Inter-Agency Healthcare for Children and Youth

Introduction

Inter-agency working includes working with more than two or more organisation in a collaborative manner to provide early and better quality health information, health analysis and develop effective health decision for safeguarding children and young individuals. The importance of inter-agency working is that it allows increased efficiency to use public resources and avoid duplication of services. In this assignment, the complex challenges to be faced by Reshma and Ahmed in accessing healthcare along with challenges and opportunities of inter-agency working are to be discussed. The impact of poor leadership in inter-agency working would affect Reshma and Ahmed and changes in policies to be made to offer them effective care is to be analysed. Further, the way multi-disciplinary teams are to work to collaboratively top meet needs of Reshma and Ahmed is to be explained.

Question 1:

Evaluating the complex challenges as well as opportunities of inter-agency working by relating the case study

1)

The inter-agency working requires the effective collaboration of different member across agency boundaries. However, the challenge faced by the agencies in forming collaboration is that clash of egos and ideas are seen between members of different agencies which leads members to provide and reach different solutions and modes of delivering care services to particular individual (Coates, 2017). This challenge of inter-agency working would lead healthcare services to be provided to single service users in different manner by different agencies acting to deliver care support. Thus, the challenge would lead services users like Reshma and Ahmed experience confusion regarding which ideas or ways suggested by the healthcare agency is to be followed to resolve their needs and demands. For instance, in my practice area, it was seen that a hearing-impaired person was referred by one agency to a certain health practitioner to receive care while another agency informed the person to avail care from another health practitioner with experience. Thus, the individual expressed confusion regarding which way to follow and which health practitioners would provide the person proper care. In the study by Solomon (2019), funding concern is mentioned as one of the challenges being faced in inter-agency working. This is because conflicts are seen to arise between inter-agency members regarding which of them require more finances compared to others to execute their role of providing care. As argued by Noga et al. (2016), funding conflicts impact on inter-agency working by making them provide hindered healthcare support. This is because the agencies are unable to provide proper healthcare as a result of lack of finances to cover care service accommodation and on-cost service delivery. Thus, this challenge may have impacted Reshma and Ahmed to face cut in financial healthcare support provided to them as well as experience deteriorated healthcare support delivery. The presence of finite time for responding to different and various healthcare priorities acts as challenge for inter-agency working as they are unable to manage and identify which priorities are to be dealt at first. This leads agency workers to make service users experience long waiting lists before availing care services thus impacting on to delay delivering healthcare support to service users. It affects service users face relapse of their disease or problems being faced (Thomson et al. 2018). For instance, the lack of time for inter-agency working would create challenges for Reshma and Ahmed to get delayed social help and healthcare support making them experience deteriorated health and social condition. In the study by Timonen-Kallio et al. (2017), lack of clarity regarding roles and responsibilities along with the inability to make effective communication are challenges related to inter-agency working. This is because in inter-agency working equal participation of all members may not be seen to communicate with one another due to cultural or ethnic barriers and egos making them unable to develop knowledge regarding which roles are to be played by which individual in the process. This is going to impact on providing hindered as well as duplicated services to service users because lack of clarity and communication leads members to lack knowledge regarding what already has been done for each service users by others. Thus, making them deliver same support which has already been provided creating duplication and wastage of resources. As argued by Joseph et al. (2019), conflict between professional protocols is a challenge in inter-agency working. This is because each of the agencies has their own rules and regulations developed based on the context of their field of working and preferences of policies. This challenge is going to create barriers in collaboratively providing care support to service users during inter-agency working as each of the members from different agencies would be facing limitation to work together in delivering quality care (Davies, 2018).

