Review may recommend children's services are removed from integrated trusts in Northern Ireland

Published by Professional Social Work magazine, 14 September, 2022

A review of children’s social care in Northern Ireland may call for children’s services to be removed from health and social care trusts.

The review’s chair Ray Jones has indicated such a move, which would end 50 years of health and social care integration, could be among recommendations when the final report is published next June.

Speaking to Professional Social Work magazine, Jones said the review is looking at the “general organisation” of children’s social care.

He believes the sector is currently not given sufficient priority within the competing demands of Northern Ireland’s five integrated health and care trusts.

“Those trusts themselves are under tremendous pressure in terms of the health service in Northern Ireland, particularly around the big hospitals with waiting times, pressures on A&E, ambulance delays,” said Jones.

“That gobbles up a lot of time and attention. One of my concerns is that children’s social care may not get the space and attention it needs. So I’m thinking hard about what that might mean in terms of possible future arrangements for children’s social care in Northern Ireland.

“I am thinking very hard about what best to do to make sure they get the space and attention they need which they are not getting at the moment.”

Jones said he wants to ensure directors of children’s services are “empowered to lead the services in the way they want and need to rather than being distracted by the pressures in the health service”.

Asked whether that meant removing children’s social care from trust management, he said: “That is one of the options. The strength of that option is we give dedicated focus and attention to children’s services.

“We allow the director of children’s services to concentrate on that core task of what is happening with children and families in the community which they are distracted from doing at the moment.”

Greater integration between health and social care is currently being pursued in England.

In February , the Westminster government published a white paper on adult health and social care integration. While not including children’s social care in its scope, the paper says local areas are “encouraged to consider the integration between and within children and adult health care services wherever possible”.

Social workers have expressed concern about their voice being drowned out by health professionals within integrated settings.

Jones’ comments about Northern Ireland - where health and social care were integrated in 1972 under the Health and Personal Social Services (Northern Ireland) Order - will do little to alleviate those fears.

Issues on the ground

Jones was appointed to lead Northern Ireland’s 16-month review of children’s social care in February.

The emeritus professor of social work at Kingston University and St George’s, University of London, was previously a director of children’s services, has written extensively on social work and is a regular commentator in the media.

His appointment was widely welcomed within the social work sector, no less so after it was revealed that Jones is donating his £108,000 fee to a university scholarship scheme for care experienced students or those from deprived backgrounds.

He has spent the last six months meeting senior leaders within Northern Ireland’s trusts, including directors of children’s services and managers. He says he has so far met between 500 and 600 social workers, more than 100 children and young people, visited children’s homes, secure children’s homes and met with parents and carers as well as police, health and school workers.

His aim, he says, has been to “get a feel for what is happening on the ground”.

Jones says he is finding the issues in Northern Ireland are “not dissimilar” to those across Britain.

“They are about the difficulty in recruiting and retaining the children’s social care workforce and social workers within that; increasing workloads as a consequence of greater need being generated, partly as a consequence of increasing poverty; real pressures in terms of workload and real pressure in terms of workforce.”

The Northern Ireland context

There are, however, differences too. “There’s clearly the legacy of the Troubles in terms of the trauma that created which still affects the communities of Northern Ireland," says Jones.

“There’s also the intimidation and threats people still experience within some communities which adds to current trauma.”

The “political vacuum” in Northern Ireland following May’s election – an ongoing legacy of Brexit – is another particular issue within the country.

“There is no functioning Northern Ireland executive because of the refusal of the DUP [Democratic Unionists Party] to engage. That delays decisions and actions been taking right across public services.”

Poverty is another factor in Northern Ireland which Jones says is “even more prevalent and intense than in other countries within Britain”.

The stalling of the political process, coupled with the threat of increasing poverty as a result of the cost of living crisis, means more families are likely to get into difficulty, says Jones.

High vacancy rates

Another key priority for the review is addressing high vacancy rates within children’s social work.

Earlier this month, a senior social work manager speaking anonymously to Professional Social Work magazine warned of a recruitment timebomb in children’s services in Northern Ireland (see September's edition).

The manager said high vacancy rates of up to 50 per cent in some departments, posts going unfilled, workers retiring and staff being promoted too quickly in a bid to plug gaps was creating the "conditions for bad things happening".

Addressing such issues should not wait until publication of the review's recommendations, Jones says.

“There are actions which can and should be taken now to mitigate some of those difficulties to start to see some progress.

“I am pushing hard while I am in Northern Ireland to start making that way forward happen.”

Among the actions he believes is needed is increasing the “skills mix” within social work teams.

“One of the things in Northern Ireland is it really treasures and wants to give priority to professionalism and professional competencies. That is a real strength.

“But one of the downsides of that is that we don’t sometimes have the skills mix across services we might have.

“We cajole social workers into doing tasks and undertaking roles that really don’t require the deployment of their full professional competencies.

“So I am pushing for a skills mix beside social workers to assist social workers in the work they are doing and make sure they can focus on deploying their core professional competencies.

“I am thinking about social work assistants, family support workers, more administrative capacity.”

Community social work

As a social worker starting his career in the post-Seebohm era of the 1970s, Jones puts great stock on community-based work.

“The core of children’s social care services is what happens in terms of understanding whether our families are struggling within communities and getting beside those families and giving that real attention to the core task,” he says.

“You need the capacity to do that, you need to be located close to those communities to do that and you need a workforce that is stable and continual in terms of getting to know those children and families.”

One way in which Northern Ireland is promoting community social work is the rollout of generic social workers with reduced caseloads in GP practices.

The intention is for these to work in a more community-focused and less prescriptive way, with less bureaucracy.

Jones is also tasking the trusts to look at their systems in a bid to reduce “some of the bureaucracy and report writing and recording required of social workers”.

Workforce strengths and public sector ethos

This closeness of Northern Ireland’s social workers to the communities they work in is a strength in Northern Ireland, believes Jones.

“One of the things about Northern Ireland is that people stay in their local communities, they work in their local communities, they stay doing it for a long period of time.

“It is not unusual to find social workers who have been doing the job in the same area for 25 or 30 years. So there is tremendous commitment, tremendous experience.”

Another area of strength is Northern Ireland’s “strong” public sector ethos, says Jones.

“There is very little privatisation of children’s social care in Northern Ireland. The statutory children service still runs children’s homes. Foster care is still largely provided from statutory children’s services.

“There has been some movement towards employment agencies providing children’s social workers but not to the same extent in England.

“So there is a real strength of a public service commitment and tradition rather than the privatisation and profit-taking from children’s services we find in England.”

Ultimately, Jones believes that Northern Ireland has a good platform from which to build at better children’s social care service.

But at the moment, he says, "that platform at the moment is creaking, as it is across the rest of Britain, and we need to stabilise it".