Inter Agency Working Case Study: Challenges, Opportunities, and Impact of Leadership

This case study discusses the challenges and opportunities of inter-agency working by dealing with immigrants, policies, models, and services implemented by the government for betterment of sufferers and collaborating effectively and efficiently with the healthcare services. It also discusses the impact of leadership on healthcare services.

Inter Agency Working CASE
STUDY

Table of Contents
INTRODUCTION................................................................................................................................
MAIN BODY.......................................................................................................................................
Question.1.............................................................................................................................................
Question 2.............................................................................................................................................
Question 3...........................................................................................................................................
CONCLUSION..................................................................................................................................
REFERENCES...................................................................................................................................

INTRODUCTION
Inter-agency work mainly a collaboration between agencies they work together because
every agency has same point of concern to deal with. In this case study the main issue involve is
social exclusion. Social exclusion means that individuals excluded from utilizing government
privilege, resources and opportunities. The main reason behind social exclusion is differentiation
in the religion, caste, culture, education and ethics. This report will totally base on the case study
of Ahmed and Reshma. They belong to Bangladesh and many rules and regulation be followed
by them according to their customs and religion which means that they have different
background in compare with United Kingdom. Thereby they didn't fully engage with factors of
social, economic and political activities. This report will focus on the opportunities and
challenges of inter-agency working by dealing with immigrants. Later this reports describe some
policies, models which used by the agency for better serving to sufferers and how lack of
leadership affect the Ahmed and Reshma living. And at last this report explain services which
was implemented by the government for betterment of sufferers and collaborating effectively and
efficiently with the healthcare services.
MAIN BODY
Question.1
Challenges and opportunities of Inter-Agency Working
Resources
In every country resources are different and may vary according to workforce,
equipment and strength of economy. From the case study of Ahmed and Reshma, they majorly
lack in resource is finances. As finance play an important part by which a person fulfils their
basic needs in any region and inter-agency help the people of society which faced the problems
from surroundings (Oddy and et.al., 2022.). Immigrants may face this challenges because they
migrate from their resident, Ahmed and Reshma are immigrants so inter-agency even help them
for their survival. The main hurdle for Ahmed and Reshma is language and translator take fee for
that and that can't be supplied for long. As Ahmed and Reshma shift recently with their children
the main problem which they face at initial is capital, and they struggle a lot even they cut
income source for their family and council didn't give any support from their side and the main
point of concern is finance.
Culture and personal value

Culture is different at different place and individuals grow with the surrounding culture.
Personal value means that thought of people according to their livelihood. Basically positive and
negative thought in particulars (Mustafa and et.al., 2021,). As Reshma and Ahmed belong to
different culture, ethics and belief. They belong to Bangladesh which have diversified culture
with different culture majorly religion is Hindu and Muslim. It is clear from case study that
Reshma and Ahmed belongs to Muslim religion. As Muslim's have different culture, beliefs, and
they fully dedicated towards their god. That is reason where Ahmed and Reshma belief interfere
in inter-agency working. For example: Muslims strictly follow custom of fasting on some days
and if a patient suffers from chronic disease and that may have affected from activity of fasting.
Patient may feel dehydration, weakness from the customs therefore a candidate who have
knowledge of Muslim culture would be provided who care well for avoiding incompetence.
Views of Muslim's on health
According to Muslims, good health is blessing from their god (Allah). Ahmed and
Reshma also dedicated towards Allah and believes that poor health is part of everyone's life.
They think that illness is a punishment which is given by god on failing some rules of customs
and rituals. On the other hand, UK citizens didn't follow such types of customs they only focus
on their health and money. In the hospitals, nurses are taking care of every patient rather a
patient is male or female. And in case of Ahmed and Reshma that is not acceptable because
privacy of women is a concern and respected. So inter-agency working require understanding on
that aspect of Muslims by providing same gender in any need that means agency need to
understand this type of concepts.
Communication Barrier
From the outline of case study, majorly Ahmed and Reshma face communication barrier
as they are come from Bangladesh even the translator services are also there for helping, but they
didn’t have money for paying such type of services (Özdora Akşak and Dimitrova, 2022.).
Increase in number of outlets leads a problem of language in UK so healthcare provided look on
that issue. The language which is preferentially used by the people of UK is English and that
creates difficulty for survival in the region. Language is second most barriers which was faced by
immigrants because they didn't understand the local language. Ahmed didn't have background of
education which means that degree of qualification is not in hand of Ahmed so there by lack in
the area of employment. In UK, strict rules and regulation are implement on the people in

