NIASW campaigns to ensure the voice of social work is heard in Health and Social Care review

Health and Social Care structures in Northern Ireland are currently under review and the changes proposed stand to have an impact on the commissioning and governance of social work services.

The review was announced on 4 November 2015 by the former Minister for Health, Social Services and Public Safety (the Minister). Since then NIASW has worked to ensure the interests of the social work profession are recognised in the review process.

NIASW has recently been informed that the Panel appointed by the Minister to conduct the review will be assigned two social work consultants to inform its decision making.­­ NIASW welcomed this development.

The following paragraphs overview the various stages leading up to the appointment of the social work consultants. They also detail the lobbying work undertaken by NIASW to date and explain the steps NIASW will take to ensure the voice of the social work profession continues to be heard in the review process.

4 November 2015 – The Minister for Heath, Social Services and Public Safety (the Minister) announced his intention to reform the Health and Social Care system in Northern Ireland with plans to:

  • Overhaul the processes for commissioning healthcare to include the closure of the Health and Social Care Board (the Board)
  • Retain the Public Health Agency (PHA) with a renewed focus on early intervention and prevention.
  • Ensure greater focus within the Department for Health, Social Services and Public Safety (the Department) on the financial and performance management of the   Trusts through the creation of a specific directorate within the Department
  • Appoint an Expert Panel to lead the debate on the best configuration of Health and Social Care services in Northern and stressed the need for a clinically led conversation to inform the development of Health and Social Care services.
  • Convene a summit to allow the other political parties to input ideas and suggest solutions for the future of Health and Social Care in Northern Ireland.

15 December 2015 – The Department published its consultation on Health and Social Care structural reform.

7 January 2016 – The Minister announced his appointments to the Expert Panel.

The Panel comprises six members and is chaired by Professor Raphael Bengoa. NIASW recognises Professor Bengoa is well qualified to preside over a review of healthcare in Northern Ireland having practiced as a doctor, worked for the World Health Organisation and served as Minister for Health and Consumer Affairs in the Basque Government in Spain. However, there is a shortcoming in terms of involvement from the social work profession as neither Professor Bengoa, nor any of the other Panel members, have a background in social work or social care. 

15 January 2016 – NIASW Country Manager, Carolyn Ewart, wrote to the Minister expressing the Association’s serious concerns that there are no social work or social care representatives on the panel. The letter explained that to reform the Health and Social Care structures it is necessary to involve the social services and a process which does not include them from the outset as equal partners is unsatisfactory.

4 February 2016 – NIASW Chair, Marcella Leonard, wrote to:

  • The Minister (in the form of an open letter) – outlining NIASW’s concerns at the proposed closure of the Board and the lack of social work inclusion in the membership of the Expert Panel. The letter was also submitted to the Department as NIASW’s response to the consultation on structural reform.
  • Professor Bengoa – seeking an urgent meeting with the Expert Panel.
  • Richard Pengelly, the Department Permanent Secretary – seeking a meeting to discuss the abovementioned issues.

8 February 2016 – Carolyn Ewart, NIASW Country Manager, participated in a BBC Radio Ulster TalkBack interview about the integrated health and social care services and the lack of representation of social work in the review.

9 February 2016 – Carolyn Ewart participated in a BBC Radio Ulster Good Morning Ulster interview about the Health and Social Care reform agenda and lack of social work and social care expertise on the expert panel

9 February 2016 – NIASW was invited to a meeting with the senior representatives of the Medical Royal Colleges and the College of Occupational therapy to discuss the Health and Social Care reform process at the Department of Health, Social Services and Public Safety.

10 February 2016 – Marcella Leonard, NIASW Chair, attends the above meeting.

15 February 2016 – The NIASW Chair and Vice Chair met with Professor Bengoa to discuss the lack of social work involvement in the composition of the Expert Panel.

16 February 2016 – Following a request by Professor Bengoa for a list of key issues for the social work sector to be considered in the review, the NIASW Chair wrote to him providing this information.

10 March 2016 – The NIASW Chair wrote to Professor Bengoa noting no announcement had been made about how the social work profession would be involved in the review. The letter also sought information regarding what steps had been taken to ensure social workers would be able to inform the outcomes of the reform process.

22 March 2016 – The Expert Panel wrote to the NIASW Chair thanking her for NIASW’s engagement with the Panel and explaining that the issue of appointments to the Panel is a matter for the Minister.

The letter reemphasised that the Panel understood the importance of the role played by social care and social workers and explained this will not be overlooked in the review. It explained the Panel had met with the Chief Social Work Officer in DHSSPS and with the Director of Social Care and Children at the Board, and that it plans to involve social care expertise closely in the second phase of its work.

The letter also noted the Minister’s announcement regarding the planned establishment of a Commission on Adult Care and Support. It welcomed the announcement and committed to engage closely with the Commission as the review progresses.

21 April 2016 – The NIASW Chair wrote to Professor Bengoa. In the letter NIASW:

  • Acknowledged the Panel’s engagement with the Chief Social Work Officer and Director of Social Care and Children at the Board but emphasised that ensuring adequate engagement with the social work profession remained a major concern for its members.
  • Noted its concern that the Association was listed by the Department as having been consulted by the Expert Panel.  NIASW stressed it was unequivocal in the view that it had not been consulted and its meeting with the Expert Panel on 15 February 2016 was to address the single issue of the lack of representation of social work/social care representation on the Panel. 
  • Explained that the review may result in structural changes that could impact adversely on the provision, oversight and co-ordination of social care. It stressed that solutions for health may create unintended challenges for social care.
  • Explained it intended to raise the lack of social work / social care representation on the Panel with both the incoming Health Minister and the Health Committee.
  • Noted it would welcome an opportunity to be fully consulted by the Panel.

4 May 2016 – NIASW met with the Department Permanent Secretary and the Chief Social Work Officer.

NIASW raised its concerns regarding the lack of social work representation on the Expert Panel. The Permanent Secretary explained that in recognition of the importance of social work and social care the Panel’s Chair had decided to appoint the Chief Social Work Officer and the Director of Social Care and Children at the Board to act as consultants to the panel.

When asked if the Panel had established a timetable for publishing its report the Permanent Secretary explained a timetable had not been set and the Panel would report when it determined the review was complete.

Next Steps

  • Once the new Health Minister is appointed NISAW will write to the Minister to highlight the importance of ensuring social work is afforded appropriate attention in the review of Health and Social Care. NIASW will outline its intention to continue to work closely with the Department of Health to inform the development of Health and Social Care structures that maximize wellbeing for all individuals in Northern Ireland.
  • NIASW will engage with the various party health spokespersons, and the Chair, Vice Chair and members of the Health Committee. NIASW will encourage them to hold the Department of Health to account regarding the extent to which the review incorporates and responds to the views of the social work sector expressed via the social work consultants.