Across the world acute hospitals are under unprecedented pressures due to shrinking budgets and increasing demand, against this backdrop they are also experiencing record levels of activity in Accident & Emergency and delayed transfers of care. Reducing pressure on hospitals by avoiding unnecessary admissions and delayed discharges has risen up the global policy agenda. However, reviews of strategies and policies have rarely involved discussions about the role that hospital social workers play in achieving timely hospital discharge. Yet discharge planning has become a, if not the, central function of these professionals. This paper presents the results of a small-scale exploratory study of hospital social work in an acute hospital in Northern Ireland. The findings reveal that the work of hospital social workers is characterised by increased bureaucracy, an emphasis on targets and a decrease in the time afforded to forming relationships with older people. Hospital social workers highlight concerns that the emphasis on discharge planning and pressures associated with the austerity agenda limits their capacity to provide other more traditional roles such as advocacy and counselling. It is argued that hospital social work should not be narrowly defined as ‘simply’ co-ordinating discharge plans. The tension that arises between expediting hospital discharge and advocating for older people and their families is also discussed.

由于预算缩减和需求增加，世界各地的急症医院都承受着前所未有的压力，在此背景下，它们在急症室和护理转移方面的活动也创下历史新高。通过避免不必要的入院和延迟出院来减轻医院的压力已经上升到全球政策议程。然而，对战略和政策的审查很少涉及医院社会工作者在实现及时出院方面的作用的讨论。然而，出院计划即使不是这些专业人员的核心职能，也已成为一项核心职能。本文介绍了北爱尔兰一家急症医院医院社会工作的小规模探索性研究的结果。调查结果显示，医院社会工作者的工作特点是官僚作风增加、强调目标以及与老年人建立关系的时间减少。医院社会工作者强调，对出院计划的强调和与紧缩议程相关的压力限制了他们提供其他更传统角色的能力，例如宣传和咨询。有人认为，医院社会工作不应被狭义地定义为“简单地”协调出院计划。还讨论了加快出院与倡导老年人及其家人之间的紧张关系。医院社会工作者强调，对出院计划的强调和与紧缩议程相关的压力限制了他们提供其他更传统角色的能力，例如宣传和咨询。有人认为，医院社会工作不应被狭义地定义为“简单地”协调出院计划。还讨论了加快出院与倡导老年人及其家人之间的紧张关系。医院社会工作者强调，对出院计划的强调和与紧缩议程相关的压力限制了他们提供其他更传统角色的能力，例如宣传和咨询。有人认为，医院社会工作不应被狭义地定义为“简单地”协调出院计划。还讨论了加快出院与倡导老年人及其家人之间的紧张关系。