2)

According to the case study, it is mentioned that Reshma and Ahmed belong from Bangladesh and has immigrated to the UK and the cultural difference would make them face barriers in accessing healthcare. As mentioned by Black et al. (2018), people according to the cultures have different perspectives and preferences regarding healthcare. This is because under each culture the individual is brought up different and made to believe in different customs. Thus, Reshma and Ahmed’s cultural belief may make them consider conditions which do not require healthcare support making them experience barrier in accessing healthcare. The case study informs that Reshma and Ahmed had no formal education before coming to the UK and are immigrants. As mentioned by Feinberg et al. (2016), lack of education leads individuals make unhealthy choices and remain uninformed about the sources of proper healthcare services. Thus, Reshma and Ahmed would face barriers in accessing healthcare as they would lack information about which agency or bodies to be availed in accessing free healthcare services to maintain their improved health condition. This is because lack of education makes them unable to communicate in English in the society leading them unable to interact with others in the society to gain knowledge about healthcare resources required by them. The case study informs that Ahmed is unable to secure any employment due to which the family do not have a steady source of income making them face financial constraints. The barrier to be faced by Reshma and Ahmed is that their lack of income would make them experience financial struggle in accessing paid healthcare services making develop hindered health condition. This is evident as all the healthcare services provided to the immigrants are not free in the UK and only a certain part is supported by the NHS (GOV, 2019). It is also seen that Reshma and Ahmed are unable to speak English and always needs an interpreter for communicating with the GP. However, recently the free services provided for the interpreter by the council are avoided. Thus, their inability to speak in English, as well as low economic condition making them unable to pay for interpreter while residing in the UK, is going to create barrier for them to access healthcare. This is because in the UK, English is regarded as the official language and it is been widely spoken by all the health professionals as well as common individuals (pure.qub.ac.uk, 2019). Therefore, the inability to communicate in the spoken language would create barrier for Reshma and Ahmed to report their healthcare needs to the health practitioner making them unable to access proper support.

3)

The cultural barrier to be experienced by Reshma and Ahmed while accessing healthcare is their lack of awareness regarding concerning health conditions. This is evident as in the culture from which Reshma and Ahmed belong it is informed that overweight is seen as symbol of prosperity and wealth. However, as per clinical research being overweight is unhealthy because it leads individuals to develop wide number of diseases such as diabetes, heart failure, increased blood pressure, obesity and others (Rudolf et al. 2019). Thus, the cultural belief of Reshma and Ahmed regarding weight issues would create barrier for them as they would avoid accessing healthcare support for obesity as they think it would make them look poor in the society hindering their status. After coming to the UK, it is reported that Reshma and Ahmed did not try to receive any form of education as well as showed avoidance to interact with others in the society to gain knowledge regarding healthcare services and support due to their inability to speak in English. Moreover, they did not consider which aspects of their cultural belief are wrong regarding health activities. Thus, their inability to communicate with others in the society due to language barriers would make remain unable to know regarding healthcare resources and health issues in turn which makes them face barrier in accessing healthcare for certain health condition. The lack of education leads individuals unable to have secured employment as they do not basic information and qualifications required to work properly (Ellison et al. 2015). Thus, Ahmed's lack of education is making him unable to secure employment in turn leading him unable to have proper finances to support the healthcare of the family. Further, Ahmed's lack of income has led him to become dependent on the council for hiring an interpreter and thus his lack of finances would make the language barriers to access healthcare more intense for him. This is because the council is not more paying for the interpreter and he is unable to hire one due to his financial failure. The inter-agency working could help Ahmed and Reshma to avail proper healthcare to ensure their effective well-being. As mentioned by Cooper et al. (2016), inter-agency workers in healthcare are seen to come from different backgrounds and cultures in providing healthcare services. Thus, the inter-agency working could lead Reshma and Ahmed to have health practitioners or GP who belong from their own culture and community having information regarding the way to speak in their language preferred for communication to offer them care support. This, in turn, resolves their language barriers experienced during healthcare services. As argued by Thandi et al. (2016), interagency working leads each agency to share responsibilities. At the present, it is seen that due to cut in grants the council is providing Reshma and Ahmed housing rent but has avoided providing them interpreter required to communicate with GP as they lack finances to meet all the requirements. However, interagency working would impact Reshma and Ahmed have access to interpreter as the responsibility to provide help to them is shared between agencies thus avoiding a single agency bear all expenses to provide them help to live in the UK. (Refer to Appendix 1)

Question 2:

Analysing the way improper leadership among healthcare agencies affects service users in relation to the case study

