UNIT 11: service in health and social care

Factors affecting access to health and Social Care provision

Pass question3, P4- Describe how each factor positively or negatively affect
someones access to services.

Merit question 2 Using the case studies below, explore the factors that affect
access to services. Give examples from the case to show how that factor may affect
the individuals access to services.

Factors Description of factors

How do these factors positively How do these factors

House Officer:
Clive is paralised on one
side of hos hody, and this
makes it difficult for him to short distance will mean easy
move around comfortably.
To ease his pains, the house transportation. In some cases, a
officer has adapted his
apartment - hand rails have minutes walk away from residents
been installed in strategic
places so that he can grab
them to move around, but
he still finds it
uncomfortable to do so.
This means that he would
still need to use the help of
other persons and
resources to live well and
comfortably in his
apartment.
Prelimivary Carer:
Clive also has a wheel chair
which he can use to move
around outside of his
apartment. However, he
needs more help with that:
someone has to push him
affect someones access to service
Geographical location has a
positive effect on a person's access
to healthcare in several ways. A
access, and cheaper
healthcare centre will be a few
for people who live in the city.
Living in the city centre also means
that one can have numerous
centres to choose from, to match
patient's preferences -
economically or quality of services.
Naomi
Geographical location has lots of
influence on health, because it, to a
large extent, determines the kind of
water you drink, what you eat, and
environment sanitation.
Accessing these basic needs vary
from place to place, and also
depends largely on financial power.
negatively affect someones
access to service
Geographical location has a
negative effect on a person's
access to healthcare, if the
patient lives a long distance
away from healthcare
centres. This especially is a
major barrier to the poor
people living in rural and
remote areas.
Their challenges can be
characterised by - lack of
transportation, high cost of
transportation and time
constraint. A poor condition of
roads which leads to the
health care centre is also a
major barrier to access
healthcare facilities.
Giselle
Geographical location has a
close relationship with
accessing healthcare. Living
in a location far from
healthcare services not only
makes it difficult to access
good health services.
him around, on the wheel
chair because it is not an
electric pwered cheel chair.
The person who pushes him
around will also work as a
surveillance, to avoid such
occurences as the incident
which led to fire when he
fell from his wheel chair.
There were conflicting
reports where one of them
actually reveals that Clive
might have Suicidal
tendencies, so he must be
watched closely.
General Practicioner:
The G.P works in
communication with the
Carer too, since he (the
carer) is required to give
Clive's medications.
Whenever they meet
withing the month, the
carer will be able to give
the G.P important updates
on how Clive is responding
to his medications. Not
being able to eat too is a
major point of concern, so
the G.P can give it a proper
attention. Without taking
eating well, medications
can not be taken.
Naomi for instance can be clear on
getting the best supplies of these
basic needs because she lives in
the city and has a good income
status which can be achieved in the
city.
She works in the city center and
earns enough money to take care
of her health system, which she will
never have access to if she were
living in a rural area.
This city center also provides
facilities for exercises, nutritionists,
information on healthcare
awareness and lifestyle which will
also in turn improve healthy living.
Infections would spread faster
before it can be controled.
Giselle lives in a site on the
outskirt of Croydon, and she
has to be seeing a Consultant
at her local hospital. There is
every possibility that this
hospital depends on
merchants in the city for
supplies of medical materials.
This may also mean that -
attending a hospital in the city
center will be more effective
for her treatments.
Human mibility is also an
important factor. Her case
states that she uses an
electrical wheel chair, which
means that mobility for her
largely depends on supply of
electricity - something she
does not have to worry about
in the city centre to get to her
healthcare provider.

Psychiatric Nurse:

Clive has a report of a

mental issue. He has to be
monitore closely to watch
him for any suicidal
behaviour, and the care
giver will records of
occurences which may be
useful to the psychiatrist.
Merit
Proximity to services Geographically, people who live in
the city are more likely to get
access to more services like GP,
Library, hospital, off licence shops
etc. it more populated and more
advance in every day basic amenity
of life, so the population attends to
health and social care services is
highly demanding unlike to the rural
areas, this is because the less
amount of population the low
services they demand in regards of
receiving health and social care
services.
It is beneficial for a patient to live
near a GP surgery for example it
enhance the patient services such
as even if the patient is unwell they
can just walk down because it only
a 2minute walk, patient will not be
late, even if they had forgotten the
appointment even at the last minute
they can still rush down to the GP
surgery, if you become to unwell
and decided to call the ambulance
because live in the city it can
sometimes take between 1-3mintue
for it to arrive.
People who live in rural areas
find it a little bit challenging to
access service like people
who live in the city especially
when they are not driving, the
GP surgery, local shops,
library can be far from where
the individuals live. If you are
unwell and want to see the
GP and you are not driving it
is even harder, the bus
doesnt come every 5-8
minute like the city in rural
area sometime it takes 20-
30min for the bus to come to
the bus stops and if you have
to change like two buses
before you get to the GP it
even becomes harder. If you
have forgetting your
appointment you dont get a
chance to say let me rush to
the GP and see if I can be
attended because by the time
you get there the surgery
would have been close
because is too far away. It
does not benefit a patient in
most case not live near a GP
surgery If you become too
unwell and call the
ambulance, it will take longer

