Challenges Faced By Immigrants In Accessing Healthcare Services: An Essay.

Importance of understanding cultural and religious beliefs

Reshma is a 25yr old woman who immigrated to the UK from Bangladesh with her husband and children. Her children were born in Bangladesh and she recently gave birth to a male child. She had an arranged marriage in Bangladesh before coming to the United Kingdom. The family has struggled financially since they arrived in the UK. They lived in a council house but had no problems with rent because the council pays their rent. The reasons for their financial difficulty were due to recent cuts by the government in family income support benefits and the fact that her husband Ahmed is unable to secure employment. Ahmed and Reshma can speak little or no English, as they both had no formal education before coming to the UK. Because of this, they communicate less effectively with their neighbours and people in the local community.

Ahmed has now lost his confidence because he cannot speak English and always needs an interpreter whenever he goes to see the GP or when he has an appointment at the council. The interpreter service used to be free but the council has stopped paying for the service due to the economic downturn. Ahmed is usually seen in the morning, taking the children to school and going to bring them home. The children are kept indoors, as the neighbourhood they live in is not safe due to young men peddling drugs in the area. Ahmed and Reshma also come from a culture where excess body size or being overweight is seen as a symbol of wealth and prosperity.

Please answer all the following questions

Using both example from your own practice as well as the information from the above case study:

• Evaluate the complex challenges and opportunities of inter-agency working - with particular emphasis on the distinct cultural needs Ahmed and Reshma have to cope with in the UK.

To fully address question 1, consider the following:

1) How your identified challenges would impact on the delivery of effective healthcare services

2) Why do you think Reshma and Ahmed would face barriers while accessing healthcare?

3) What could potentially be the reasons for your identified barriers and how could inter-agency working impact positively on their wellbeing?

In care provision, service users and carers may have complex needs, which may require different types of help being provided by a range of agencies:

• Analyse how lack of good leadership amongst healthcare agencies would impact negatively on Ahmed and Reshma, particularly within the excerpts of the principles of care ethics as well as the multi-disciplinary working initiative in healthcare.
• In reference to the case study above, outline some of the policy issues faced by Ahmed and Reshma, explain what you could have done differently.

Context:

Amongst several other government initiatives, the government issued many policy documents – requiring collaboration to improve efficiency and effectiveness in healthcare services. As the direct result, a white paper “Modernising Social Services” in 1998 clearly stated that, “people do not fit into neat service categories, and that if partner agencies are not working together it is the user who suffers” (DH, 1998 cited in Community Care, 2019).

With the above understanding and in reference to the case study or own experience, evaluate the characteristics of multi-disciplinary teamwork in healthcare.

• Explain how effective multi-disciplinary teams work together in order to increase the chances of meeting Ahmed and Reshma’s family’s identified support needs.

Interagency working refers to the collaboration between two or more agencies. The reason behind working together is that they do have a common concern or issues to deal with.  These issues may involve the problem that is in this case study, social exclusion (Busuioc, 2015). Social exclusion refers to the process whereby individuals are denied access to various opportunities, rights, and resources. The reason for this social exclusion is because of variation in social class, education, religion, race, and ethnic origin (Amin, 2019). Reshma and Ahmed come from different backgrounds as compared to society in the United Kingdom. Therefore, they are prevented by various factors from participating fully in political, social, and economic activities of the community they live in (Kwibisa and Majzoub, 2018). This assignment will focus on the challenges the inter-agency faces with the cultural setting of the people they help. The paper will also expound on the effect of leadership in the healthcare system on the people under social exclusion. Apart from looking at the style of leadership, there will be an emphasis on the best leadership to use in the case of Ahmed and Reshma. Finally, the paper will look at the structure and attributes of multi-agency.

Resources.

