession to do what it does best and what only it can do, and the service that vulnerable people receive should be of the highest quality possible.

The greater divergence among the workforces around children, adults and the elderly can be positive, particularly in the context of extra funding, which we expect to see coming into the system through the decisions that the Chancellor and the Government make. Some will say that that is overdue and insufficient, but I can say that from my experience in a local authority it will be most welcome. It will ease a lot of the pressure that has been building up in the system and, because the local authority funding model is so diverse across the country, it can re-base social services departments so that they are more consistently funded through a national programme in a way that putting the burden on council tax payers cannot achieve because of the diversity of how much funding is raised.

The social work profession has an opportunity to consider parallels with what is going on in other professions, especially across the public sector where we see many similar roles. How is the nursing profession developing? How are the lessons from professional development being applied? In teaching and policing we see not just similar salary levels, but often common qualifications and of course a focus often at the most vulnerable end on the same families, so are there things that we can do to improve the way that the training and development across all those professions is aligned so that they can work more effectively together?

The pandemic period, the debate today and the celebration that has been referred to have demonstrated once again that social workers and those who support and work with them remain a key part, often a hidden part, of the social infrastructure of our country. The local authority with the most people coming into contact with any part of social care has less than one in five of its population receiving any form of support from social care during the whole of their lives. Most people will never be touched by social care, but for a critical group in society it is absolutely vital that they receive care to the highest possible standard, and I join the hon. Member for Lancaster and Fleetwood in paying tribute to the work that social workers have done in keeping society together during the pandemic.

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[Jim Shannon]

The hon. Gentleman is absolutely right. Many social workers I deal with are probably of a certain generation. He makes the point that we need to be preparing, and that goes back to my question to the Minister about having a strategy and plan in place.

I understand that many young people do come into social work, because I have met some, but—I say this very gently, and it is not in any way meant to be critical—they need to have experienced social workers to work alongside and gain their knowledge. Young people will sometimes be confronted with cases that they might not have the life experiences to deal with. That is not a criticism; experience is gained over many years. I have been confronted by such cases on behalf of constituents, and I feel that decisions are not always made—in my opinion, as someone who is not a social worker—as they could or should have been.

[David Simmonds]

I entirely agree with the hon. Member’s point. Does he agree that programmes such as the fast-track ones bring the opportunity, in particular for young social workers who might be graduates straight out of university, to work with people who may have been in the profession for 20 or 30 years? Young social workers would have the chance to learn from experienced people and to see how they dealt with cases with which I, as a lead council member, was sadly familiar—for example, sometimes, the sexual abuse of children committed by professionals who were meant to be caring for them, or elderly people suffering complex financial abuse within a family. It is important that the Department of Health and Social Care and the Department for Education continue to support that type of professional development, so that we can grow our own highly professional social workers in the future.

[Jim Shannon]

As my friend, the hon. Member for Glasgow East (David Linden), said—and as I am trying to say, in my broken words—people have to start somewhere in life; they have to start their job somewhere and learn about their role.

Social care organisations have revealed that 75% of social workers feel more negative about their work life in 2021 compared with in the first year of the pandemic. People come to us all the time with problems, and I like that because it is my job. Many people say, “I don’t know how you do your job, listening to people’s complaints and always solving their problems, and so on”, but I reply, “That’s what life is about. Life is about making lives better.” We need to be aware that social workers sometimes deal with complex and difficult issues. My question to the Minister is, has any assessment been done of the impact of the pandemic on social workers? If the figures are right—I understand that they are—that 75% of social workers feel more negative about their work life in 2021, we have a potential problem. I hope we do not, but we must at least consider that and respond.

This situation is down to the increasing pressures and challenges that the social work sector has faced. Referrals of children to social services in Northern Ireland have increased every month since February 2020. The highest figure was in April 2021, with 3,616 children being referred. That clearly indicates that parents are struggling to cope, and is a clear sign of the increasing pressure on our social workers, which the hon. Member for Lancaster and Fleetwood illustrated very well in her contribution, and as other Members have reported.

We must not forget the impact that the covid outbreak has had on the social sector in relation not just to children, but to the elderly and the vulnerable. The hon. Member for Ruislip, Northwood and Pinner (David Simmonds) rightly referred to an issue that is on my mind as well: people who depend on family members to look after their financial affairs. I have dealt with a few of those cases, which are always difficult because there are often two sets of family members saying two different things—but there is a person in the middle who is losing out.

The BBC revealed in mid-2021 that almost 2,000 people in Northern Ireland are waiting for care packages, so that they can be supported to live in their own homes. Just this week, a very lovely man who I have known all my life—he is well into his 80s now—has been ill and had to go to hospital. Although he wants to come home, and would be able to, he needs a care package in place before he can come home because, due to the nature of his disability, his wife would be unable to provide the physical care that he needs. That is not the Minister’s responsibility; I am just illustrating the issue.