The presence of good leadership is essential in healthcare so that high-quality healthcare can be provided by the well-managed healthcare staffs to the service users (Carragher and Gormley, 2017). However, the lack of good leadership among healthcare agencies creates various issues out of which lack of collaboration between the staffs of the agencies to work properly is one of the problems being faced at the most. As mentioned by Gopee and Galloway (2017), due to poor leadership in inter-agency working the service providers of the agencies lack coordination and collaboration between one another to provide efficient and effective care services to the service users. This is because the service providers are confused without a potential leader regarding the way they are to manage and overcome their egos and ideas which conflicts with others in different agencies to act together in providing effective services. Thus, the lack of good leadership among agencies would impact Ahmed and Reshma to experience confusion regarding which agency for which nature of care services is to be approached. Moreover, they would face lack of collaborative help from agencies to resolve their barriers experienced to access health support. The presence of good leadership among agencies makes the inter-agency staffs have proper knowledge regarding the way they are to act and execute their actions so that no negligence and malpractices are experienced (Van Rossum et al. 2016). This is because good leaders educate and guide the staffs about the commitments and values to be followed during inter-agency working so that they are able to deliver ethical care. However, lack of good leadership leads the staffs among the agencies to lack information and guidance about the specific actions to be performed to deliver effective care, in turn, making them deliver neglected care (Dauvrin and Lorant, 2015). Thus, the lack of good leadership would impact Ahmed and Reshma to experience negligence from the agencies in supporting their needs and demands regarding healthcare in timely manner, in turn, making them suffering hindered health and social condition. For instance, Reshma and Ahmed due to poor leadership among the agencies would receive delayed assistance and care for resolving their negative thinking regarding weight loss and supporting their weight gain issues. This, in turn, may make them develop health issues which would make the suffering intense health condition. The lack of good leadership among the agencies makes the staffs unable to protect the confidentiality of the patients as well as access informed consent in delivering them proper care (Smith, 2015). This is because improper leadership makes the staffs among the agencies lack knowledge regarding the protective measures to be taken to ensure the confidentiality of the service users. Moreover, they lack guidance regarding the way information regarding care is to be provided to the service users to take effective informed consent from them regarding their care. Thus, lack of good leadership would impact Reshma and Ahmed being at risk in the society because their confidential health information may be exposed which may make them experience harm and abuse from the society as well as they may receive care without providing consent for it hindering their rights. For instance, the lack of good leadership may make the staffs among the agencies reveal their thinking regarding gaining weight in the society which may make them experience mocking and abuse in society. As criticised by Reichenpfader et al. (2015), poor leadership among healthcare agencies results to raise the healthcare costs for the service users by making relapse of symptoms and raising hospitalisation frequency. This is because without effective leadership the staffs perform poorly to deliver care which results service users to suffer more intensely for their health condition rather than availing services to resolve them. Thus, the poor leadership would impact Reshma and Ahmed suffering from health condition rather they being resolved raising the cost of healthcare for them.

The lack of good leadership among healthcare agencies creates low morale and high turnover among the staffs. This is because the staffs lack motivation and proper direction regarding the way they are to work to fulfil the goals provided to them (Sfantou et al. 2017). This would impact Reshma and Ahmed to be unable to receive proper care and support when required as there would be lack of service providers present to support them. The lack of good leadership among healthcare agencies leads staffs to lack synergy and proper information regarding which roles are to be performed by whom to provide satisfactory care to the service users (Martin et al. 2015). Thus, it would lead to raise confusion among the staffs of the agencies while providing care leading the service users to receive duplicated care support. As argued by Spurgeon et al. (2015), lack of good leadership among agencies leads the staffs to be involved in criticising one another for any issue. This, in turn, makes the healthcare staffs show improper accountability towards caring for the service users. Thus, it indicates that lack of good leadership is going to impact Ahmed and Reshma to receive irresponsible and non-coordinated care from the service providers in the agencies. The poor leadership leads the staffs to execute malpractice as there are no effective leaders to monitor and take effective steps in making them penalise by identifying their mistakes (Chipeta et al. 2016). This, in turn, would make Reshma and Ahmed receive hindered care that would make them unable to ensure proper health of the family as their newborn baby. The presence of improper leadership leads the staffs among the healthcare agencies develops lack of confidence in providing effective health support and services to the service users. This is because without a good leader the employees are confused regarding their performance as there are no individuals who can criticise and provide them solutions to be followed to correct their mistakes (Harden and Fulop, 2015). The lack of confidence regarding care delivery leads the healthcare staffs of the agencies executes unintentional mistakes and errors in care to service users (D’Innocenzo et al. 2016). Thus, the lack of good leadership would lead Reshma and Ahmed to experience wrong care which would result in deteriorating their health. As argued by Martin et al. (2015), lack of good leader among healthcare agencies leads the staffs unable to get informed about the goals to be accomplished by them at work. Thus, the lack of direction and proper information regarding the work gaols makes the healthcare staffs working in a hindered manner that fails to provide satisfied care to the service users. Thus, as a result of bad leadership, Reshma and Ahmed would experience unsatisfied care as they need would not be fulfilled properly by the confused healthcare staffs.