working sector i.e. without degree a person is not qualified for work in the cooperate company.
So they struggle for their livelihood and in the healthcare services the communication is required
and Ahmed and Reshma not able to communicate well with the service providers, and they didn't
get actual point of such type of immigrants (Arfa and et.al., 2020.).
For example, the child of Reshma and Ahmed suffer from acute disease and have no
money for consultancy, medication and without medicines disease can't be cure and good
communication is also requiring for conversation they lack in that as well so thereby they are not
able to give description about the disease and may service provider confuse and misguided about
the problem and give medicine according to that. The inaccurate medicine may create a big
problem for the child.
The another barrier is lack of knowledge and mentality, as it is mention in the case study
that Ahmed and Reshma are quite short mentality because they believe that the person who take
drugs are not good but in UK they didn't get affected by the surrounding and they perpetrate
according to their need without judging and influence by others. From social point of view, they
dislike such type of practises (Nyikach, Hansen and Kassah, 2022). Ahmed and Reshma think
that their children get affected by surrounding hindrance so they kept their children inside and If
some drugs comes under in medication that also not giving by them to children
Reason for barriers and how Inter-Agency work positively
As it is clear in above discussion that Ahmed and Reshma suffer a lot when they shift to
UK from Bangladesh, many challenges they face for their livelihood and the main issue for
suffering is lack on knowledge which result in unemployment. Ahmed and Reshma didn't have
any formal degree on which they earn wages from any company. And without formal degree, the
survival in UK country is quite difficult and sometime next to impossible for some peoples. The
another reason which comes in upfront is communication. It can be say that from the case study,
they are not being able to communicate with surrounding in their particulars and often shoulder
on the interpreter. They even isolate themselves from being social with the neighbour that is a
proof of their problem. Communication barrier can be reduced by the agency by operating a
department of developing communication immigrants that play an essential role in survival of
migrants.
Another barrier which was recognized by the case study is cultural customs and beliefs.
Ahmed and Reshma belongs which have vast diversity of culture and in the UK government,

many rules was implemented for helping other at the time of emergency in terms of clinical
providence (Hiam and et.al., 2019). According to Ahmed and Reshma culture, obesity and
oversize is a sign of wealth and prosperity and according to UK context obesity is a disease and
refer as nation emergency. That difference in understanding between the different culture creates
a clash of thinking. But Reshma and Ahmed concluded that they live in between prosperity and
economically wealthy but that is not point of concern/ case.
From the above barriers it can be said that the problem of commodification such type of
sufferers can be mitigated by organizing an educational programme for those who have difficulty
in conversation in English. Agency work in a collaboration that means the services which have
high pay can be cut down in continent to the sufferers. The agencies also higher some
counsellors which basically deals with the actual problem of sufferers and analyse their weak
point in right manner there by it is quite easy to solve sufferer's problem which may result in
future employment (Ntale and et.al., 2019). Inter-agency can't change their thought on customs
and beliefs. Inter-agency easily tackles the issue by doing accountable work for the people which
actually get in trouble,
Question 2
Impact of Leadership
The concept of leadership refers to the ability of an individual using which such
individuals effective guide others. The capability to make the resources mobile and ensuring that
the services are reached in adequate amount in the field of health and social care is linked with
the effective and appropriate leadership quality (Zaghini and et.al., 2020). The application of
leadership in the field of nursing is associated with inclusion of care principles along with the
ensuring of ethics being followed in the process. Connecting with the case of Resume & Ahmed
the below principles will be assessed.
Principle of Ethics
The guidelines that are prepared for the healthcare includes almost all codes established in
relation to ethics. Any personnel in health and social care cannot look the system laws,
procedures and policies as doing so may lead to arising of problems. The decision that is taken
by the carers must be done after the proper evaluation of the system policies.
Principle for Autonomy