The wait for care packages could mean an increase of patients to residential care. My constituency of Strangford takes in the South Eastern Health and Social Care Trust, which has reported that 282 people were waiting from the end of August 2021. Social workers are a key part of making that a success story. The provision of home care is crucial in taking the additional pressure off of hospitals and care homes. We must ensure that our social workers have the capacity to deal with the increasing amount of care packages needed. I have never seen anything quite like it. I know that we are getting older—we are living longer and our bodies are breaking down, meaning that more people need care packages—but there has to be a strategy and a vision for how we deal with that, as has been pointed out in other contributions.

There is an increased risk of covid infection for those who work in the social work industry, as we have seen happen over and over. That is nobody’s fault; it is the nature of life. It cannot be helped when tests are positive and people must take time off work. However, that is where we can step in to ensure that there is a sustainable number of social workers to cope with the level of care needed by children, the elderly, the vulnerable and the disabled.

We must also take into consideration the impact of the pandemic on our social workers’ mental health. Some 55% of respondents to a survey said that they felt increased anxiety—in an already difficult job—given the risk that they posed to the vulnerable by potentially carrying covid. I am keen to hear the Minister’s thoughts on how we can better deal with that. One way would be to have extra staffing, as the hon. Member for Lancaster and Fleetwood mentioned earlier. Social workers are as prepared as they can be in terms of personal protective equipment, as the Government and the Minister have done extremely well in responding to that need, but the Government must step in when it comes to staffing and workload. Many social workers have stated that their casework load has increased by as much as 40% over the pandemic. They are working longer hours—I know that, because they tell me that and I see it—and those longer hours are probably for the same money. Overtime rates will never compensate for the loss of physical wellbeing and mental health.

The Department of Health and Social Care must have provisions in place to ensure that our social workers are not under the most extreme pressure. I very much look forward to the Minister’s response and the encouragement that she will give us. I urge her and her Department to consider the impact of that pressure not only in England, where her responsibility lies, but across the United Kingdom. I know that the Minister, like those in other Departments, regularly contacts her equivalent Minister in the devolved Administrations, be that in Scotland, Wales or, in my case, Northern Ireland, so I know that there is continuity between those Administrations. I say very gently to my two friends, the hon. Member for Glasgow East and the hon. Member for Linlithgow and East Falkirk, that I very much think that within this great United Kingdom of Great Britain and Northern Ireland, we are always better together; we can work together and exchange ideas, and we can all benefit from that. I say that gently to my friends in the SNP, because I know that they really do agree with me that we are better together.

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[The Minister for Care and Mental Health (Gillian Keegan)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I thank the hon. Member for Lancaster and Fleetwood (Cat Smith) for securing the debate so close to World Social Work Day, and for using her excellent speech to highlight the excellent and varied work that social workers do day in, day out. I had the pleasure of attending the world social worker of the year award ceremony, which was held here in Parliament on World Social Work Day. I know that many Members from both sides of the House enjoyed going along, meeting their local nominees and celebrating the fantastic work of social workers, as well as congratulating the winners of the awards.

Social work is a highly valued vocational profession and we thank all social workers for their important work to support those who are hardest hit, especially during the pandemic when we really relied on their support. Social workers provide a critical model of practice for the health and social care sector. They undertake relationship-based engagement with individuals, their families and communities, and combine emotional support with practical help at a time of great need. Their strengths-based personalised approach in understanding what matters enables them to shape people’s care and support so that they can have the best possible lives. I pay tribute to them all, including the hon. Lady’s father, who obviously contributed to changing many lives during his career.

Importantly, social workers work across agencies and connect people to the resources and the services that they need. They span the boundaries of our health and care workforce, ensuring that people’s human rights are protected and that the individual’s choice and control of their care and support is respected at all times. The pandemic has taught us that co-operation and collaboration across the health and care sectors are absolutely critical, and social workers are central to embedding that way of working. They co-ordinate health and care planning and make vital links to ensure that people with care and support needs do not slip through the gaps in provision.

We have never needed the expertise and insights of social workers more than we do now. As we emerge from the pandemic—into fresh anxieties and tragedies born from the war of Ukraine, the cost of living crisis and other things that we will have to deal with—we will turn to the social work profession for advice, guidance, leadership and support. Covid-19 had a significant impact on health and social care services, including social work, and the response of our workforce was one of dedication and commitment to the people whom they support. Those were unprecedented and challenging circumstances and we stand by the entire workforce and thank them for their vital work to make a difference to people’s lives.

Our focus has always been on ensuring that the adult social care sector has the resources that it needs to respond to covid-19. Throughout the pandemic, we have made available more than £2.9 billion in specific covid support funding for adult social care, including £1.81 billion for infection prevention and control, £523 million for testing, and £583 million for workforce capacity—recruitment and retention—as we know that there are shortages across the sector.

The infection control and testing fund and the workforce recruitment and retention fund supported the care sector to prevent the transmission of covid and to support local authorities in working with providers to boost staffing and support existing care workers until 31 March of this year. Some of that funding helped to enable local authorities to provide continuous support to those in need of social care, including by delivering social work appointments virtually, as well as in person where it was appropriate and safe to do so.