Outlining policy issues experiences by Ahmed and Reshma and the way it is to be resolved

The NHS England Accessible Information and Communication policy inform that individuals who have limited knowledge or no information regarding the way to communicate in English are to be provided a professional interpreter which is to be paid by the NHS England. This is required so that the individual is able to inform their healthcare needs to concerned health professionals for achieving proper care support (NHS, 2016). However, in case of Reshma and Ahmed, the policy was violated which is evident from the case study where they are being denied by the council for interpreter even though they do not know English to help them communicate with health practitioners regarding their health issues. In this case, the council could have contacted the NHS to intervene in the condition to arrange an interpreter for them. Moreover, the council could have arranged a language translator device for Reshma and Ahmed which they can use to communicate their needs to the health practitioner and others without the help of a paid interpreter. In the UK, to avail a work visa as per immigration policy the individual required to have knowledge regarding the English language. Moreover, they are to appear for an English language test to get an approved work visa (GOV, 2019). This policy of accessing work visa would create issues for Reshma and Ahmed to be unable to find proper employment in the country for financially supporting their family. This is because as per the case study the individuals Reshma and Ahmed had no formal education in Bangladesh and thus do not have knowledge regarding the English language. In this case, the council supporting their stay are to arrange free English teaching courses for the individuals by contacting with NGOs so that they can develop basic knowledge regarding the English language required for them to work in the country to support their family.

Question 3:

Explaining the way the multi-disciplinary team is to work together to meet the needs of Reshma and Ahmed

The Multi-disciplinary team is referred to a group of healthcare providers who belong from different disciplines that are developed for providing holistic care to the service users. The members of the multi-disciplinary team include social workers, medical secretaries, occupational therapists and others (Brogan et al. 2018). An effective multi-disciplinary team works together to improve the chance of meeting the identified needs of Ahmed and Reshma's family by developing proper communication between the team members. As mentioned by Kane and Luz (2017), effective intra-communication and inter-communication between multi-disciplinary team members are required so that they can discuss about the activities provided to be executed for supporting the service users. This is because sharing feelings and ideas during communication to perform the care activities helps the team members reach decision regarding the best way to deliver care for the service users. Thus, effective communication by the multi-disciplinary team members would help them to identify best ways in which the identified needs of Ahmed and Reshma can be achieved. The multidisciplinary team to increase meeting the chances of fulfilling needs of the service users tries to understand and respect each other role in the context. This is because understanding each other role makes the members avoid interrupting the members during care service delivery as well as makes the individual limits their boundaries to act so that duplication of services are not experienced (McLaughlin, 2016). Thus, effective multidisciplinary teams respects each other roles and responsibilities to improve chances of meeting the needs of Ahmed and Reshma’s family as it leads them to determine which role is being performed by whom in turn avoiding to interrupt in care or create duplication of services. As mentioned by Ehrlich et al. (2017), multi-disciplinary teams mix their skills and value diversity to meet the needs of service users. This is because mixing skills helps the members to understand and determine way complementary care is to be provided to the service users for ensuring their better well-being. The effective multi-disciplinary teamwork collaboratively for increasing the chances of achieving the needs of Reshma and Ahmed’s family emphases on analysing and capturing the effectiveness of their services on the service users for reaching the targets. The analysis of the effectiveness of services is done by the multidisciplinary team to understand the extent they have been able to meet the well-being of the patients and the further actions or changes required in the service delivery to ensure better care (West and Markiewicz, 2016). Thus, this action would be effective for the multi-disciplinary team to determine the referrals, timeliness of services, improvement in information delivery and other activities to be executed to ensure meeting the need of Ahmed and Reshma in an enhanced manner. The multi-disciplinary team by working together improves the chances to meet the identified needs of Ahmed and Reshma's family by organising and processing appropriate team resources. The proper organisation of team resources by the multi-disciplinary team includes performing paperwork for arranging care, managing workload, maintaining proper physical resources and others (Weller and Civil, 2018). This is required so that smooth integration of the services needed by Ahmed and Reshma’s family is able to be done by the multi-disciplinary team.

