(a) The ways in which service users access health, social care and early years services, including:

self-referral professional referral third party referral (b) Barriers which exist to accessing these services, including: Physical barriers including stairs, lack of lifts and lack of adaptations Psychological barriers including social stigma, fear of loss of independence Financial barriers including services that are means tested, services that are charged for and those which have fees attached Geographical barriers including distance of services provider from service user residence, poor transport links Cultural/language barriers including differing cultural beliefs, differing first language Resource barriers including staff shortages, postcode lottery, lack of local funding, great local demand.

Objectives: All will be able to identify the three different types of referrals.

Most will be able to assess health and social care scenarios and explain the correct referral.

Below are a number of anagrams try and figure out what these words mean. GO! GO! GO!

Drat Phi Try Pilafs sooner felS are Brr i ic veers lrferare

= = = = = =

TASK- Work with the person next to you and think of as many different services that is available to use in the health and social care environment.

Services in Calderdale

What does a referral mean? Work with the person next to you to come up with a definition.
Self- referral means:
An example of this:

Professional referral means:

Third party referral means:

An example of this:

An example of this:

TASK- Read each scenario and place the correct method of referral in to the box.

Scenario A customer collapses in the shop where Geeta works. She immediately calls the emergency services Paul has a very high temperature and sore throat. He visits his GP. Kate has been feeling out of breath. After an initial examination, her GP arranges for her to have a chest x-ray. Cathy is concerned about her daughters best friend after overhearing a conversation between the two of them. She telephones social services. Saskia has been experiencing severe headaches. She makes an appointment to have her eyes tested at the opticians.

Method of referral

TASK- You need to create two different scenarios about referrals. You will be swapping your booklet with your peer to test that they understand the different types of referrals. A good one looks like this; Jim lives alone since his wife died last year and he has not been able to manage cooking and cleaning very well. His neighbour often calls in and cooks a meal for him. The last time she called to see Jim his neighbour noticed he looked very unwell and had developed a bad cough. His neighbour telephoned Jims doctor to arrange a visit.

Scenario 1
Answer:

Scenario 2
Answer:

Objectives: To recap the three types of referral. To introduce physical barriers to accessing services

TASK- Read each scenario and place the correct type of referral.

1. Sarah is five and her mum thinks she has a chest infection. She rings the local health centre to make an appointment for Sarah to see the GP the same day.
TYPE -

2.Louise is thirty and she has found a lump in her breast. She has been to the health centre and seen both the practice nurse and GP about it. She is now waiting for an appointment with the specialist at the hospital.
TYPE -

3.Mark is fifty and gives informal care to his father. He is worried about him as he had a fall and hurt his knee. He has called NHS Direct who have advised him to take him to the accident and emergency department at the local hospital.
TYPE -

4.Simon is feeling unwell. He has called the local health centre and made himself an appointment to see a GP the next day.
TYPE -

5.Rachel is in a residential home. Her daughter referred her to the service after worries about her general well-being living on her own.
TYPE -

6.Hannah has issues with depression and anxiety. She has tried antidepressants but to help her condition she has been referred to a psychologist by her GP.
TYPE

Look at the image below, what does it remind you of and why?

What experiences have you had when accessing a type of health and social care service?

TASK- Using the information on the board place each type of barrier into each
circle. Extension- Place examples of these barriers around the edge of the circle chart.

Barriers in

health and
social care services

Objectives: To be able to identify some physical barriers to services. To describe methods that can be used in health and social care services to overcome these barriers.

Key Words Stairs Lifts Adaptions

TASK- You are going to make a floor plan of a service of your choice. The idea behind this is for you to show as many different ways of adapting a physical environment to minimise physical barriers. Extension: For each barrier tell me why it is important to overcome each barrier in a service.

Objectives: To be able to identify some financial barriers to services. To describe methods that can be used in health and social care services to overcome these barriers.

TASK- Get out your mobile phone and find out: The price of prescriptions Who are exempt from charges for prescriptions The price of sight tests Who are exempt from charges for sight tests Price of prescription? Who are exempt?

Price of sight test?

Who are exempt?

How do you think these barriers could affect a person accessing the services that they needs? How could is affect their self-esteem?

Read the paragraphs below and fill in the gaps..

Health, social care and early years services are sometime only available if they pay some or all of the costs involved in providing them. For example, unless you fall into an exempt group you will have to pay charges for NHS prescriptions, eye tests and dental services. The financial costs of these and other services can act as a barrier to care for some people. The range of health, social care and early years services provided by companies and individual practitioners who make up the private sector are only available to people who can afford to pay the fees for these services. Some people pay into insurance schemes or are given health insurance by their employees to cover these costs. However, many of the people who would have otherwise had to pay out of their own pocket are put off by the cost of private sector fees. As a result financial barriers do prevent some people from obtaining some forms of health, social care and early years services that they would otherwise benefit from. In social care, adult services are means tested. This means that service users have their savings and income assessed before services are provided free of charge. This means that some people will have to pay the majority or all of their costs. Those who dont have the money or employer to support them are likely to see the cost of the private sector costs as a financial barrier to them gaining the services they require.