The practitioners and carers are encouraged to respect person’s independence by this
principle. According to this principle services provider must respect the decision of the user of
their services by listening to them as such decisions are associated with the concerns for their
life. Referring to the case study given of Ahmed & Reshma adaption to appropriate leadership
style will enable the agencies to show respect towards their cultural background & religion
(Smith, Minor and Brashen, 2018). It is the principle that the service provider must ensure that
the service user dignity is protected and interference to their decision is not done by them.
Principle of Beneficence
This principle is made to ensure that the personnel related to health and social care brings
positive changes in the life of care seekers through their actions. The motives of healthcare
practitioners and service providers should cause no harm to the persons they provide services to.
The inter-agency should to concern over providing welfare to public rather than being attracted
towards profit earning. Encouragement to people in healthcare and social care to prevent any
kind of evil or harm being faced by their patients is given by this principle of beneficence.
Referring to the current case study Reshma and her family lives in neighbourhood that is not
secured, leadership by inter – agency should focus on ensuring providing of services with
promotion to safety culture. Further, the leadership is accountable in providing healthcare
effectively.
Principle of Justice
The case study highlights the issue of social exclusion by denying Rashma & Ahmed
from the privileges on the basis of differences in their religion, background and also education.
According to the principle of justice such actions are not accepted as it promotes equality in
providing services. The nations do have the option to restrict immigration by exercising its rights
but this should not violate the principle of justice. This principle will be incorporated through
leadership ensuring fairness and equality in the act of providing healthcare services. This
principle is interpreted as equal accessibility of services in healthcare to all. The events of
discrimination, etc. can be avoided through effective leadership.
Principle of Non-Maleficence
Following or applying this principle resist people to cause any harm to service takers or
patients in health and social care institutions in the intention to earn benefits in financial terms.
The focus of inter-agency is to enhance their services so as maximize the benefits given to the

care seekers but this is not possible for true in each case (Maijala and et.al., 2018). Referring to
the given case study keeping in the view of culture background of Ahmed and Reshma there are
various activities that cannot be performed by them, this can be either due to cultural background
or their distinct religion.
All these principles will act as guiding agents for ensuring the dignity and equality for
Ahmed and Reshma.
Leadership Styles
Transformational Leadership
This type of leadership style is believed to be an approach of leadership that can bring
changes into the social system and lives of the related individuals. Having this type of leadership
being followed by the multi-disciplinary teams will allow getting desirable outcomes by effective
analysation of situation and identification of opportunities available. The delivery of healthcare
services improves with bring changes into culture.
Autocratic Leadership
This kind of leadership if followed by the leader of multi-disciplinary teams will ensure
that the changes or transformations are brought by them extremely without seeking input from
the team members. In this type information may also be not fully disclosed to the members of
such teams.
Laissez – Faire Leadership
When this type leadership style is followed the members of the multi-disciplinary teams
are not provided with any kind of feedback from their nursing leaders. Such leaders allow the
teams to entail their duties as per their preferences by not interfering (Bahadori and et.al., 2018).
This style linked to the current case may give the disadvantage for the multi-disciplinary teams
in the form of creating of demands by Ahmed and Reshma and getting it done by the
practitioners or service provider for their benefit.
Democratic Leadership
In the health and social care, the nursing leader following democratic of form of
leadership thrives to build relationship with the multi-disciplinary teams by taking care of their
job satisfaction and development at jobs. The decisions of the leaders are executive after
involving and hearing from others in the team. Such a style may help the case study sufferers by
taking into account their morals, values and decisions while providing services.