Resources may vary from the workforce, economic strength, and equipment. In Ahmed and Reshma's case, the most needed resources are finances. As has been the case with the many inter-agency working, the fund remains an issue in helping people who face problems in societies (Kwibisa and Majzoub, 2018). Immigrants like Ahmed face constant financial constraints that even the help of multi-agency can help. Re their language is a significant barrier to getting service (Aouam and Vanhoucke, 2019). The translator charges fee and the monetary stipends they use to get can no longer be supplied. Collaborative care is mostly a solution for individuals with complex needs like Ahmed and Reshma. This collaboration helps to reduce the service gap while at the same time, improve individual's access to health care. Ahmed and Reshma thus require a system-wide approach which may involve collaboration between the state health services and non-governmental organization. From the case study, they have struggled financially since coming to the UK. There's a cut on their family income support. The council no longer pays for their interpretation services, and they cannot secure employment. As with most interagency, the availability of funds to offer such services may be a hindrance (Rosen, 2017).  While primary and secondary care is a government service, but the case of Ahmed and Reshma is different, and thus, finance may be a problem.  

Financial and communication barriers

Personal value and culture

Personal values refer to what people think is of significance in their lives. What one likes or dislikes. It is not easy in this case study to foretell what Reshma and Ahmed like or hate. But we can be able to look into the culture of Ahmed and Reshma. They come from Bangladesh, which has a diverse culture incorporated by different social groups (Ebert and Okamoto, 2015). Religion is mostly Islam, Buddhism, and Hinduism. It is valid from the case study that Reshma and Ahmed are Muslims. Therefore, there may be instances of modesty and confidentiality among Muslims on matters involving care. Their beliefs may also interfere with inter-agency working. For example, the issues to do with fasting. A patient who is ill with chronic diseases may be significantly affected by the activity (Kurzman and Lawrence, 2015). There may be cases of dehydration, weight loss, and lack of concentration. Therefore, a person who provides care to them should be well conversant with muslin religion and culture to avoid incompetence.

Muslims view health as a blessing from Allah. Therefore, people like Ahmed and Reshma believes that illness is part of life, and sometimes a test from God. There may be instances where they think that disease may be as a result of punishment from God for failing to follow certain Islam tenants (Helseth, 2018). In the contemporary UK, nurses may discharge care to any patient regardless of his or her gender. But the case is different for Ahmed and Reshma. Muslim privacy and modesty should be respected. Therefore, inter-agency needs to understand this concept, which may be against the way they do their operations (Helseth, 2018). Reshma and Ahmed in a time they are accessing health care, a practitioner of the same gender should provide the services. Touching, shaking hands may be prohibited. The patients or health care receivers may also avoid maintaining eye contact with a nurse of the opposite gender (Miller, 2016). Therefore, in assisting them, the agency needs to understand certain services that may be necessary for others may not go hand in hand with what they believe. They may adhere or non-adhere to those services.

As outlined in the case study, Reshma and Ahmed face communication barriers. Even with the availability of translation services, they cannot afford it because they don't have any source of livelihood. Increased immigration generally results in a language barrier (Fatahi and Krupic, 2016). Thus, healthcare and health care services providers need to tackle and adapt to this issue. The language barrier is considered the second most challenging issue when dealing with immigrants after psychosocial problems. Although these agencies have an interpreter, to understand their preferences, their values and religion may be difficult (Cheong and Park, 2018). Again, it is not guaranteed that the interpreter may consider Ahmed and Reshma's reasoning with various inter agencies' policies (Fatahi and Krupic, 2016). Besides, the system fails in organizing special classes for people like Ahmed and Reshma.

Inter-agency collaboration as a solution

Another reason why Reshma and Ahmed may face a barrier when accessing healthcare is the lack of funds.  The family has struggled financially, according to the case study (Daly and Ferragina, 2017).  Most immigrants are left in health care schemes. The conditions even make it hard for them to pay for healthcare (Aouam and Vanhoucke, 2019). Ahmed can secure employment due to his academic background. He is academically deprived and doesn't have formal education. They lack even money to pay for their interpretation services. Thus, in accessing healthcare, it will be hard for them to pay for medication, services, and consultations (Frattini, 2017). The national hospital service of the UK says that individuals who are not residents of the UK are required to pay for medical services on their own. However, they give allowance in case of emergency or accidents, infection from infectious diseases, physical abuse, and palliative care (Cheong and Park, 2018). However, the case of Ahmed and Reshma is different since we can't understand if they are asylum seekers, refugees, or even victims of modern slavery.

