| Abstract: | Correspondence to Eileen McLeod, School of Health and Social Studies, University of Warwick, Coventry CV4 7AL, UK. Summary Well-established internationally, the current development ofsocial work in UK accident and emergency (A&E) departmentsis part of a conjoint health/social care policy drive to divertolder people from ‘unnecessary’ admission to acutehospital care on social grounds. However, from older serviceusers' standpoint, the prime criterion for assessing A&Esocial work is not its powers of diversion, but its contributionto optimum health and social care. Our account indicates thatA&E based social work can provide important benefits, includinghelp with negotiating the A&E environment and readier accessto social services. Nevertheless, continuing professional–serviceuser power imbalances, together with shortages in health andsocial care services, undermine its positive contribution bothwithin A&E and following discharge. Notably, under-resourcedcommunity based health and social care can lead to servicesimplemented through A&E, swiftly unravelling. This has seriousconsequences for older service users facing interlinked healthand social problems, and may be implicated in re-attendanceat A&E. |
