You may not know that the Department of Health produces a regular social care bulletin. Hear it from the bureaucratically correct mouth itself:

http://www.dh.gov.uk/en/Publicationsandstatistics/Bulletins/Socialcarebulletin/index.htm

I looked at an article because I thought it sounded a bit weird, but actually I ended up being impressed and thoughtful. It talks about voice-simulated-experience (VSE) and to read the abstract, you would think that nurses had listened to Stephen Hawking-like voice simulators talking about patients’ problems and it improved their intellectual empathy with patients. Unlikely, I thought, so I read the article.

What they did was find out from mentally ill people who heard voices and auditory hallucinations what it was like, and reproduced this experience on an audiotape. Then they asked the trainee nurses to do various ordinary things while listening to the tape. The nurses found out what it was like trying to live your life when voices were whispering to you or auditory hallucinations were going on in the background. They found it a good experience of what it was like to be mentally ill, and it increased the nurses’ determination not to stigmatise or reject patients’ experiences.

This set me to wondering about the importance of really listening to patients’ experiences, trying to understand those experiences and reproduce them, not only in written and spoken stories but in ways similar to what these authors did. It would be a powerful, real learning device, and particularly responsive to patients’ feelings about their life experience.

And a salutory lesson in reading the actual article when presented with an abstract and in writing abstracts that explain clearly what you’re talking about to people who don’t share your assumptions.

Dearing, K. S. & Steadman, S. (2009) Enhancing Intellectual Empathy: The Lived Experience of Voice Simulation Perspectives in Psychiatric Care. Jul 2009; 45(3): 173-82.

The Third Sector magazine published its shortlist of prize-winners in its annual awards. This is also a business-oriented thing because they believe that the most important thing about being a voluntary organisation (sorry ‘third sector’) is things like ‘brand development’ instead of what you’re doing. ‘Well it’s our job to help you while your husband is dying and I’m sure you appreciate that our brand development is second to none’.

And a lot of prize schemes like this cannot afford to assess the quality of the work that an organisation does, so they can only look at efficiency according to some business view. Business does not do caring, it does making money. It is not the same thing and being efficient at it is not what you should be looking for in a voluntary organisation.

But never mind, they’ve got one category of ‘at work’ with a few minor awards, and they’ve got a psychotherapist as one of the assessors for this – it looks from her organisation and the fact that she majors on being a ‘coach’ as if she psychotheraps in the city, alongside many of the other judges, most of whom are policy wonks and businessmen (and I say men advisedly), although some of them have escaped to the voluntary sector (which they probably like to call the third sector). In case you care, I can identify one social worker among the judges, the soon-to-retire Robin Currrie of PSS (you might not know this from the information, PSS stands for Personal Service Society and is a famous old Liverpool charitable institution, now expanding across the country on the back of NHS and social services contracts).

Of course, most of the shortlist are fundraising teams or ‘corporate partnership’ jobs. Organisations related to palliative care and even one hospice are competing strongly in corporate partnership (i.e. extracting money from big businesses by trying to look as much as possible like big business), you’ll be pleased to know they are: Macmillan Cancer Support; Marie Curie Cancer Care; Teenage Cancer Trust; Treetops Hospice. And Julia’s House, a children’s hospice in Dorset, is in the running for best employer.

That’s all right then, no need to worry about whether any of these organizations are actually doing a good job with people who need care because they’re partnering corporately and employing well. Not that I mind that they’re doing so well at this, but I’d like to see an award that put doing a proper caring job at the top of the list and spent time and money assessing that.

Look at the shortlist here: http://www.thirdsectorexcellenceawards.com/sites/default/files/shortlist_pdf.pdf

The print magazine Guardian Public has recently gone online, and often contains interesting articles about social care matters; it’s not searchable as far as I can see, so you might not find anything on palliative care. There’s an archive and you can sign up for a regular email. You might like to look at the health and social care ‘theme’ or the ‘wellbeing’ topic.

However, the way it thinks about and presents things is very much about local government, where they get their main readers from, so you have to be used to local government language and priorities.

Website: http://www.guardianpublic.co.uk/

A fascinating report has been published about consultation in east London with local minority ethnic communities about the services provided by St Joseph’s Hospice.