The effective multi-disciplinary team develops a clear vision as well as role and purpose to be followed by the team to make them understand the direction to be followed for establishing effective care delivery that meets the needs of the service users. This is because without proper direction the team members are unable to determine the pathway to be followed for appropriate care (Brogan et al. 2018). The effective multi-disciplinary to work collaboratively to enhance meeting the needs of Ahmed and Reshma’s family ensures they have a good leader to guide them in the process. This is because a good leader provides effective information to the team members regarding the way the goals being mentioned are to be achieved as well as assist the members to resolve any conflict or problems experienced at work between team members (Doulougeri and Montgomery, 2019). As mentioned by West and Markiewicz (2016), the multi-disciplinary team maintain flexibility within team to ensure meeting the needs of the service users. This is because it makes them able to cover roles and responsibilities of each other at work by understanding each other boundaries, in turn, avoiding unnecessary interruption that may delay the care delivery to service users. Thus, the flexibility within the multi-disciplinary team is maintained so that in all condition the needs of Ahmed and Reshma are fulfilled effectively. The multi-disciplinary team ensures they receive proper training for improving their knowledge regarding the way of delivering care to different service users. Moreover, they ensure continuous professional development is achieved and effective education is provided to them while they work for providing services to patients (Barrow et al. 2015). This is because in this way they would have updated knowledge and information regarding the way to resolve the complex needs of the services to offer them enhanced care. In addition, a reliable and trusted team culture is maintained by multi-disciplinary team where each of the members shows commitment to work collaboratively to achieve the needs of the service users in enhanced manner (Brogan et al. 2018). The reliability and trust within the team are required so that the team members feel safe as well as comfortable to open up with other team members regarding their work to discuss the appropriate actions to be taken to avoid risks and meet their responsibilities (Leeftink et al. 2018). The effective multi-disciplinary team to work together in meeting the needs of Ahmed and Reshma’s family works accordingly as mentioned. The multi-disciplinary team members to work collaboratively to improve chances of meeting the needs of Reshma and Ahmed’s family in an enhanced way ensures that few of positive personal attributes such as good organisation skill, willingness to compromise, sharing knowledge, patience, open to learning and others are present. This is because it leads the team to work in an excellent way with limited conflicts (Brogan et al. 2018).

Conclusion

The above discussion informs that the challenges in inter-agency working include clash of egos and ideas, funding concern, finite time, lack of clarity regarding roles and responsibilities and others. The opportunities of interagency-working which are going to impact Reshma and Ahmed are arrangement of language interpreter, offering them health professionals who understand their language and others. The poor leadership in inter-agency working is going to lead lack of coordination and collaboration in providing services to Reshma and Ahmed since the staffs would have lack information and guidance regarding the way to work. Moreover, the confidentiality of Reshma and Ahmed cannot be protected and ineffective care would be provided that would deteriorate their health condition and offer then unsatisfied care. The Multi-disciplinary team by developing proper communication between the team members, understanding and respecting each other role, emphasising on analysing and capturing the effectiveness of their services and others would act in enhancing the way of meeting the identified needs of Reshma and Ahmed.

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