Social workers went above and beyond during the pandemic and they deserve huge thanks for their tireless work. That is why continuing to help social workers manage their mental health and wellbeing remains a priority for the Government. We are determined that everyone working in social care should feel they have someone to talk to or somewhere to turn when they find things difficult. As many hon. Members have said, they deal with the most complex and difficult cases. We are committed to supporting social workers to recover from their extraordinary role in helping our country through the pandemic. We will deliver a listening service to help relieve immediate pressures, as well as talking therapies and coaching sessions for those with more intensive needs.

The chief social worker for adults, Lyn Romeo, has implemented a range of measures during the pandemic, including partnering with Tavistock and Portman NHS Foundation Trust to issue guidance to support the wellbeing of adult social workers and social care professionals. She meets regularly with the principal social workers in each local authority and NHS trust, advising and supporting them on practice and workforce support for their staff during the pandemic.

We have invested in increasing the number of social workers completing their approved mental health professional qualification for local authorities to increase their capacity in responding to the needs of people with mental ill health. An additional 228 social workers will be supported to complete their training. Social workers have been supported to improve their knowledge and skills in working with people with learning disabilities and autism.

My hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds) mentioned the vital work that social workers do to support people with learning disabilities. The chief social worker for adults commissioned the British Association of Social Workers to develop a capability statement for social workers working with adults with a learning disability in 2019. That supports best practice in this important area, especially considering the impact of the pandemic on those with learning disabilities and/or autism.

As well as our focus on wellbeing, we know the importance of building and strengthening our social care workforce. A number of hon. Members mentioned that it is vital to strengthen the social care workforce so that we can meet demand now and in the future. It is encouraging to note that the number of child and family social workers in the workforce is increasing every year, up from 28,500 in 2017 to 32,500 in 2021. That is 2% more than in 2020 and 14% more than in 2017.

The hon. Member for Strangford (Jim Shannon) rightly focused on recruitment and strengthening the workforce. The Government invest over £130 million a year on recruiting, training and developing social workers to ensure the social care workforce has the values, capacity, skills and knowledge to perform its roles. This includes investments in bursaries for undergraduate and postgraduate social work degrees. A new and very popular addition, which I am very proud of, because I worked on it in my last role, is degree apprenticeships.

We have education support grants to support practice placements in organisations delivering social work services. That is vital to build that experience that was mentioned by the hon. Member for Strangford and the hon. Member for Glasgow East (David Linden). We also have a range of postgraduate fast-track training programmes for those wanting to work in children and family social work or mental health social work. Our attention is not just on training our social workers of the future; we also invest a significant amount in leadership and development programmes for qualified social workers. That includes leadership programmes for social workers and the assessed and supported year in employment for newly qualified social workers. That provides high-quality support for every newly qualified social worker by sharing best practice and quality-assuring provision.

We have announced record investment in developing the social care workforce. In our recent White Paper, “People at the Heart of Care”, we set out our workforce development strategy and plans for the investment of £500 million over the next three years. I am sure we will be discussing that many times as we develop those plans. The investment will help us to realise our vision for a workforce of people experiencing rewarding careers with opportunities to develop and progress in the future. That includes a focus on how we can develop new training routes for people who want to become social workers.

We will also work with the adult social care sector, including providers and the workforce, to co-develop a universal knowledge and skills framework and careers structure. As well as supporting the development of our care workforce, we will help those wanting to progress into regulated professions such as social work. I am also delighted that the number of people taking part in the new social worker degree apprenticeship programme continues to increase, with 660 starts in 2019-20 alone. That is only the second year for which it has been available, so that is phenomenal growth.

Looking forward, we have commissioned Health Education England to work with partners to develop a robust long-term strategic framework for workforce planning. For the first time ever, the framework will include regulated professions working in social care, such as nurses, social workers and occupational therapists. That work will look at the key drivers of workforce supply and demand as well as careers, as has been mentioned, and will inform the direction of the health and care system over the next 15 years.

The framework will help identify the main strategic choices facing us, develop a shared and explicit set of planning assumptions and identify the actions required at all levels of using all our system levers. That will ensure that we can plan for a workforce that is skilled, confident and equipped with the right support to deliver the highest quality health and social care in the future. It will also form the basis of our next phase of work to develop a long-term workforce strategy, led by NHS England and NHS Improvement in partnership with Health Education England and the Department of Health and Social Care.

[David Simmonds]

I very much welcome what the Minister is sharing with us today. Does she agree that it would be worth considering how to develop the finance function of health and social care? The recent Competition and Markets Authority report highlighted that a lot of the provision the private sector has brought into the care market, both in children’s homes and adult social care, is, frankly, quite an astonishing rip-off for the taxpayer. Profit margins of 30% and more are not unusual and these are complex structures that are extracting resources that could be spent on care. Does she agree that there is an opportunity both strategically and in developing the skills of social workers and others involved in those decisions locally to bring more focus to the issue so that we can ensure we procure the best possible care with an eye to value for money for the taxpayer?

[Gillian Keegan]

My hon. Friend raises an important point that we will address as part of the White Paper, “People at the Heart of Care”. It is important that we equip local authorities with the skills and tools they need to commission well in the market and to get the balance right between paying a fair cost for care while making sure that they get value for money for taxpayers.