Examples of some of the things said are:
“I am surprised that the hospice people have asked us to consult with them and talk about our point-of-view being a Somali and Muslim and this shows that they are so interested to learn about our culture which is really good and I was not expecting people like them will come and meet with us” Somali Person

“After attending these sessions I have spoken to other people in our community about death and dying. I have spoken about the fact that death will come to everyone regardless of whether they are religious or not. Although at first people don’t want to talk about it or hear after I explain to them that if we talk about it then we can look at how we prepare then they understand. Coming to these sessions has helped me to talk about it [death] to others. It would be really good to have these discussions on a wider scale, include more people involved in the discussions” Bengali P

This report makes it clear that people from minority ethnic groups do want to be consulted about their healthcare, and need help to riase the issues that may be important to them.

Khatun, M. (2009) Dialogue Groups 1: Report of a process of discussion between local Bengali and Somali people from East London and clinicians and managers from St. Joseph’s Hospice in Hackney, East London London: Social Action for Health

http://www.scribd.com/doc/18437899/Dialogue-Report-August-Final-09

If you have not come across Scribd before, you can scroll through the report in its window, or download and save or print the document. Scribd is a social publisher. Anyone can upload documents and they are immediately published on the internet, and will come up in search engines. Social Action for Health have several interesting documents on their site; one is about minority ethnic group members’ experiences of mental illhealth, for example.

If I look for coverage of palliative care and pallcare social work in the documents on social work from the Task Force and the DCSF Select Committee, this would be a very short post. Instead, I ask what we might say about their absence from consideration.

One point is that, although I know from personal contacts that palliative care social workers are sometimes hard to find for hospices and pallcare teams across the country, I also know there have been some ace appointments of really fine staff in recent months too, not least here at St Christopher’s. So perhaps pallcare is not in the crisis of job vacancies and work pressure that local authority social work experiences. It has always been the case that people have often started their careers in general social work, built up a good range of experience quickly in busy general departments, found out what really interests them in their career and then moved towards a specialist area that really allowed them to develop their skills and their contribution. The accusation then is sometimes that they are moving out of the kitchen into the sunny uplands of less pressure. On the other hand, I do not know a lot of social workers who think pallcare social work is a doddle; interesting, yes, satisfying, yes, but also dealing with difficult human issues at a time of real crisis in people’s lives which all of us at some time in our lives do not want to face. No, a lot of students and colleagues say, I think I’ll stay with the care management or child protection.

Also, social work’s way of applying general principles in all settings means that you don’t get stuck. One of our medical consultants said to me enviously a little while ago how lucky social workers are to be able to move between specialties, taking a high level of skill with them, and learning new information about their new area. I’m a little cautious about this. Talking to a very experienced social worker about some research on groupwork that I’ve been doing recently, it was clear that some of the findings about issues discussed by bereaved carers in the groups reflected her experience over twenty years, but had clearly been new to the groupworker, who has moved medical specialties. So you have to look at the specialised areas, in this case responses to bereavement, and identify where the specialised knowledge is, and what is more general that can be transferred.

So the failure of these reports to think about social work’s small-scale specialties and the knowledge that is required for them is one important weakness in these reports; they need to look at the interaction between general and specialist and see where they can foster each other’s progress. It’s understandable that the government is looking at the big services that it is responsible for itself. But thinking about the profession as a whole, it has a duty also to think about how it can build, retain and train for the myriad of specialist areas in social work. And there is a payback, too. The building of specialist knowledge and skills feeds back into the regard for social work in the community, and the store of skills in the profession. Several of our really good pallcare social workers have moved back into child protection, adult services, mental health or general hospital social work in recent years. It renews their interest and commitment to work in a new area and they will take their resilience in helping with powerful human emotions and knowledge of dying and bereavement into those areas too. We are always pleased to employ a mix of people from children and families, mental health and adult services work coming in the other direction, because it enriches the services we offer, too.

What the social work specialities also show, and pallcare social work is a prime example, is that imaginative human helping is entirely possible, valid and worthwhile as part of our services. All social work does not have to be bureaucratic and rule-bound. Let a little imagination in and official social work can be human helping too. One of the weaknesses of the statement about social work written for the general public in the Task Force document is that it focuses very much on the individualised, concrete, risk averse things that you can say social workers provide and, in the cause of public understanding, does not convey the richness that social work may contain. Pallcare social workers, and many others working in specialist areas, can claim to be demonstrating that richness every day.