Can we learn anything from social care in the Falklands?

It’s a remote territory 8,000 miles away from mainland UK, but we could learn from the island’s model for integrating health and social care, reports Gill Hitchcock

Integrated working across health and social care in England remains patchy, despite its potential to improve services, an Audit Commission report revealed earlier this month. The document makes recommendations to remedy this, but social service managers could look at how a British territory 8,000 miles away integrates services successfully.

In the Falklands Islands the team leader in the social services department is “part and parcel” of the senior management team in the health service, explains David Jenkins, the director of health and education for the islands. And there is a close relationship between social workers, home helps and health professionals.

“This integration definitely helps when we are looking at multidisciplinary meetings, because we were looking at all angles,” says Jenkins. “Everybody will automatically come on board with any concerns they have, so the information sharing is first class.”

Another form of integrated working is the way in which a range of social services are delivered by a small multi-skilled team across a total population of about 3,000. The Falklands has a team of three qualified social workers, three social work assistants, sheltered housing wardens, home helps and administrative support staff.

Jenkins describes how the Falklands provides “a whole variety of generic services; so both social and welfare services for vulnerable adults with mental health or physical disabilities, care for the elderly, children in need, child protection, fostering and adoption services.

“We also include a transition service for school leavers with severe physical and learning disabilities and we co-ordinate and deliver day centre activities for the elderly. We are involved in the allocation of sheltered housing and ongoing support for the elderly. Also, we do probation and pre-sentencing assessments.”

Social worker Sharon Kelly joined the Falklands’ social services team in September 2009 for a three-year stint. She says the range of work experience she gained in the UK after qualifying in 1993, mostly with adults and children with disabilities and in a hospice, was useful preparation for the islands’ generic “cradle to grave” services.

She maintains that most social work skills are transferable, however. There are a lot of skills within the team and its members are able to learn from each other.

The formal and informal training provided in the Falklands has been excellent, according to Kelly. “We have had trainers come from the UK, which has been very good and we have had multidisciplinary training. We’ve trained with the police as well.”

What Kelly found particularly challenging was taking on probation work for the first time. “As a probation worker you are usually trained quite differently,” she says. “But we have very experienced social workers who have been able to share the experience and knowledge that they have. So I have been able to develop my skills as well.”

While UK social workers contend with traffic jams, or bus queues to get to clients, their Falklands counterparts use of a land rover, or light aircraft to reach the West Island. But as most of the population lives in the capital, Stanley, the majority of clients come into the social services office there.

Given the remote location of some residents, the Falklands health department is in the early stages of developing tele-medicine. Jenkins does not rule out the adoption of the type of technology by social services in future, but for now, it makes occasional use of video-conferencing.

Kelly is positive about the level of face-to-face contact she has with clients, however. “I am able to work very much directly with clients, which is what I came into social work to do, and something which I think social workers are doing less and less in the UK.” She adds that the social services team has no waiting list and is able to respond very quickly to referrals.

Also is contrast to the UK, this small, close-knit community has no gang culture, no children on the child protection register, only three children on care orders and, according to Jenkins, intervention is viewed as valuable support by the families concerned.

He points out that the Falklands enjoys a good standard of living and has very little unemployment. “That definitely has an impact on social services requirements. We have only got 14 people on welfare benefits, for example. We have got about 26 who are getting attendance allowances. There is a very strong work ethic and employment opportunities are good, and that makes the role a lot easier.”

“Another of the differences here is that we have not got social services being run by local authorities; they are run by government which is also responsible for monitoring for those services.”

In 2009-10 the Falklands spent just over £706,000 on its social services. “Unlike what is happening in the UK at the moment, we are still investing in social services and we are trying to take them forward,” says Jenkins.

“We are doing more work with children with additional needs, linking in with training and education and looking at how we can further enhance the transition of young people from school into the adult world. And we are developing more services for our senior residents, and obviously education and training for the staff as well.”

Jenkins believes the government has done particularly well in investing in a “first class” service for its small community.

“I think the other thing that helps the team work so well is that when they do something very well it is reflected in the general community. It is known about,” he says.

“If you make a mistake everybody knows about it too. But it’s pretty open system, and I think social services should be open and transparent.”