In the UK, around 20% of new requests for adult social care arise as a result of a hospital admission, and older people are the most likely demographic to be in need of social care support. This paper draws on interviews and surveys conducted with 108 members of hospital social work teams across the UK about their work supporting the discharge of older people from acute hospitals. We demonstrate that some of the unique contribution of hospital social workers can be framed using ecological systems theory. We focus on the way in which social workers act as a temporal bridge, highlighting the impact of chronosystems on the individual, and taking a holistic approach that includes consideration of the individual’s past, present, and future. Framing hospital social work using ecological systems theory can help articulate the value of social work in a hospital setting, especially as policy in the UK moves to favour shorter hospital admissions.

Teaser Text
Older people often need social care support when they are discharged from hospital, and this support is often arranged by a social worker, however we do not know much about the social work role in hospitals. This research involved 108 members of hospital social work teams. They told us that they support patients by identifying what is important to them - in their family and social circle, their history, and their future. Social workers felt that no other professionals in the hospital pay the same amount of attention to time, or the past and the future. They also felt that paying attention to the past and the future is important, because it helps patients and the professionals supporting them to make better decisions, for example about whether an older person’s needs might be best met in residential care or how they can be supported to go home from hospital.