Case finding and screening for social work in acute general hospitals

Summary: Since the first appointment of a 'Lady Almoner' social workers in hospitals have complained about the problem of obtaining referrals appropriate to their skills and knowledge, and sufficiently early in the patient's stay to allow for effective intervention. Often, due to shortage of staff, workers have to rely on referrals from other staff, patients and carers. But where social workers find their own cases, a wider range of problems and patients are selected. In the United States during the past twenty years there has been a rapid spread of screening at the point of admission or pre-admission, to identify high risk patients for social work assessment. The evidence for the effectiveness of this approach to case finding is examined.