‘We are the gatekeepers’: the role of health Social workers in safeguarding health equity during emergency discharge policies

This article examines the role of health social workers (HSWs) in implementing emergency bed-reduction policies in Israel, with a focus on their efforts to safeguard continuity of care and promote health equity during the Iran–Israel war (June 2025). Using a qualitative design, we analyzed administrative notes from a real-time telephone survey with 17 heads of hospital social work services, alongside seven follow-up interviews. The analysis yielded two central themes: (1) Challenges arising from emergency discharge and bed-reduction policy, including institutional barriers, limited community care options, and patient- and family-related obstacles that undermine continuity of care; and (2) The role of HSWs in navigating structural gaps and ensuring equitable transitions of care, through bridging fragmented systems, participating in emergency decision-making, and advocating around social determinants of health. Findings show that under emergency discharge conditions, HSWs moved beyond routine coordination to engage in ethical logistics, systemic navigation, and advocacy for vulnerable patients. In so doing, they acted as “bureaucratic activists,” reshaping institutional practices from within, safeguarding equity, and alleviating pressures on the healthcare system. The discussion outlines practical recommendations for policy and practice, emphasizing the need to position HSWs in a leadership role at the center of discharge planning during crises.