About the Service

The NHS Social Work Service supports adults and carers whose health and wellbeing is affected by social determinants of health, and who require support to overcome practical and environmental barriers to independence and recovery. We help people overcome barriers to independence so they can stay well and get the right support earlier.

The service is part of the Community Care Division. Social workers are embedded in District Nursing teams, working alongside nurses and other professionals.

We help people address social determinants of health and wellbeing, such as housing, finances, social isolation, and access to community support. It focuses on prevention, independence, recovery, and wellbeing. Helping people stay well, stay safe, and avoid unnecessary reliance on statutory services and hospital admission where possible.

The model supports the NHS Long Term Plan and the Trust’s vision for integrated, preventative, and community‑based care. It delivers measurable benefits for service users, carers, staff, and the wider system by prioritising preventative care, social prescribing and addressing unmet social care needs, particularly within areas of highest deprivation.

The NHS Social Work Service is for:

Adults who are supported by Mersey Care District Nursing and have social or practical needs that are affecting their health, wellbeing or recovery.

Carers who need support to look after their own wellbeing and continue in their caring role. We can help carers access the right advice and support, including signposting to statutory services when needed

We offer a preventative, non-statutory social work service for people whose needs are not being met through commissioned services or support under the Care Act 2014. Embedding a personalised care approach to give people choice and control over the way their care is planned and delivered.

We work with people to understand what matters most to them, agree goals, and plan individual support that fits their strengths, preferences, and lived experience. Promoting self-management – giving people the knowledge and tools needed to live well with their health condition.

We will work with people to help build the knowledge, skills and confidence to make health decisions that work for them and to live well with their health conditions, to give people more confidence, independence and leave them feeling healthier and happier.

We help people connect with social prescribing and other non-statutory support, including help provided by the Voluntary, Community, Faith and Social Enterprise (VCFSE) sector.

We can sometimes use a one-off Personal Health Budget (PHB) to pay for small items or practical support that helps someone stay safe, stay well, or stay at home.

We also help make sure carers are offered the right support and that NHS responsibilities towards carers are met when a family member is receiving District Nursing support.

We bring social work expertise into the multidisciplinary team (MDT). This includes advice on relevant law and statutory frameworks, support with decision-making, and advocacy for service users and carers.

We focus on the social and practical issues that can affect someone’s health, wellbeing and recovery. Our aim is to help people recover, stay independent, and get the right help early—often by connecting them to local universal services.

  • Staying connected (loneliness, social isolation, building connections and support networks)
  • Managing day-to-day life (a safe, suitable home and being able to manage daily activities)
  • Managing money (support with budgeting and financial pressures)
  • Coping emotionally (building resilience and managing stress)

We do this through strengths- and assets-based case coordination, making the most of social prescribing and other non-statutory support, including services provided by the Voluntary, Community, Faith and Social Enterprise (VCFSE) sector.

Carers are key partners in care. We will involve carers in discussions and decisions (where appropriate), and provide clear information about conditions, services, and support pathways. We also help carers find community and VCFSE support to protect their own health and wellbeing and reduce the risk of carer breakdown. This work supports the Trust’s duties under the Care Act 2014, Children and Families Act 2014, and Equality Act 2010.

Adults and carers can be referred to the NHS Social Work Service through Mersey Care District Nursing. If a District Nurse thinks the service could help, they will talk it through with the service user (and carer where appropriate) and agree the next steps to make a referral.

For further information about the NHS Social Work Service, please contact the team via

Email:

Telephone:

The service works in partnership with:

  • District Nursing
  • Voluntary, community, faith, and enterprise organisations

By working together, we support prevention, recovery, and community-based solutions. This helps people access everyday universal services and support and reduces the need for statutory interventions where appropriate.

The NHS Social Work Service has been redesigned with the aim of demonstrating its impact on the wider health system, its value, and its sustainability. As part of this initiative, the Trust is collaborating with the University of Liverpool through an academic partnership that will support a comprehensive evaluation of the service’s impact.

The evaluation will specifically examine the benefits of integrating NHS Social Work and District Nursing teams, with a particular focus on areas facing high levels of deprivation. This process will involve a detailed and longitudinal study, emphasising health economics within the first 12 months. Outcomes will be assessed using the Elemental data platform, National CIPHA dataset measures, and dedicated patient and carer outcome measures such as DIALOG. The results will provide guidance for future expansion and reinforce the Trust’s commitment to delivering whole-person, community-based care.