Merit Naomi
Naomi lives in the city centre, and
this is an advantage for accessing
healthcare facilities at ease.
Because of the fact that Naomi is
living within London she will be able
to comply with all her appointments
and the travelling time is not going
to be an issue as well as the
transportation means. In other
words, if she has an advocate that
will be taking her to the GP for
appointment, it will be an extra
help.
Apart from being late, it might occur
that there are lots of patients
seeking medical attentions. Usually
the first reason for disparities in
healthcare is that there are several
time because ambulances
are not much in rural areas
the distance from the
individuals house too is
another factor.
Giselle
Because Giselle settled on
the outskirt of Croydon he will
find it very hard to get to all
his appointment with the local
consultant, because any
appointment he gets, by the
time he comes back he will
be very tired because is far
from where he lived.
Giselle might also fall a victim
of healthcare disparity - she
will most likely get there late
and meet several persons
there. She might have to
come back another day, and
the cycle continues.
Also considering the fact that
she always needs help to do
 persons who are seeking a
professional's attention at the same
time. One way or the other, a rule
will be established and whoever
comes after the rule had been
made plays by the rule.
Therefore for this reason, proximity
ensures that you know who made
what rules, and you might even be
part of it, or in disagreement, simply
because you live close enough to
minitor your turn.
Transport links pass Transportation is very important to
life and health, it make everything
work fast for service users if there
is link from one place or the other, it
improve access to services easily,
access to education, employment,
fresh food, friends and family,
leisure, and health services
enhancement, all this can only
happen when there is good
facilitate by good public transport,
roads, footpaths and cycle ways
that bring down journey times. it is
easy to get to work, get to social
activates, transport can improve
access to health-improving life
opportunities such as education,
fresh food and health care.
A good transport link can provide or
increase routine outlet for physical
activity, good transport planning
can reduce the way you use cars or
bus and increase on your walking
and cycling which can increase
physical activity levels. It is also
easy and fast for ambulance to turn
up in a service users house when
there is a lot of road connecting
each other.
People who walk or cycle on the
street can also make the street
almost everything, she might
always be the last person to
be attended to, except she is
actually the first.
Transport link also have
negative impact the same
way it has its own positive
impact, it can be very
distressing when the
transport linking 009 is not
connecting each other, when
the transport planning is not
adequate, it is inter relating
with each other it can be
frustrating. When there is
accident it can lead to
someone be traumatise.
Also, because it involves the
linkings of multuple shorter
roads, using these links might
actually make a person's
movement slower, and the
journey longer.
The linked roads will probably
have fewer lanes for vehicles,
and because there will be
more users if the roads on
bicycles, tricycles, wheels
and foot, speed limit will be
quite slow (around 30km/hr)
 another form of socialise because
they will be meeting people on the
street and be interacting with them,
and they can start building up a real
good friendship from there.
Merit Giselle
Transport links would be a really
helpful feature for person line
Giselle. She is someone who
obviously needs all the help she
can get, and good she could move
around on her wheel chair.
Cerebral Palsy has no cure, but
there are management measures
which can help CP patients. One of
such measures is to maximize the
patient's independence and social
engagements.
Giselle can move around
independently on her electric
wheelchair, and the transport link
pass comes handy for her as she
can move around and do more
outdoor socializing with other
people which are walking on foot.
While moving around, she would
make friends on the road - friends
with like people moving on wheels
too. She will get helps from people
riding bicycles, take fresh air, and
do some sightings as a form of
recreation.
Naomi
Transport links can
sometimes not be favourable
for people like Naomi and her
wife Tracey.
She is a homosexual, which
may be fine with healthcare
professionals. The couple can
be safe from criticism from
healthcare providers, but
other persons may not have
such understanding.
When these people move on
the road, they want to keep
things to them selves. They
probably want to avoid been
seen together by people who
do not accept or agree with
their sexuality, and they dont
want to be talked down. In
such situation transport link
pass may serve a negative
purpose to accessing
healthcare for such persons.
2: socio-economic Social and economic factors are of The negative effect of the
Factors a paramount importance to social and economic factors
accessing healthcare. Factors like can be seen in the rural areas
education, finance, housing, where education is poor and
environment and health itself all access to information and
contribute positively to good access health awareness is most
to healthcare in the city. likely is develop like the city
People living in the city enjoy clean style or way of life
air and water, have access to Most importantly this leads to
education and information easily a poor lifestyle which can
and also have financial advantage cause self-afflicted health
Merit
which makes it possible to meet up problems.
with cost of healthcare services.
Good paying jobs can mostly be
found in the city, and you need a
good educational qualification to
Giselle
even think of staying here in the Giselle's case is also a
first place. A person's health will perfect example to relate
enjoy all the benefits of living in the healthcare with Socio-
city, but there are also loads of bills economic factors. Giselle has
to be paid so much challenges which all
Naomi
have a common root: she is
Naomi's case is a perffect example
Cerebral Palsy patient.
to relate healthcare with Socio-
Giselle cannot work, therefor
economic factors. Here one can
she cannot earn money - she
say she has her own health
can only live on financial aids
challenges too, but she stands a
and bene which mostly will go
good chance of overcoming her
for her healthcare and
health challenges with a good
feeding. She will not even
success.
think of living in a city as she
She is recently diagnosed of cancer
will not be able to afford it.
and she is going for treatments
She also has a learning
already, she has a hearing
difficulty, which also mean
impairment and she has hearing
