Child protection healthcare staff have said bureaucracy is keeping them from front line practice in Northern Ireland.
The complexity of cases involving domestic violence, drugs, alcohol and parental mental health has also increased, workers told Regulation and Quality Improvement Authority (RQIA) inspectors.
Significant progress was made in other areas to support vulnerable children.
RQIA welcomes significant progress made to support improvement in outcomes for vulnerable children and their families in Northern IrelandDr Lourda Geoghegan
An RQIA report said: “Staff reported that, while the number of cases social workers are expected to carry may remain fairly stable, the complexity of these cases is increasing all the time.”
Some health trust staff expressed concern about the number of unallocated cases in the system, which is causing stress to social workers who are worried that these families are not receiving a service.
Concerns were also raised about temporary vacancies.
The report said: “Staff expressed particular concern about the amount of bureaucracy and form-filling they are expected to comply with, which they believe keeps them away from front-line practice.”
The RQIA published its Review of Governance Arrangements for Child Protection in Northern Ireland on Tuesday.
Dr Lourda Geoghegan, RQIA director of quality improvement, said: “RQIA welcomes significant progress made to support improvement in outcomes for vulnerable children and their families in Northern Ireland.
“We found evidence of strong leadership and a committed workforce, but noted concerns in relation to workload, which includes often complex cases, and the management of unallocated cases.”
Dr Geoghegan continued: “We also found evidence of good training, supervision and records management, and effective inter-disciplinary working across all disciplines, including social care and paediatric teams.”
The watchdog said the issue of temporary vacancies was a real concern for health trusts trying to cover short term absences, with staff reporting long delays in getting temporary replacements.
“All trusts expressed some frustration at the regional recruitment process and the Human Resources, Payroll, Travel and Subsistence (HRPTS) system implemented by the Business Services Organisation (BSO) in respect of recruitment.
“Staff believe that regional recruitment has led to unnecessary delays in recruitment and an unwelcome increase in management time, servicing the technical requirements.
“Trusts also reported challenges in providing a social work service in rural communities, as many social workers prefer to remain close to more densely populated areas.
“This is particularly difficult for Trusts attempting to cover large geographical areas which are sparsely populated.”