Bureaucratic Leadership
The main emphasis is over management and control in this form of leadership. Such
leaders are concerned with the outcomes as well as the process that is followed for attaining
those results. All the rules and regulations are adhered and complied by such leaders hence the
processes are more ethical (Lotfi and et.al., 2018). There are three approaches that can be
followed by a bureaucratic leader, namely function, trait and behavioural approach.
Issues related to Policy that affects Reshma & Ahmed
Some policies are outlined into the case study that affects the sufferers. To begin with the
family income policy has affected them. This policy is a form of life insurance policy that offers
family certain sum of money as an income, this income has two important features one is that it
is fixed and the other is that no tax is levied on such income. In the given case study such income
has been reduced for Ahmed and Reshma, as a consequence of which it became difficult for the
family to afford their living in United Kingdom (MEIYANI and Putra, 2019). In addition to this
the family also not comfortable speaking and understanding in English, this worsens their
situation. Because of linguistic barrier they are not able to secure any kind of formal employment
in the country. Their family income is active currently but at a reduced amount, making them
unable to bear the economic pressure of UK (Karim and et.al., 2022). Decrease in income is seen
in many cases of family income, the policy is only advantageous in case of death of earning
member of the family. In the given case both the sufferers are alive hence the decreasing value of
income by policy is disadvantage for them. Next policy is discussed below.
Interpretation & Translation Policy
Primarily, the services of interpretation and translation were given to the sufferers free of
cost but because of the changing economic conditions these services are now needed to be paid
by Ahmed. The current financial status of the sufferer does not allow making payments for such
services (Tookey and et.al., 2018). Ahmed and Reshma are marginalized, they belong to
minority section of their neighbourhood and also linguist barrier impacts their routine life. As per
the National Health Services, a policy formulated for assisting people residing in UK and can’t
communicate in English. Changing policy impacted their lives and welfare in UK.
Appropriate Style of Leadership
On the basis of the study the two most suitable leadership styles in context of the case
study are bureaucratic and democratic leadership styles. Democratic leadership style is suitable

as it will facilitate decision making and participation of all members of teams. This style is
further collective, advice-giving & affiliative (Jankelová and et.al., 2021). This style will provide
Ahmed and Reshma to present their thoughts and reach a proper solution to their problem. The
justification for the suitability of bureaucratic style is that the agency will focus on providing
solutions to the need of the people and also the goals of administration. Further, following the
behavioural approach will enable people in understanding of behaviour of leader and their
performance in every aspect including decision they take over the matters affecting societies.
Question 3
Characteristics of Multidisciplinary Team Works
The term multidisciplinary teams mean a group of members having additional skills,
qualification & experience. The contribution of such members is towards the formulated
objectives of the organization, by working in teams. The importance of such teams is recognized
in the current world because they help in different ways for solving of problems effectively. A
multidisciplinary team is basically a group of professionals that is designed to take valuable
decisions over specific issues or subjects collectively (Iles and et.al., 2020). Multidisciplinary
teamwork is highly popular in the healthcare & community care sector. The reason for its
popularity is that with such kind of working the root cause of any issue can be reached easily.
The problem is first discussed by the group of individuals who are all professionals and then
challenge is being faced by their collective expertise which comes from analysing the same
situation which different perspective inclusion. Such teams can be of members from similar
departments as well as it may also include distinct department members. The main characteristics
of multi-disciplinary teams are, first, these teams have individual members with different set of
skills, knowledge and expertise which are used collectively for any specific project which is
concerned with the welfare of people. The next characteristics is that the basis of the team is
shared principles. The members of such teams get the opportunity to learn from other members
having some sort of skills that are unique and extraordinary. The main elements of multi-
disciplinary teams are collective creation and collaboration. In such time one of the characteristic
that can be observed is complementing of distinct abilities, knowledge, skills possessed by the
different members.
Evaluating the Characteristics of Multidisciplinary Teams