that she might not be able to
aid to control that too. She is
get a normal education.
financially stable, and lives in the
Giselle is obese, she has a
city where she has access to a
poor lifestyle - perhaps she
good accomodation, cleaner water
eats only what she finds and
and air, electricity to improve
has no choice of what she
lifestyle and the freedom to live a
consumes.
life that fits her sexual orientations. These all are a result of
All of these are socio-economic
socio-economic challenges
factors which contribute to
playing out.
healthcare systems.
Education Education in the form of facts
that have been learned, and
ideas people are exposed to,
plays an ample role in
healthcare. On one hand,
education will affect the
accessibility of healthcare
services by improving human
capital - this implies that with
adequate education, more
Merit health workers and several
skills beneficial to the health
sector will be available.
Adequate education especially
in the rural and remote areas
can help to minimize the
challenges of long distances
and transportation, because
education will help train more
personnels and increase the
number of healthcare providers
in such areas.
Naomi.
Education has a strong
influence on access to health
care services, Looking at the
case of Naomi who works in
London as a financial manager.
As a financial manager, to
have attained such position in
a city like London suggests
that Naomi has a good
educational qualification. A
diagnosis reveals that she has
breast cancer, and not long
she is already prepared to go
for a proper treatment.
Naomi would probably be
sourcing for funds to undergo a
No matter how far or
close one is from a
healthcare provider,
ability for a patient to
express health challenges
is key. This can actually
prevent a patient from
getting effective attention
if the individual cannot
properly relate his/her
health issues to the
health worker. inadequate
education can actually
put an individual in this
ugly situation.
Poor health education, or
total lack of it can also
cost an individual
accessing healthcare
service the ability to
grasp instructions and
prescriptions from a
healthcare provider
Samuel.
From the case of Samuel;
at 35 years of age he is a
builder - a self-employed
builder. This suggests that
he probably has a low
level education, or non.
Certainly, he does not
have Naomi's kind of job
which could cover his
medical and domestic
expenses while he
receives treatment for the
next three weeks, at
least.
Also, his wife is probably
treatment at this time if she
had no job. Sourcing for fund
may take a longer time to
achieve, and within that period
the cancer may spread,
leading to a more severe and
life threatening situation.
not educated, because
with Samuel's low profile
job it is only imperative
that his wife gets a job to
support the family, if she
is employable.
Health awareness and In some regions of the world,
lifestyle choices like Africa, HIV/AIDS kills
people more than any other
diseases. This is so, because
the major means of
transmitting the virus is
through sex.
Sex is one activity which
humans engage in very
frequently and as such, the
chances of getting infected is
quite high.
Merit.
Awareness of this culprit will
help tremendously in accessing
good health. Health care
workers create this awareness
by sensitizing people on such
disease, and how to prevent
infection.
A healthy lifestyle will also
reduce, or eliminate the
chances of getting infected:
like having protected sexual
intercourse or total abstinence,
not sharing sharp objects, etc.
Physically enough rest and
sleep, minimize stress and
anxiety, maintaining work-play
balance, and regular exercise
are also lifestyles which
enhance health. Above all,
being interested in health
information and articles will
create plenty health awareness
and improve lifestyle.
Naomi.
Apart from the fact that
Naomi's level of education
A poor lifestyle can
usually arise from lack of
proper health care
awareness.
Poor lifestyle will always
result to one health issue
or another - for example a
poor eating habit can
result in obesity; smoking
can result in a lung
cancer; unprotected sex
can lead to infection of
STD, etc - all poor
lifestyles.
People like to consume
food that are tasty, they
do not care what it
contains. Many times we
consume food that
contain lots of additives
and preservatives simply
because they taste good,
people consume
unknowingly substances,
and do not control their
excessive sugar intakes,
which could be harmful to
health.
Joaquin
Joaquin quits his job after
he noticed he is not so
well mentally. I believe
Joaquin lacks health
awareness, because he
had started hearing
voices in his head before
he would seek medical
3: Equality and Diversity
Basically when there is a huge
number of patients seeking
healthcare at the same time, from
perhaps the same region everyone
can't possibly be attended to. In
such a situation there has to be a
way out - usually a formula for not
discriminating.
By equality and diversity we mean
Merit
ensuring every person in a system
has equal opportunities, and
appreciating the differences in
different people. This also implies
that regardless of their abilities,
their background or their lifestyle
values, beliefs and culture must be
treated with respect.
When persons are accepted like
this, no one will avoid visiting any
healthcare Centre, for fear of
rejection or being undignified.
Giselle
Giselle's case says a lot about
equality. She has all the disabilities
working against her - she cannot
work, she cannot wash her clothes appointments with her.
or bath her self. It seems the only
things she is capable of doing is eat that the healthcare
and move around, to see an
healthcare provider.
But evidently she is being treated
with equality regardless her
condition. She is an active member treatment, Tracey might be
of a travel group - she has traveled the only family she has to visit
When equality is not
promoted effectively women
especially tend to suffer it
most. This creates even
bigger problems and may
cause women to loose self-
confidence approaching a
health centres. They keep
ailments to their selves until
things gets out of hand. This
is common among the rural
communities.
Diversity, similar to equality
but has to do with factors like
culture and values. This one
can even get more sensitive,
as people can avoid you
totally if they notice you do
not share their values.
Naomi
Healthcare must focus strictly
on such issues that concerns
health. The beliefs and views
of patients should never
interfere with the healthcare
business.
Professional health workers
where Naomi goes to for
treatments do not interfere
with her sexuality so this
makes it possible for her wife
Tracey to attend
If she got the slightest hint
professional finds her
sexuality strange, she would
never use such facilities. Or if
she does however, then she
will not get the best of it.
While on ger cancer

