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Challenges in Primary Care

shutterstock_386979349COMMUNICATION – CULTURAL DIFFERENCES

We had many problems relating to not speaking the same language. It was difficult to get access to appropriate interpreters, especially when there was an urgent medical need. Translation is sometimes difficult. There isn’t always a literal translation from English to the child’s native tongue, needing to re-work what we said, and simplify explanations.

We also encountered Religious issues, there was a need for appropriate places for worship. We always had to have respect for their needs related to food and religious festivals.
TRUST

A lot of the children/young people were frightened, hyper-vigilant and suspicious.  Many had been failed or let down by supposed people in authority or ‘professionals’. It took time to build up a rapport and get a complete story. Their trust had to be earned. Sometimes it took more than one or two consultations to be given all of the facts.


CONFIDENTIALITY

The legal aspects of what to share, when, to whom and why. We were often asked by various agencies for information with no signed consent by YP to release it. It’s not an aspect they are familiar with, being asked for their consent – we needed to explain the pros and cons, not to make them feel pressured no matter who is asking.


IDENTIFICATION

Many of the children / young people have very similar names and the same or very similar dates of birth, such as Mohammed, Mohamed, Muhammed, Muhamed.

Documentation must be 100% accurate between staff and agencies, using  a 3rd identifier at least if possible. Name to be full, in the correct order, such as Mohammed Ali or Ali Mohammed a DOB and NHS number as a minimum.  We also got photographic ID for every child. It is important to double check everything to reduce the risk of errors.


SAFETY

We needed to be ensure the health and safety of the children, staff, us, and other residents. There were unknown communicable diseases such as Hepatitis B.
Any challenging behaviours would be dealt with effectively and preventative actions taken.
Protection must be taken including wearing gloves with body fluid spillages. Risk assessments were also completed                                                                                                                                   
EXPECTATIONS

What the child or young person expects, has been told or led to believe the experience in the UK will be. The reality can be very different leading to frustration and anger.


CONTINUITY

When moving from our unit the continuity of care is important, communication between agencies to ensure hospital follow ups, medications and investigations, linking all the correspondence form different departments and agencies to the child’s new place of residence.


ATTITUDES

Attitudes were a big consideration both from the UASC’s and from the staff working with them. The Young people needed to be taught about British Culture, respecting women, and appropriate behaviour towards women and other people.

The staff attitudes were sometimes that of Indifference, lack of understanding, and a lack of sensitivity. Which also needed to be changed just as much as the young people.

by Jacqueline Nudd

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