Covid-19 Pandemic – Ethical Guidance for Social Workers

This Ethical Guidance for Social Workers aims to respond to the very specific circumstances generated by COVID-19 which disrupts health, care, safeguarding and support services.

Updated November 2020

First version published 01 April 2020

Preface to version 2

This guidance has been updated to reflect the changing situation of the pandemic and experiences of social workers and society over the past six months. Most of the guidance remains relevant and is untouched. Substantive changes to version 1 are in blue.

BASW surveyed social workers and consulted the sector widely on the practice and ethical challenges social workers are facing in March 2020. This Guidance is shaped by the emergent themes from this consultation and survey and will continue to be updated as new themes come through.

BASW has developed topic specific practice guidance to supplement this Ethical Guidance and these will be updated and new topics published throughout the pandemic.

Introduction

Covid-19 remains a threat to every person and community in the United Kingdom. All are at risk. While the prospect of an effective vaccination being rolled out to the whole population is closer to being realised, until there is strong evidence to suggest otherwise, we should assume the risk of infection remains. We should continue to adhere to national guidance on distancing, use of protective equipment, washing of hands and other safety measures, as determined by local and regional Covid protection measures across the UK.

It remains the case that because of social, demographic and economic factors the most vulnerable individuals and communities, in other words, people that we most often work with as social workers, are at particular risk. Differential outcomes for different members of our communities have become evident throughout the crisis.

For example, some people will be less able to follow government guidance to protect themselves or prevent the spread of the virus, whilst others may be under greater stress because they have less access to protective factors such as healthcare, good nutrition, good housing, education, a safe home and social networks. Stresses are likely to increase for many as a result of (for instance) job loss, ‘stay at home’ requirements and school closures. Members of black and minority ethnic communities have had particularly poorer outcomes, both in infection and recovery rates.

This Ethical Guidance for Social Workers aims to respond to the very specific circumstances generated by COVID-19 which disrupts health, care, safeguarding and support services. Practitioners are often working in emergency situations and may face choices and decisions that go far beyond the bounds of usual ethics and practices, including rationing of support and resources and more stringent prioritisation.

Social workers are also experiencing the ethical challenges of not being able always to maintain levels of contact with people such as they would expect in normal times. This challenge includes wondering how to fulfil legal and professional duties, practical challenges in finding new ways to ensure services can be provided (e.g. through digital contact and safe distancing) and emotional challenges of not feeling able to ‘do enough’. This guidance is intended to support practitioners in managing these.

The Ethical Guidance does not supersede the BASW Code of Ethics which expresses the profession’s commitments to social justice and human rights. It seeks to apply them in the very specific circumstances that we face.

It is important to remember that an ethical response by social work to dealing with COVID-19 is not only about the decisions or actions taken by individual social workers. Social work employers, other professionals, the governments of the four countries and the regulators have ethical responsibilities too. BASW supports social workers to challenge and/or have dialogue with managers and others where they feel their ability to discharge their ethical responsibilities is hampered by contextual factors (e.g. lack of resources, restrictive practice, lack of creativity and solution focus).

The Guidance will continue to be shaped by listening to members and reflecting the challenges they face as the pandemic unfolds.

As Ethical Guidance, this document does not respond to the implications of specific legal and policy issues such as the Coronavirus Act 2020. For updates and commentaries of such developments, check the BASW Bulletins, website and PSW magazine.

Who is this guidance for?

This Ethical Guidance is for social workers in practice, social workers in management and leadership roles, student social workers, social work lecturers and researchers, and social workers who are currently not in practice whether through a career break or retirement. In this guidance when we use the term ‘social worker’, we use it to be inclusive of all colleagues.

Ethics of personal and collective care

Social workers are a very diverse group and face different challenges during the pandemic. These include personal health concerns, caring responsibilities, financial worries and many other issues that impact on our capability to offer support to others.

Social workers have a responsibility to be aware of their own care needs and worries, seek help and to look after themselves and each other in difficult times. Kindness to self and others will be crucial for wellbeing and morale.

Many social workers will be already attending to the ethical imperatives described below. This guidance is not intended to worsen anxiety or engender self-blame if you feel ethical standards are hard to uphold in these difficult times. It asks that members, all social workers, strive to apply ethical consideration to their situation and to support one another to do the same.

Ethical responsibilities of social workers as members of the community

Social workers are part of communities. Social workers’ ethical responsibilities do not end when they leave the workplace but extend to every aspect of our lives. This includes but is not limited to the following:

1. Social workers should follow government and public health, evidence-based behavioural guidance on COVID-19 such as staying at home and social distancing. These behaviours are required to save lives and as professionals we should uphold them.

2. Government guidance is regularly updated to respond to the ongoing threat from Covid-19. We have a responsibility to keep up to date with the latest developments for ourselves, our loved ones and the people we work with. In doing so we need to understand whether something is required by legislation or statutory guidance, or whether the relevant guidance is only advisory.