four times in two years and they
presently live together. She has a
local doctor who takes care of her
case. All of these make her feel
good being human, and worry less
about her disabilities.
Cultural and religions To access the best healthcare
service a close interaction
between the patient and the
healthcare professional is key.
There has to be a kind of
personal relationship playing
out between them, so that the
patient should be able to speak
with ease and openness.
A healthcare provider who
understands the patient's
Merit
values and beliefs will achieve
more from the interactions,
even in a short period of time.
An improvement in cultural
diversity has a huge positive
effect on healthcare, both in
short and long terms.
A healthcare provider who
understands more than one
language, including that of
minority group is an added
value.
Joaquin.
The case of Joaquin states that
he had moved to London from
Mexico - another country
entirely which is expected to
have different cultural values
her in th hospital and
inequality will pose a problem
in this stance.
Cultural and religious beliefs
are not always on the same
side with medical practices,
yet patients want their beliefs
respected.
This can create bottlenecks
for the patients many of the
times. For instance a religious
patient would get confused
which to attend of a medical
appointment or a church
meeting. A patient looking for
cure from local herbs when
he or she is supposed to take
a medical diagnosis to find
out what the problem is and
get it treated.
Cultural and religious beliefs
are mostly setbacks to
medical treatments.
Joaquin.
It is established that
religious diversity should
be considered in
healthcare provision.
However in some cases,
such as Joaquin's - it may
become undesirable.
Joaquin had started
hearing voices in his head
which suggest severity in
his ailment. Within the
grace of one week given
 and language from what is because religious
obtainable in London. reservations his health
might have got worse. In
Usually a G,P is expected to
this regard, observing
recommend a stay in the
patient's religion is not
hospital for him, for urgent
being helpful.
treatment, but he was given
another one week grace to
watch for improvements. In the
real sense, this allowed so that
Joaquin can still attend his
church for bible studies. Then
when it is deemed that he
must be admitted, he would
understand that considerations
have been given his belief
already, and this time urgent
attention must be paid to his
health.

