Social Workers in Schools (SWIS): A Cluster Randomised Controlled Trial of School Social Work in England, UK

Background and Purpose

School-based social work is well-established in many countries. Yet there is limited causal evidence about its impact on social care or educational outcomes. ‘Social Workers in Schools’ (SWIS) is a school-based social work intervention that was developed in England, UK. It aimed to reduce the need for children to receive statutory child protection services. This presentation reports the main findings on the effectiveness of SWIS evaluated using a randomised controlled trial (RCT).

Methods

The study was a pragmatic cluster RCT (schools clustered within local authorities) with two arms, with schools as the unit of randomisation. The primary outcome was child protection enquiries and secondary outcomes included care entry and duration, and educational attendance and attainment. The hypothesis was that SWIS would lead to improvements in social care and educational outcomes. Social care outcomes were reported independently by local authorities using standardised protocols; educational outcomes were gathered from UK government statistics. Analysis was performed on an ‘intention to treat’ basis (primary and secondary outcomes) and on a per-protocol specification, and subgroup effects were also explored (including of different levels of implementation). A mixed-method process evaluation explored how SWIS was implemented and experienced, through surveys and interviews, and an economic evaluation analysed cost-effectiveness. The study was registered with an international trials registry and the protocol pre-published.

Results

The study involved around 280,000 children aged 11-16 in 268 mainstream schools. At 23 and 35-month follow-ups, no evidence of benefit from SWIS was found on any outcomes. The rate of child protection enquiries was estimated as 5.5% higher in the SWIS arm than control but this effect was not statistically significant - the 95% confidence interval ranges from a 4.5% decrease to a 16.6% increase. All effects of SWIS on the secondary outcomes (referrals, assessments, children entering care and mean number of days spent in care) were similarly small and none were statistically significant. SWIS therefore cannot be considered cost-effective. The process evaluation indicated SWIS was implemented relatively well considering its scale and the impact of the COVID-19 pandemic, and was well received by both school staff and students. Notwithstanding challenges in recruiting and retaining social workers, the overall mean proportion of time social workers were in post across the 21 local authorities was 78%, and the majority of schools achieved the maximum rating in our bespoke categorisation for implementation quality.

Conclusions and Implications

SWIS appears ineffective in reducing the need for child protection services or improving educational outcomes. As a result of the study, UK government officials cancelled plans to expand the roll-out of SWIS - a multi-million pound impact. The study demonstrates that it is possible to conduct a large-scale school-based social work RCT in English schools with no loss of data at follow-up. As well as identifying interventions that are effective, it is equally important for research to highlight approaches that do not achieve the policy objectives they are designed for.