3. Some social workers may face financial challenges as a result of COVID-19. Independent social workers may have contracts ended; partners may lose jobs; family businesses may fail; care costs for loved ones may escalate. BASW aims to fulfil its ethical responsibility to support all our members in these difficult times. We will provide information, advice and access to online support. We will help social workers in the most need access the Social Workers Benevolent Trust. We have launched our Professional Support Service (PSS) which provides trained peer coaching support for members needing to talk through their experiences of Covid and beyond, and find ways forward, solutions to challenges and new opportunities.

4. For those social workers whose financial situation is secure, you may wish to consider giving money or other donations to groups that work with the most vulnerable and whose income may be profoundly decreased by the crisis e.g. charities that support the homeless, those that support refugees, asylum seekers and those with No Access to Public Funds (NRPF) and foodbanks. Charities have lost both funding and volunteers as the crisis has developed. If they are not supported, they cannot support the most vulnerable both now and in the future.

5. All members are encouraged to contribute to community support and volunteering activities where this is possible and safe to do so. This may include registered social workers or members no longer registered who have social work skills to offer and who cannot or do not want to return to the social work workforce. This may include telephone, online and/or writing work or volunteering to support people in particular need or isolated. This may also include using social work skills in influencing, lobbying and advocacy.

6. Access to food and medicine has been a challenge for many groups including older people, people with pre-existing conditions and critical key workers (e.g. doctors, nurses, police, teachers, social workers). Equitable access is needed, and systems need to be put in place to support this. In the meantime, social workers should adhere themselves and encourage others only to buy what is needed. By panic buying the vulnerable, or those in other critical areas of work may be deprived of basic essentials.

7. Social workers who remain registered with their regulatory body, who do not have other fixed commitments and who are in good health/not in a group considered either vulnerable or extremely vulnerable to Covid-19 may consider returning to practice. Your skills are needed. Many local authorities and other social work agencies may experience high levels of vacancies as staff fall sick or need to self-isolate.

8. Similarly, social workers who have recent experience of practice, but whose registration has expired, should consider re-registering so they can re-enter practice. Your contributions to our workforce are needed. Check with your regulator to find out how people who have the appropriate skills and experience can re-enter practice. There are routes in for all countries of the UK. While staffing held up quite well in the first wave of the pandemic, maintaining the wellbeing of the workforce and retaining staff remains a concern throughout the winter months in particular. Returners to practice may be very important in coming months, depending how long the pandemic goes on.

9. Specific measures have been made in some of the countries of the UK to allow final year social work students to enter practice early. Their skills are needed. BASW is advocating this is done in an informed and appropriate way and that social work students have appropriate support in the workplace both now and post the COVID-19 crisis. BASW will be developing further guidance and support for newly qualified social workers entering the workforce at this unprecedented time. If you are in a position to support less experienced and newly qualified social workers, it will be important to reach out to them and recognise they may have had disrupted learning and placement experiences and may need additional support and guidance.

Ethical responsibilities of social workers in practice

Social workers deal with ethical dilemmas and moral decisions all the time. The same principles of upholding human rights, promoting social justice and maintaining professional integrity apply during the pandemic. The same approaches of building relationships, understanding situations and responding in a person-centred way apply. Principles of prioritising need and managing risk are central to the response during the pandemic.

Ethics and risk

Covid-19 is a threat to life for some people. It is widely accepted that doctors, nurses, paramedics, the police, social care staff and others in essential, people-facing occupations will be risking their health in the course of their duties. Social workers, who by nature of their work, come into contact with and are responsible for the people are most risk and who encounter people in community settings, sometimes in situations of high tension, face many of the same risks in this pandemic situation but this is less well understood and codified in guidance and public understanding. BASW has provided guidance and advice on good practice I our series of guides. In some of these we have stepped into a national vacuum of clear information for social workers.

Prioritisation and risk management will need to start with consideration of the risks involved in each particular situation for each person.

The following ethical elements are important:

a. Clarity of goal is already a central part of social work practice. Social workers need to be particularly clear about what they are trying to achieve in their work with service users and be prepared to articulate it. However difficult circumstances become, social workers should always show respect for the people they are working with and be open and honest with them.

b. A good knowledge of human rights that relate to your area of practice are key to prioritising services and advocating effectively for decisions and services that relate to service users. Social workers should refresh themselves on the human rights that relate to their areas of practice[1] and be prepared to call on human rights legislation to argue their case.

c. Advocacy is an accepted part of social work practice. Social workers need to advocate with their managers, and others, where there are clearly shortfalls in both the provision of services and in supporting social workers themselves e.g. PPE, or IT services that allow remote working.

d. Social workers need to come together with others in their profession to make their advocacy as effective as possible. Social workers who are not already members of an organisation should identify how they can lend their voice to the profession.