Gender In many societies today, the For reasons of gender

systems are structured almost
in ways which seem to put
women under pressure of
oppression and abuse, in the
form of cultural practices. This
tends to make women more
vulnerable to health issues.
Gender equality will go a long
way in solving this problem,
and improving access to
healthcare tremendously.
Merit In addition, Health equity is
also another factor which can
ensure that there are no
differences in healthcare for all
persons, people, sexes and
sexual orientations - and this
will further enhance access to
healthcare services.
inequality, some societies
in India and Africa tend to
educate the male child
more than the female
child because it is
believed that the male
child has more earning
power to cater for the
family in the future. This
has a negative effect on
women's access to
healthcare, because
education itself is a major
contribution to health
care.
Education also increases
the chances of people to
earn more money - so
that when women have
been denied education,
earning enough money to

Samuel.
In Samuel's case here, his
income is obviously not
enough to cater for the needs
of his family, but his wife do
not work still. Perhaps as
Jewish he has belief that the
role of women, his wife should
be to take care of the home.
Gender equality could have
played it out that the woman
too be out there working to
support the husband. That
way, cost of healthcare would
not have so much effect on the
home.
Samuel's wife could have been
able to help out in domestic
expenses like feeding the kids
and their selves, while Samuel
uses his own income to solve
more pressing issues like rents
and healthcare. That way there
would have been a cushioned
effect, for the loss of income
during treatments.
Loss if income during
healthcare is a terrible
challenge on its own, because
it is like spending on two front:
spending while you earn
nothing.
access healthcare
services may become a
problem.
Giselle
Sometimes rules have
exceptions which occurs in a
very painful way.
Giselle is a young woman
who is obviously not a victim
of molestation, or gender
inequality. Yet she has a
difficulty in learning, and also
suffers from Cerebral Palsy.
Even though she must be
treated fairly and equally with
everyone, she still requires
special attentions and
treatments. She has a major
disability so she cannot work,
she bath her self or wash her
dress. In her case, call for
gender equality has no effect,
no special positive advantage
to healthcare access.
4: communication There is a strong correlation
between a healthcare
professionals communication skill,
and his ability to manage a patient
to follow through medical
recommendations. The level of
connection which a patient feels
with a care provider can readily
improve the patient's condition
because he will happily take
instructions, if he feels safe with the
professional.
Some patients who do may not be
able to afford prescriptions will
relate this to a physician who has
been able to connect with them
through a good communication.
Communication is not limited to
adults. Communication with adults,
youth can actually be easy,
Merit compared to communication with
kids or even infants.
When infants cry, they are trying to
tell healthcare professionals
something, which can only be
heard by those who have
developed this skill properly. Kids
and toddlers may be friendly or
hostile to medical instructions, and
it depends on the level of
communication between the kid
and the healthcare provider.
Adolescents may be secretive or
generous with helpful health
information which could help in
treatments depending on how
issues are approached by the
healthcare worker.
Samuel
Communication is a factor in
healthcare which can not be over
emphasised. communication
Communication is a two-way
traffic, where one person
sends a message and
another receives. With so
much emphasis on
communication, a good
communication may go
wrong.
A healthcare worker might be
saying one thing and the
patient will pick a totally
different understanding from
the original intent of the
speaker.
This could lead to a wrong
perception of the patient as
regard the service received -
he may term his experience:
as not satisfied.
Joaquin
Joaquin must have had a
thorough talk with his
healthcare provider. They
have been in a long
communication, they have left
no stone unturned. They
probably have considered
Joaquin's religious activity,
finance strength for payin for
the healthcare services, and
others, and theyvhave
reached a final agreement
that after one week of no
response to treatments he
 comes up all the time, between
every patient and their healthcare
provider.
Here is one between Samuel and
his physician: he needs to forget
about every thing called work for
now. Samuel needs to focus on
getting well for the next three
weeks, and thereafter stay home
for another three to recorver, and
not bother himself about work or
friday church meetings. What Is
most important is getting well, so
that he can get his life back.
Age appropriate language A good communication
by professionals between a healthcare
professional and the patient
can leads to increased rates of
recovery, establishing some
sense of protection. It even
gets more sensitive when the
worker has to talk with patients
of younger age - he brings
himself down to the level of
the child, and chooses the right
words to use.
Age appropriate language
when used by professionals
Merit can improve communication
between the healthcare
provider and patients of
different age.
Some children may want their
parents to be part of any
decision that will be made
before there can be progress in
the treatment process,
because the parents know the
right things to say at the right
time. However the parents
may not always be around to
must be back to the hospital.
Now that is a good thing that
has been achieved from a
good communication, but it
might eventually be a delay in
treatments, because it will be
better to even start a full treat
immediately and not
postpone staying in the
hospital for a weeK.
A poor communication
between a healthcare
worker and a patient can
lead to a weak
relationship between
them, and breed a sense
of non-satisfaction.
When speaking with
younger patients who do
not feel that tender
closeness, adherence to
treatment instructions
may become an issue.
Trying to communicate to
please persons of certain
age; like older people or
very young patients can
sometimes slow down
healthcare process. A kid
who does not like to
swallow tablets or be
injected. A healthcare
worker trying to persuade
such child will have to use
appropriate languag for
the child to understand
why he or she has to take
 participate in what needs to be
done. In this regard, a
healthcare professional who
knows the age appropriate
language to use will make lots
of progress.
Giselle
The best way to communicate
effectively with someone like
Giselle who has Cerebral Palsy is
to first accept the responsibility.
This will cause the healthcare
professional to find good strategy
and language that will support good
communication.
Giselle is 23 years - a young girl in
her youth. A healthcare
professional will speak with her as
a 23 year old so she will have her
dignity as a human. This will make
her feel responsible, and she will
gladly give usefull information
which will help in her treatment.
She has to be listened to so that
the healthcare provider will better
understand her receptive language
and communicate with her
accordingly.
Use of jargon and Access to quality healthcare
acronyms services highly requires that a
it. This can actually delay
treatments.
Joaquin.
Joaquin went for G.P and
instead of staying back on
admission, the physician
gave him some medications
for treatment that he need to
take, which if there is no
improvement after one week
a stay in the hospital will be
recommended.
This decision is partly due to
objection from Joaquin.
Perhaps he has raised the
point that he is a christain
who has an obligation to
attend church and to read
bible daily.
It is professional not to argue
with an old man like that, so a
compromised is reached that
if after a week there is no
improvement things have to
be done the physician's way.
This seems like a subtle way
of communicating with an
older man, but it is also
delaying healthcare.
 patient understands the
healthcare professional
perfectly. In fact, to be a good
health worker, one must also
be able to teach effectively for
a patient to understand clearly.