NHS prescriptions financial barriers money

financial barrier means tested private sector costs

insurance schemes employer cost of private sector fees

TASK- As we have now learnt that not all services are free, in the table below create a list of different services, both that we have to pay for and what the NHS pays for.

NHS paid services

Private funded services

Objectives: To be able to identify some geographical barriers to services. To describe methods that can be used in health and social care services to overcome these barriers.

Key Words Distance Service user residence Transport links

TASK- Your job for this barrier is to research your doctors surgery and place it into a poster. Geographical barriers can prevent services user accessing extremely important services that provide them with the day to day support that they need to survive. The key for this letter is to find out whether your GP surgery encounters these barriers. Things you need to include: Where is your GP service on a map? Is it in a rural or urban area? What bus, train, car routes are there to your GP surgery? How many miles if your service from four surrounding towns? What will your service do if service users do not have the transport to attend their appointments?

Objectives: To be able to identify some psychological barriers to services. To describe methods that can be used in health and social care services to overcome these barriers.

Work with the person next to you and think of as many different ideas as to why someone may not want to use a service.

Why might people be scared of using services?

TASK-Find out these key words: Key Term Social stigma Definition

Fear of loss of independence

Embarrassment

Fear of the consequences Extension: Challenge yourself by adding examples! TASK- Highlight the key parts of the following case study. Then answer the questions on the next page. Edna is 74 years old, her husband Eric sadly died a year ago and Edna is struggling to cope. Edna is a very independent person who refuses help from her family and will not even go to the doctors if she is ill. She has suffered with arthritis for many years now and she is struggling to cook for herself and maintain her day to day personal hygiene. Edna is very strong minded and feels as though she is perfectly healthy, even though she is not and believes that residential homes are where you incapable within society and you are left their alone.

What psychological barriers can you identify of Ednas? What would you recommend to help her?

Objectives: To be able to identify some cultural &language barriers to services. To describe methods that can be used in health and social care services to overcome these barriers.

TASK- Write down as many different languages that you can see.

Now answer this, how would you feel if you were trying to access a service and they couldnt understand you? What methods could services use to overcome language barriers?

Video Analysis- Write down all the language/culture barriers from the clip.

Cultural/Language barriers in video clip

TASK- Find out what the following words mean.

Word
Jargon Slang Dialect Ethnic NBM Mother tongue Translator Interpreter

Definition and example

Each culture has different beliefs which can act as a barrier to accessing services. It is important to acknowledge these and respect. One example of this is whitemiddle classed people want other people to look them in the eye. In some cultures looking away or down is a sign of respect. Also some cultures are not familiar with dealing with women who have a high professional status; men sometimes find it difficult or feel awkward with female workers.

TASK- Create a mood board of how you could overcome at least 6 language barriers, (you can use pictures and annotate them to say how you overcome them

Objectives: To be able to identify some resource barriers to services. To describe methods that can be used in health and social care services to overcome these barriers.

What does resource mean? ........................... TASK- In pairs work together and think of as many different resource barriers.

Possible resource barriers

Key words
Staff shortages Postcode lottery Local funding Local demand-

TASK- On the next page create a list of ideas of how health and social care
services can overcome resource barriers. Extension: Explain the implications of overcoming each barrier, e.g. costs.

Resource barrier

How to overcome this barrier

Implications of overcoming barriers

Barriers Project
Mr Smith and Miss Morgan have requested that you undertake a barriers project around school. Your job is to use all the knowledge that you have learnt over the past weeks and identify the barriers that exist within school. You will use this information and create a PowerPoint with all your findings. Once you have done this you must then think of all the ways in which we can change the school to overcome these barriers and include this in your presentation. You will present your findings and suggestions to the rest of the class. In addition to this you are going to work in small groups to prepare a formal letter that will be sent to Mr Smith and Miss Morgan with your investigation and your solutions. Within your presentation you need to: Explain each type of barrier, with an example to illustrate your understanding. Identify possible barriers that a service user could face attending Hipperholme and Lightcliffe High School. Describe what effect this could have on your service user e.g. self esteem Explain possible strategies to overcome these barriers. Please note that this activity will involve you walking around the school at some point. This does not mean that you do not complete the tasks and cause disruptions to other classes. Any misbehaviour will result in a lunch time detention and you will remain in class doing written note work.

Planning Sheet

Will needs a knee operation but due to a high demand for this treatment he will have to wait a year.

Tom has been permanently excluded from school following violent drunken outbursts. He is unaware that he has a drinking problem.

1) Which barrier is preventing each person from getting the health or social care service that they need?
Pierre and Francine have just moved to Romford from Calais they cant find a nursery school with anyone who speaks French.

2) Suggest ways
Cherie doesnt earn much in her job as a waitress. She now has a really bad toothache but cannot afford the root canal treatment that she needs.

the barrier could be overcome.

Akha would love to go to his local primary school but many of the classrooms, plus the library and ICT suite are upstairs meaning he will have no access to them.

Betty lives alone in a village the bus to town comes 3 times a week but not on a Thursday when her diabetic clinic hold their surgery.

Answers Will Tom Cherie Pierre and Francine Akha Betty