‘We have to re-imagine, not just re-open. What have we learned? How do we improve and how do we build back better? Because it’s not about a return to yesterday. There is no return to yesterday in life. It’s about moving forward.’
This statement by Andrew Cuomo, Governor of New York, is a neat summary of what is happening in social work and social care across the country. Notwithstanding the essential immediate focus of addressing the spread and impact of COVID-19, organisations are positively and proactively identifying learning and opportunities to improve care and protection experiences and outcomes in the future.
It is incredible how quickly and effectively practitioners and managers have adapted to the disruption COVID-19 has brought to their working lives. I has been good to see organisations introducing – at virtually no notice – a range of new ways of supporting their people’s physical and mental wellbeing. This has been very important as staff have not only needed to change their ways of working but have done so while often experiencing worries around fear of infection, their own isolation, potential relationship strains, and reduced job security. But these personal pressures have not prevented a real focus on what can be taken from the current crisis.
In Doncaster Children’s Services Trust, managers have initiated ‘The Big Conversation’. The conversation will certainly identify what has not worked and needs to revert to ‘normal’ as rapidly as possible, but is also generating views and ideas on where the revised COVID-19 arrangements have actually worked and should be retained and maybe developed further.
One thing is for sure – sound, safe, risk-based and managed decisions that are focused on the child’s current and future experiences and outcomes will remain at the heart of good social work practice. What is different right now is that those decisions are needing to be made in a climate where referrals are significantly down with real disruption to practitioners’ normal ‘eyes and ears’. Practitioners have less insights from schools (mainly shut), health colleagues (focused on immediate challenges) and far less direct contact in people’s homes.
So with only limited reference to these usual channels, decisions are having to be made with less direct information and intelligence. And the sharing of information within and across organisations is having to be carried out in ways other than direct face to face. Our enhanced dependence on digital and remote communication technologies inevitably limits the non-verbal cues on which good meetings depend and which were always such a feature of our social work training.
So using all available information from other sources becomes all the more important. But we must tread with care. As my first manager said years ago, ‘once you go into a household and simply base your judgments on what you’ve seen before you shouldn’t be in the people business anymore’. Absolutely. This was a sharp reminder that over-categorising, or adopting one size fits all approaches, will never be how we work with individuals and those around them. Good social work and social care will always be about people and families with distinct – if sometimes conflicting – beliefs, fears, experiences and goals. Thankfully too we’ve better recognised the benefits of exploring people’s strengths and not just areas where help is needed.
Certainly the COVID-19 disruption gives us the opportunity to reflect on whether our traditional communication channels and modes of decision making are sufficient. In particular, we should recognise the strong case for using wider data to assess risk and support decisions. The truth is that almost all aspects of life are increasingly improving as a result of using data more effectively. The NHS is increasingly using risk stratification, pulling together data sets to help assess risk in different patient groups. This enables advice and interventions to be targeted at those most vulnerable to conditions and broader health deterioration, without overriding professional judgment tailored to the individual. And better use of data also enables more efficient travel, better logistics, more informed purchasing, and so on.
So the question arises: Why should social work and social care be different?
We need to take a more holistic view of an individual’s needs and risks, bringing together and using diverse data around people’s health, social and economic context, as a foundation for taking better informed decisions. We already use – at least intuitively – our knowledge of what sort of support and interventions are likely to be helpful to people’s specific circumstances. Bringing this knowledge more explicitly to the fore can now be done as decision support tools become sophisticated, more reliable and more adaptable in social care as in many other industries. And again, using such data is emphatically not about replacing, pre-determining or undermining judgements that are the bedrock of our profession.
It’s about knowing more about what sorts of advice and interventions for people in varying situations have proved most beneficial in the past, aggregating and interrogating that intelligence and applying it to circumstances which confront us in our professional lives.
The terms used for such approaches –‘predictive analytics’ and ‘algorithms’– are not terribly edifying and have an Orwellian ring. But as a basis for informing professional judgment such data can enable decisions to be better informed and tailored to the particular circumstances. And this may be especially helpful when more detailed and specific information is lacking.
Again we need to take care and understand the potential for unconscious bias and prejudice in the underlying analysis of such data and deploy such capability carefully. Transparency about data’s origin, protocols for use and information governance is essential to reassure practitioners and managers. However the case for more actively exploring and testing the opportunities modern technology brings is undeniable. And frankly, were I disabled with a long-term condition or a family engaged in a child protection investigation, I’d far sooner the worker was using all possible contextual information to support their risk assessments and decisions.
The justification for better use of data to support social work and social care is clear as the profession continues to grow and mature. In an era where decisions need to be made at speed and often with incomplete information, the case is stronger than ever.
Tony Hunter is former chief executive of the Social Care Institute for Excellence and current chair of Doncaster Children’s Services Trust (writing in an independent capacity)