The use of medical terms may

help patients to learn more
random medical ideas, but Joaquin
Merit such medical jargons must be No person should postpone
broken down and explained getting necessary healthcare
when used to avoid any form attention for any reason. Not
of communication breach. in the case of Joaquin who
has mental challenges that
Electronic mails are another has grown to the point where
form of messaging which may he now hears voices in his
be useful, when using technical head.
medical terms. Unlike speech, Assuming a scenario where
Emails can be stored for he actually objected to remain
references. So that when a in the hospital for treatments,
patient does not understand for reasons of attending
certain information at first, he church services. Perhaps the
or she can go back to it at a physician used medical
later time. jargons to tell him the case of
Samuel his mental health, he does
Samuel has a situation. He has lost not really understand the
income because of his accident, severity.
and things will be this way for more This is to say that when
than three weeks ahead. Because jargons are used, they should
he is the only one working and he be explained futther.
needs to provide for his family, he
would choose to even reduce his
period of treatments by half so that
he could get back to work as soon
as possible.
The healthcare professional has
explained to him that he has to be
on the hospital bed for at least
three weeks. He has told him also,
he needs even more weeks at
home to enable him recover.
At this time he must have used a
medical jargon before finally saying
 it in plain language, for Samuel to
understand what is involved.
5: Financial factors Finance is one of the most
important factors which affect
access to quality healthcare
services. With a steady finance,
one can access any type of
healthcare services and insurance.
It will not matter where one resides
or how far it is from health care
providers.
With finance, no place is too far, no
drug is too expensive, and feeding
will not be a problem. It is also
important that issues of
emergencies can be handled
Merit properly when there is finance
readily available. People living in
the city will have cars to drive
around not only to a nearby health
facility, but to one of choice where
the best services can be accessed.
Naomi
Naomi will be able to avert a
high risk involved with the
spreading of cancer because
she has the financial strength
to handle the situations in its
early stage. If she had financial
challenges it would have been
a totally different story.
Apart from the breast cancer
diagnosis, Naomi also has a
hearing impairment, which she
is able to afford a hearing aid.
Perhaps without the hearing
aid, communication with her
will pose some issues both at
Barriers to health care can be
terrible for persons with
income which are low.
Finance is the number one
factor that leads to healthcare
disparities in the whole world.
Sometimes the healthcare
services required by some
medical conditions may be
too expensive for what the
patients can afford, thereby
going for a cheaper service
which may not be solutions to
the main health issue.
Lack of finances to pay for
healthcare services may also
present a patient from
seeking medical help when
necessary, which may lead to
complications before getting
necessary medical attentions
- this is a major causes of
death from sickness for poor
people.
Well done on point !
Samuel
Samuel obviously has
financial issues. While he is
at the hospital for treatments,
he gets no income. He will
still have to live this way for
the next 3weeks after he is
out from the hospital. His
family suffers from
inadequate feeding and other
things which require finances.
The healthcare professional
also told him that after
treatments he would still
spend more days resting at
home to gain recovery. Lack
of finance is an issue Samuel
 work and at the hospital. and his family are going to
experiencs terribly.
Finance has positive effect on
the access to healthcar