There are various benefits that are associated with the multi-disciplinary team working to
begin with, such working ensures that the patients are given access to the expertise of the
members of entire team. Further the coordination of services provided gets enhanced with the
multi-disciplinary team works. The member of MDT offers greater level of efficiency with
respect to the services that are provided to the patients (Liao and Roen, 2021). The well
coordination in the services ensures uniform delivery of treatment to the patients. The process of
referral fastens up with the effective multi-disciplinary team working. The creation of new
avenues for the implementation of services is done through it. There are certain limitations too.
The working in multi-disciplinary teams mean that the two aspects are needed to be considered
for each of the patient and the limitation of time pressure is always present.
Multi-disciplinary Teams encouraging team governance
The governance aspect of the multi-disciplinary teams outlines the clinical management's
purpose. The policies & guides relating to the operating and communicative process with the
patients. Varied strategies and methodologies are aligned in the matter of patients, the annual
progress is also accessed and compared with the different governmental organizations (Walters
and et.al., 2019). The aim of governance is to enhance the level of transparency, competency and
credibility of the services that are provided to the patients. The public is kept engaged into the
routine functions and activities by the members of such teams. The enhancement to the
independence of the members is ensured and focus is laid over the people who are in need of
care.
Application of multi-disciplinary in the case of Reshma and Ahmed
There are various security and social needs of Reshma and Ahmed. One example is their
neighbourhood which surrounds them with people who are living in insecure place where the
cases of drugs peddling are seen normally. The multi-disciplinary teams can help the community
by inclusion of the matters that impacts the minority people. The concept of neighbourhood
policing can be applied which the evidence of the activities in order to minimize the harm and
disturbances which are caused to the community. With the help of the agency people like Ahmed
can seek the help of police in getting rid of the issue they face. According to the policies of
United Kingdom access to education to the immigrants' children are provided by the governing
authority. But this does not mean any kind of guarantee with regards to their stay in the country
(Lavelle and et.al., 2018). The provided case of Ahmed & Reshma include the point where

Ahmed is seen taking his kids to school and bringing them back which outlines that the
education policy secures the education of their children in United Kingdom. From the case study
it is interpreted that the language related barrier is the main obstacle that they face and also the
educational background is a disadvantage for them. IN the solution to which the multi-
disciplinary team working can ensure that care specialist respects the independence and culture
of Ahmed and Reshma.
CONCLUSION
On the basis of the above report it has been concluded that there are various types of
barriers and challenges that are faced in the inter - agency working. The opportunities that are
provided by such working in providing assistance to Ahmed and Reshma have been discussed in
the study. The report has covered the barriers that are faced by the suffers while accessing
healthcare. The potential reasons for the determined barriers in impacting the inter – agency
work on the well-being of Ahmed and Reshma have been highlighted in the report. The report
has analysed how the lack of good leadership practices in the healthcare based agencies
negatively impacts the case study sufferers while relating to the principles of ethics in care and
initiatives by the multi-disciplinary working. In the report the policy issues that were faced by
Ahmed & Reshma have been outlined. Lastly the report has discovered the various
characteristics of multi-disciplinary teamwork and has evaluated them. It has been explained
how the effective working of multi-disciplinary teams collectively enhances the potentiality of
meeting the support needs of Ahmed and Reshma.

