Hospital Social Work

Workforce characteristics, hospital role, scope of work

Three sections follow:

1.      Background Material that provides the context for the topic

2.      Suggestions for Practice

3.      A list of References

Feedback welcome!

Background Material

Introduction

Social workers employed within health services provide direct intervention to patients and their families/carers aiming to minimise the impacts of illness, injury, biopsychosocial severity, complexity and treatment. A social worker's role within health is to enhance biopsychosocial and emotional functioning through targeted evidenced based, patient centred interventions. Social workers are essential members of the multidisciplinary team. As such social workers can significantly influence the patient’s care plan to be more reflective of their needs, directly influencing positive outcomes, reducing the need for health service demand (New South Wales Health, 2023).

Workforce characteristics

Workforce modelling indicates the need to grow the NSW social work workforce by around 20 to 34 new professionals per annum to meet community need in 2040 within the Health (community and hospital) sector.  In NSW Health in 2021 there were 2769 social workers employed for an average of 31 hours per week.  87.6% were female with average age of 43.3 years.  1.5% were Aboriginal people (New South Wales Health, 2023).

There is an increased demand for social workers because of increases in:

• Complex health and social needs, including among older Australians

• People people with histories of psycho-social distress or trauma

• People diagnosed with a disability

• People at risk of violence and harm

• Natural disasters and pandemics that increase psychosocial issues in the community (New South Wales Health, 2023).

Social workers in hospitals

Hospitals are one of the largest employers of social workers in Australia with professional social workers employed in a wide range of hospital settings. Social workers offer a unique contribution to the hospital system in providing services to meet the multidimensional needs of patients and their families/carers.  They provide direct services to patients and their families/carers (including significant others) aiming to minimise the negative impacts of illness and hospitalisation. Social workers intervene in the context of a patient’s social environments and relationships, recognising the effects of the psychological, familial, social, economic and cultural determinants on health and wellbeing. Social workers advocate for the rights of patients and their families/carers against discrimination, exclusion and abuse they can sometimes experience (Cordoba, 2020). With effective assessment and case planning tools and reliable networking with hospital staff, the social worker can advocate on the patient's behalf and help to paint a new picture of what a person's quality of life may look like upon discharge (AASW, 2024).

Scope of practice for hospital social work (Cordoba, 2020; AASW, 2024)

Assessment         In the assessment phase social workers recognise the effects of the psychological, familial, social, economic and cultural determinants of health and wellbeing on the patient.  The social workers' key roles involve mitigating risk factors—child abuse and neglect, family violence, intimate partner violence, elder abuse, sexual abuse and exploitations.

Counselling, mediation and therapeutic intervention      Some of the main approaches social workers might use with patients include systems theory, brief intervention therapy and the solution-orientated approach. Grief and trauma informed practice may assist patients who struggle to adapt to a recent diagnosis or loss.

Crisis intervention           Social workers support vulnerable people in crisis to communicate their needs and wishes. 

Advocacy               It is important that social workers learn to advocate for themselves and the patient, so the medical and allied health team are aware of the patients' broader social and emotional issues. These factors may be impacting on the patient's overall health issues.

Case management, service co-ordination and multidisciplinary work      Social workers must communicate well with the hospital team, from the doctors and nursing staff on the wards to the allied health professionals and volunteers in outpatients. This includes writing concise, factual case notes.  With effective communication in place social workers can develop a clear, concise care plan where all the allied health services goals, interventions and outcomes are documented.  This ensures that patients, families, and staff have a clear plan and are working towards a safe and healthy discharge.

Policy program, design, and research      Social workers can be effective at the organisational level by assisting with the development and implementation of a patient-centred care model.

Specialist clinical experience in addressing psychosocial aspects               Social workers should address psychosocial aspects of care which may include child abuse and neglect, family violence, grief and loss, socio-legal issues and ethical decision making, chronic health conditions, family interventions and support, and developing culturally responsive and inclusive interventions.

Simpson (2026) sees an important role for social workers in hospitals, suggesting they can be involved in both the clinical and social dimensions of care.  Social workers are trained to see and offer support multiple patient issues: trauma history, grief, caregiver dynamics, relationship discord, housing instability, lack of support, and internalized stigma.  Simpson suggests the outcomes of social worker involvement with a patient can include:

• Reduced length of stay.

• Less likely to require inpatient psychiatric hospital care post discharge.

• Leaving the hospital with practical tools, such as cognitive restructuring techniques, mindfulness strategies, and safety planning.

• Increased adherence to psychiatric medication, and more likely to engage in follow-up care upon discharge.

• Educating future physicians around treating mental health with a more comprehensive and patient-focused approach.

Suggestions for Practice

In their commitment to self-determination and respect, hospital social workers ensure that patients, and their families/carers, have access to information and are able to make informed decisions concerning their health and wellbeing.  Social workers contribute by:

• Conducting comprehensive and culturally appropriate psychosocial assessments that greatly inform the decision making of other professionals and the multidisciplinary health team

• Reducing inappropriate health service demand through comprehensive psychosocial assessments and intervention including linkages and referrals to community-based services

• Preventing re-admissions through rigorous discharge planning and by addressing critical psychosocial determinants including the establishment of strong, supportive familial and community networks and access to appropriate resources

• Leadership when working in multidisciplinary team around response planning for issues of risk, abuse and trauma

• Providing professional development for other health professionals on psychosocial issues relevant to recovery (Cordoba, 2020).

Case Study: From Surviving to Healing

Patient X is a 45-year-old individual who has survived a self-inflicted gunshot wound to the head. A social worker meets patient X right where they are—medically compromised, emotionally overwhelmed with sadness, anxiety, and fear. Patient X’s story is heard and valued at a detailed level—the emotional weight behind the attempt and the stressors that led to it. Together, worker and patient begin to build a crisis management plan that is grounded in patient X’s own values. Almost daily visits include evidence-based practices of cognitive restructuring, emotional regulation skills, and meaning making conversations that help patient X reconnect with a sense of purpose and hope. Over time, these visits start to become a place where patient X is looking forward to talking, reminded they are not alone, and able to become an active participant in intentional healing—knowing healing is possible.  With each visit, Patient X begins to build a toolbox of skills to carry into life after discharge. These are strategies they can use during moments of distress or uncertainty. The discharge plan extends beyond finding placement. It also includes follow-up care for therapy and psychiatry services. Their support system is also engaged in the discharge planning process. In this new model, Patient X doesn’t just survive their injury at the hospital, but they begin the work of healing, with mental health support integrated into their recovery from the start (Simpson, 2026).

References

AASW: Australian Association of Social Workers.  (2024). Social workers role in the hospital - Bridge to the social world.  https://my.aasw.asn.au/s/article/Social-workers-role-in-the-hospital-bridge-to-the-social-world

Cordoba, P. (2020). Scope of social work practice: Hospitals.  https://www.researchgate.net/publication374809857_Scope_of_Social_Work_Practice_Hospitals  doi: 10.13140/RG.2.2.33619.55842

New South Wales, Australia, Health. (2023). Social work: Workforce modelling factsheet.  https://www.health.nsw.gov.au/workforce/modelling/Pages/social-work.aspx

Simpson, A. (2026, Winter). At the bedside and beyond: Reimaging social workers’ role in hospitals.  Social Work Today, 26(1), 8-9.  https://www.socialworktoday.com/