Cost of transportation and Cost of services tends to be Communities in remote

cost of services directly proportional to the areas will find a long
quality of medical services distance away from
obtainable in a healthcare healthcare centres as a
centre. In this regard, a high problem - it adds an extra
cost of service may translate to cost to the actual cost of
a sound healthcare service. health service.
Considering this factor,
The cost of healthcare services
patients may avoid
Merit in the city already is always on
seeking healthcare
the high, and this is because
attention, just to reduce
facilities and medications are
spending.
perceived of high quality,
clinical skills of providers are High cost of
fine, and there are usually transportation also may
enough personnels. Healthcare also result to patients
staff have good attitudes coming late for
towards patients, with strong appointments with the
adherence to system policies. healthcare provider, if the
There is adequate drug poor patients decide to
availability and diagonistic walk on foot.
equipments and materials.

all of these contribute to great

healthcare services, hence the
high cost.

Joaquin
Joaquin, again was suppose to be
admitted to staybin the hospital for
his treatments but the G.P gave
him initial one week to take his
prescriptions from home. This
gesture or consideration for
whatever reason will have reduced
his cost of healthcare service
drastically.
He does not have to stay in the
Samuel
Samuel, from the first day has
to be admitted to stay in the
hospital for his treatments
because of the nature of his
case - he sustained three
fractures, and perhaps will
not be able to walk on his
own.
The cost of hospital service
will have a strong effect on
him and his family - it will land
 hospital and accumulate bills for
that one week, and since he will be
taking his prescriptions from home
he also will not have to spend on
transport to the health centre.
This is another possibility why the
physician gave him this ine week:
to reduce healthcare cost for him.
Loss of income due to What is meant by loss of income
receiving treatments due to treatments is not difficult to
understand. What is, is how a loss
of income can ever have a positive
effect on healthcare. Personally i
think it just pre informs you there is
a situation as such. So that before
it happens, you might or would
have made some savings available
specifically for healthcare, or try to
put a healthcare insurance in place.
This may happen in any of two
Merit
different situations :
1. Outright loss of a job which
results to zero income, at a time
when a person is seeking
healthcare services.
2. Increase in cost of healthcare
services while income remains at
the same level.
Samuel
In the case of Samuel, he
understands his kind of job. He
knows that if he doesnt work, he
gets no income from any source,
but he still kept his wife at home as
a full wife, perhaps for reasons of
religion or culture. But if he had
really listened for what a possibility
his household in debt.
He is not even receiving any
income from his work, apart
from a statutory sick pay
entitlement which is even
much less than he gets from
his business.
If his original income were
enough he would probably
have an extra savings. So
that a much less statutory pay
will not do much for the family
, because the healthcare cost
will take most of it.
When it happens that there is
increase in cost of healthcare
it puts pressure on other
areas of ones life. Feedings
especially is usually
patronized with reduction.
This may later result to mal-
nutrition.
Samuel
This case states that Samuel
has no other sources of
income while he is taking
treatments. His family can not
find this easy, and it is not
even good for his health too.
The thoughts of not being
able to provide for your
family, or knowing that they
are starving is harmful to
someone who is taking
medical treatments. This can
even be depressing too,
which may lead to other
 of 'loss of income during treatment' health complications.
was saying all along he would have
done things differently. Lesson here
is that one stream of income can be
risky, so that one has to include
plans of getting medical insurance
or get other sources of generating
income to enable savings for
unplanned healthcare
requirements.

6: Quality of care provision Quality Healthcare provision is Because quality of healthcare

concerned with the delivery of
healthcare services to the public,
and to individuals. it takes into
account what is capable of
satisfaction and people's needs,
which can make them to always
want to seek medical attentions.
1. It involves that which prevents
patients from pains: physical and
emotional Pains.
2. That which is done to save time,
while still keeping treatments
effective.
3. It involves cost effectiveness.
How cost favours people of all
classes.
provision is also measured by
how these healthcare
services are perceived by
individuals, It is usually
patient-centred. In a place
where there are so many
patients, services may get
ineffective due to this reason
of being patient-centred. At
Some point, service may vary
in quality and some patients
might get the weak part of it,
and pass their judgements.
This kind of judgement may
cause some persons to avoid
such services next time
concluding the services are
poor.

4. How healthcare services focus

on individual differences.

5. Efficient - avoiding waste of

equipment, supplies, ideas and
energy.
Respect from professional Every person wants to be Reapect is such a complex
respected as an individual. A and multi-functional idea.
healthcare professional who
knows the values of respect
Merit and lets patients have their
privacy when necessary gives
the patient a sense of security.