REFERENCES
Books and Journals
Arfa, S. and et.al., 2020. Disabled and immigrant, a double minority challenge: a qualitative
study about the experiences of immigrant parents of children with disabilities
navigating health and rehabilitation services in Norway. BMC health services
research. 20(1). pp.1-16.
Bahadori, A. and et.al., 2018. The relationship between nursing leadership and patient
satisfaction. International Journal of Medical Research & Health Sciences, 5(10),
pp.134-141.
Hiam, L. and et.al., 2019. Overcoming the barriers migrants face in accessing health care. Public
Health. 172. pp.89-92.
Iles, R. K. and et.al., 2020. Development of a clinical MALDI-ToF mass spectrometry assay for
SARS-CoV-2: rational design and multi-disciplinary team work. Diagnostics, 10(10),
p.746.
Jankelová, N. and et.al., 2021. Leading employees through the crises: Key competences of crises
management in healthcare facilities in coronavirus pandemic. Risk management and
healthcare policy, 14, p.561.
Karim, A. and et.al., 2022. The Effect of Gender Independence and Leadership Style on Audit
Quality in Makassar Public Accounting Offices. International Journal of Social Science
Research and Review, 5(7), pp.114-126.
Lavelle, M. and et.al., 2018. MBRRACE in simulation: an evaluation of a multi-disciplinary
simulation training for medical emergencies in obstetrics (MEmO). Journal of
Obstetrics and Gynaecology, 38(6), pp.781-788.
Liao, L. M. and Roen, K., 2021. The role of psychologists in multi-disciplinary teams for
intersex/diverse sex development: interviews with British and Swedish clinical
specialists. Psychology & Sexuality, 12(3), pp.202-216.
Lotfi, Z. and et.al., 2018. Relationship between ethical leadership and organisational
commitment of nurses with perception of patient safety culture. Journal of nursing
management, 26(6), pp.726-734.
Maijala, R. and et.al., 2018. Successful implementation of lean as a managerial principle in
health care: a conceptual analysis from systematic literature review. International
journal of technology assessment in health care, 34(2), pp.134-146.
MEIYANI, E. and Putra, A. H. P. K., 2019. The relationship between islamic leadership on
employee engagement distribution in FMCG industry: Anthropology business
review. Journal of Distribution Science, 17(5), pp.19-28.
Mustafa, M. and et.al., 2021, May. Religion and Women’s Intimate Health: Towards an
Inclusive Approach to Healthcare. In Proceedings of the 2021 CHI Conference on
Human Factors in Computing Systems (pp. 1-13).
Ntale, P. D. and et.al., 2019. Inter-agency collaboration for graduate employment opportunities
in Uganda: a case for investigating the structure, social capital, and agency of
organizations. Journal of African American Studies. 23(1). pp.111-130.
Nyikach, D. A., Hansen, K. L. and Kassah, K. A., 2022. Transition to adulthood: experiences of
service providers working with immigrant disabled adolescents and young adults in
Norway. Disability & Society, pp.1-21.
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Oddy, J. and et.al., 2022. Experiences of forced migration: learning for educators and learners: a
report. International Review of Psychiatry, pp.1-8.
Özdora Akşak, E. and Dimitrova, D., 2022. Walking on a tightrope: challenges and opportunities
for civil society organizations working with refugees and migrants in
Turkey. VOLUNTAS: International Journal of Voluntary and Nonprofit
Organizations. 33(2). pp.374-385.
Smith, G., Minor, M. and Brashen, H., 2018. Spiritual Leadership: A Guide to a Leadership Style
That Embraces Multiple Perspectives. Journal of instructional research, 7, pp.80-89.
Tookey, P. and et.al., 2018. From client to co-worker: a case study of the transition to peer work
within a multi-disciplinary hepatitis c treatment team in Toronto, Canada. Harm
Reduction Journal, 15(1), pp.1-11.
Walters, G. I. and et.al., 2019. Characteristics of hypersensitivity pneumonitis diagnosed by
interstitial and occupational lung disease multi-disciplinary team
consensus. Respiratory medicine, 155, pp.19-25.
Zaghini, F. and et.al., 2020. The relationship between nurse managers' leadership style and
patients' perception of the quality of the care provided by nurses: Cross sectional
survey. International journal of nursing studies, 101, p.103446.