e. Being informed is key to effective advocacy and practice. The situation with Covid-19 is developing rapidly. Social workers need to regularly update themselves on developments and how this effects their practice. Regularly accessing reliable and trustworthy sources of social work information is key to maintaining best practice.

f. Supervision is not a something than can be discarded under pressure – in fact it is even more important. Social workers should ensure that they receive appropriate supervision and if they do not, ask for it, advocate for your professional needs in this difficult time, and establish peer supervision and support.

g. It is always legitimate for social workers to ask for the reasons why a service is, or is not, being provided. A simple question of: ‘Just explain to me why we’re doing/not doing this …’ can be powerful. As duties under care and mental health legislation may be set aside throughout this pandemic (via the Coronavirus Act or other legislation), it will be very important that social worker uphold ethics and rights by advocating for as little deviation as possible from the fundamental right enshrined in enduring laws.

h. Being accountable through recording is a normal part of social work. Effective recording (which is not necessarily lengthy) is key to maintaining accountability and being safe in practice. Under current circumstances it is essential recording captures decisions about what services are, or are not, being offered and why. Social workers should pay particular attention to proportionate, meaningful recording during the Covid-19 crisis.

i. Social workers should always include Covid-19 infection in their risk assessments at this time. Social work always involves some element of risk (e.g. if there is a risk of violence, a social worker will make an assessment of risk to determine whether a member of the police needs to be present). Balancing potential risk to self and others against not engaging in a piece of work is a fundamental ethical issue for health and care workers. The Covid-19 situation is a stark, new version of this. Social workers should follow organisational, public health, governmental and BASW advice on risk with the aim of fulfilling social work responsibilities. Social workers should apply their ethics and capabilities to weighing up duties, outcomes and risks.

Social workers are skilled in working with people who may reject professional and official attention, often for historically good reason. It is important that during Covd-19 social workers resist pressure to shortcut social work engagement with people and move rapidly to coercive responses. Social workers need to seek advice and guidance on the use of PPE where this may be an additional barrier to engagement, rapport and help, while maintaining their and the other person’s health and safety.

j. Relational skills with colleagues such as listening and empathy will be highly important. This needs to be consciously pursued and upheld even where staff are working from home. Social workers and their managers should ensure ‘virtual teams’ are maintained. Social workers should offer support to colleagues. Social workers will be operating at the limits of their practice experience. They should seek help and advice where necessary and share learning in order to improve outcomes.

k. Social work has always recognised multi-professional working. Social workers should seek to work in partnership and support colleagues from other agencies and organisations who are also under pressure. Work with other professions and agencies should continue and digital communications and telephone contact should be used to maintain and build relationships to benefit people.

l. As individuals and teams come under pressure being calm, purposeful, keeping good humour and being compassionate are key behaviours to maintaining work-based relationships – even when we may disagree. Good supervision and self-care should ensure we can ‘let off steam’ appropriately, be supported and be heard on our worries and concerns – in order to maintain a positive emotional temperature with colleagues and the people we work with, who will be very vulnerable throughout this crisis.

Social workers need to have access to the protective equipment and ways of working that enable them to fulfil the responsibilities specific to their role.

BASW continues to campaign for PPE (Personal Protective Equipment) to be available for social workers along with effective protocols. PPE is not just about protecting the health of social work staff – it is also about protecting vulnerable service users from the unwitting transmission of Covid-19.

We are also campaigning for effective testing, tracking and tracing systems across the UK, and prioritisation for social workers to be recognised as essential professional visitors, able to safely access domestic homes, residential care, other accommodation and hospitals to discharge their safeguarding and rights protecting roles. In the first wave, social workers have not had sufficient access which has severely compromised local authorities’ and other organisations’ capacity to safeguard at risk adults and children.

Note:

This ethical guidance sits within wider ethical frameworks relevant to UK social workers. This framework is described here in three levels.

Top level ethical guidance: this is not related to the pandemic. The main guides are the IFSW Global Statement of Ethical Principles (https://www.ifsw.org/global-social-work-statement-of-ethical-principles/) the BASW Code of Ethics and the ethical guidance from the four social work regulators across the UK.

Second level guidance: this relates to broad ethical principles affecting social workers and their context during the Covid-19 crisis. This document fits into the second level. The recently released Department of Health and Social Care (DHSC) document ‘Responding to Covid-19 – the ethical framework for adult social care’ is an example of another document that sits in the second level.

Third level guidance: this covers ethical considerations within specific areas of law, policy and practice during Covid-19 such as the BASW statement on ethical implications of the changes mandated by the Coronavirus Act and the BASW Home Visiting practice guidance. Further policy and practice guidance will be produced throughout the crisis as needed and will reflect on ethics throughout.

[1] See for example: ‘Social Work and Human Rights: A Practice Guide’. BASW