Respect from a healthcare

professional is a recognition,
that every patient has a bunch
of unconditional values as
persons. Such respect involves
respecting the freedom and
autonomy of persons recieving
healthcare attentions. Also,
care must be taken not to
display any form of favouritism
amongst patients at the
detriment of another, they
must all be given equal
regards. Giving one more
regard over the other may
create some bitterness, which
is not a healthy feeling in such
environment .
Naomi.
Naomi is a homosexual, and
she is married to Tracey. While
she attends appointments with
Tracey it is expected
professionally that they'd be
accepted and respected by
healthcare professionals, even
if they hold a different view as
regards sexuality. The respect
they perceive from the
professionals will make these
people feel secured, and never
hesitate to access healthcare
Joaquin
Joaquin case is a mental
problem. He deserves to be
respected as a human too,
but how do you separate
what is supposed to be called
respect from what should be
the norm in some cases? For
instance, because of the
mental problem, Joaquin may
put up an argument with a
healthcare professional for
administering drug injection to
him simple because he felt a
sharp pain - he may want to
refuse it another time. So
should his wish be respected
at the detriment of his health?
Sometimes the situation gets
more serious than just a
simple argument from a
mentally ill patient.
 services.

Respect makes them feel

accepted in the clinic and that
boosts their self confidence
too. Self confidence, and the
feelings of acceptance a
patient has will even go a long
way in making the healthcare
process go smoothly. The
physician will be able to get
important information from a
patient who is well composed
and happy.

Preserving dignity Preserving the dignity of From body movements, to

patients must be the first thing
to expect from a professional
healthcare provider. The idea
of lying on a hospital facility,
sick bed with patient's clothe
stripped off and barely covered
with a gown may seem
undignified to some. In such
situation, some patients
especially those with low self-
esteem will really benefit from
Merit confidentiality and privacy
policies.
Other types of patients who
have different lifestyles, for
example gays will still want to
have their dignity as humans
respected. So the policy of
preserving dignity of patients
hand gestures or speech -
everything a health
worker does can actually
enhance perception of
preserving dignity, or
disregarding it. For
example, a professional
may give a simple
instruction to a patient
and because he needs to
ensure the patient is
following, as basic as it is
- he asks the patient the
question: 'do you
understand?' Some
patient may interpret that
to be degrading.
With a factor as sensitive
as dignity preservation,
 improves healthcare access.
Naomi.
Naomi works in the city of
London, but she lives in
Catford. To a large extent, the
distance maintained here is
probably for reasons to keep
her relationship with Tracey
private, as many persons do
not share their view on homo
sexuality.
Therefore when they go for
healthcare services together,
confidentiality is one factor
that keeps them satisfied with
quality of service rendered at
the centres.
caution must be observed
as the chances of faulting
a patient is high, which
might lead to some
patients being
discouraged from seeking
healthcare services.
Joaquin
Joaquin case study says
he is a devout Christian.
He is supposed to be
admitted for treatments
but he has been given a
week in consideration of
his religion. How long will
this consideration for
religion continue?
In this kind of situation
preserving dignity might
pose more problem than
be a solution .

Case Studies

Giselle is 23 years old and has Cerebral Palsy and a mild learning
difficulty. She uses an electric wheelchair to get around independently, but
she needs assistance to wash and dress. Giselle needs ongoing treatment
for a heart murmur and sees a Consultant at her local hospital. Giselle is
a member of a Traveller community, who have moved 4 times in the last 2
years. They have currently settled in a site on the outskirts of Croydon.
Because of her disability, Giselle is unable to work and is in receipt of
benefits. Giselle is obese and her diet is poor.
Naomi is 45 and works in the City of London as a Financial Manager.
She has recently been diagnosed with Breast Cancer and is about to
undergo a course of treatment. Naomi has a hearing impaired and wears
a hearing aid. Naomi has been married to her wife Tracey for the past 3
years. Tracey plans to attend all of Naomis appointments with her, to
offer support. Naomi and Tracey live in Catford.

Samuel is 35 and is a self-employed builder. He was admitted to

hospital yesterday after he fell from some scaffolding and suffered 3
separate fractures. Samuel is entitled to Statutory Sick Pay whilst he is
off, but this is much less than he gets from his business and his wife does
not work. Samuel is Jewish and he attends the Synagogue every Friday
evening. Samuel has been told that he will be in hospital for the next 3
weeks, but will need several more weeks at home recovering before he is
able to return to work.

Joaquin is 61 and moved to London from Mexico 3 years ago and lives in
Brockley with his daughter and son-in-law. Joaquin is experiencing
mental health problems and has started hearing voices and seeing things
crawling on his skin. He attended his G.P last week, who has prescribed
him medication, but has said that if there is no improvement, then he will
recommend a stay in hospital. Joaquin was working as a teacher until last
summer, but gave it up when he started to feel too anxious and unwell.
Joaquin is a devout Christian and it is important for him to attend church
and to read his Bible daily.