The benefits of cooperation may enhance shouldering the pressure of funds among various agencies.  It also enhances a sense of community ownership when assisting families like Ahmed and Reshma (Kwibisa and Majzoub, 2018). If an individual agency operates on its own, there may instance of service duplication. Therefore, inter-agency working ensure services run smoothly without errors. Clients like Ahmed and Reshma will be able to receive improved services as a result of collaboration. This collaboration provides the services in maximum by cutting down the cost needed to operate. There are also improved inter-personal relationships within an agency, which makes it easier to deliver agency services effectively without indifferences (Frattini, 2017). By doing so, the inter-agency will be able to assist Reshma and Ahmed to tackle the problem of social exclusion especially in accessing healthcare in the United Kingdom.

Like already discussed above, Reshma and Ahmed may face financial barriers. The reason for this barrier may be a lack of unemployment, which is characterized by a lack of formal education for them.  Another reason for this barrier would be their communication (Ebert and Okamoto, 2015). From the case study, they are not well conversant with the English language and often depend on interpreters. I believe. Another challenge that was highlighted above was the communication barrier. The reason behind this is the society they live in speak English, and they don't understand it (Busuioc, 2015). This is evident in the way they don't socialize with anyone in the neighborhood. Although the problem in communication is easy to tackle, it needs unique collaboration from the state and interagency to the education department.   Another barrier was a different society with different customs and values. As shown in the case study, Ahmed and Reshma culture believes excess body sizes or obesity is a sign of economic potential and prosperity. In the year 2016, health secretary Jeremy Hunt described obesity in the United Kingdom as a national emergency.  Besides, the World Health Organization has stated that 28.1% of the UK population is affected by clinical obesity. The statistic also shows by the year 2020, a third of the UK population will be obese (Wilding, 2018). Therefore, it is easier to for Ahmed and Reshma to conclude they are surrounded by wealthy and economically potential people, whereas this is not the case.

Multi-disciplinary teamwork in healthcare

With the barriers, the interagency can facilitate a translator to help in tackling the problem of the communication barrier. Additionally, through numerous education programs for non-English speakers in the UK, they can be enrolled in the program, which may further help them with unemployment. However, the cultural problem is complex (Lucas, 2017). Interagency cannot change the beliefs and values of the society in which Reshma and Ahmed live.  

Leadership refers to the ability to guide others. The ability to mobilize resources at disposal to ensure adequate services are reached. This section looks at how effective leadership can help in supporting Reshma and Ahmed. Leadership in nursing must involve the principles of care to make sure the ethical process is followed.

Principles of ethics

Most codes of ethics are put in place to provide guidelines on the performance of healthcare. Personnel cannot look up to policies, systems laws, and procedures because a problem may arise, and making a decision must be made before the conclusion of the system policies (Dietrich Bonhoeffer et al., 2015).

Principle for Autonomy

The principle of autonomy generally encourages health care practitioners and service providers to respect the independence of a person (Dietrich Bonhoeffer et al., 2015). Service providers must listen to the decisions of others, which concerns their lives and respect them. For example, in this case, study effective leadership would allow the multi-agency to respect Ahmed and Reshma's religion and cultural background. The service provider must give a human his or her dignity and not interfere with their decisions. Looking at the case study, the cultural context of the subjects is very different (Dorsey, 2015). In giving services, they may not interact thoroughly with individuals of the same gender, maintain contacts through handshakes, and even eye contact. Therefore, the agency will be able to look at this principle and respect their choices, preferences, and decisions.

Principle of Beneficence

This principle requires people to bring goodness in their actions. Their motives should not harm another person. In supporting Ahmed and Reshma, the inter-agency should not be motivated toward financial gain but rather to improve their general welfare (Comelles, 2016). It encourages people in health to always prevent evil or harm. Leadership from inter-agency should promote a culture of safety while providing services. In the case study. Ahmed and Reshma live in an insecure neighborhood (Ingmar Persson, 2017). This neighborhood is crime-infested, and they are disadvantaged since they are minors. Leadership in providing care should be accountable for the effective health care of patients.

Impact of identified challenges on healthcare services

The principle of justice.

 Initially, the paper explained the concept of social exclusion. That the marginalized people like Ahmed and Reshma are denied services or privileges because of their background, religion, and education.  However, the principle of justice discourages these actions by providing equality and equity in service provision (Phillips, Padfield and Gelsthorpe, 2018). Although nations have legitimate rights to control immigration through their borders, the power should be guided by the principle of justice. Therefore, effective leadership will incorporate the guidelines of this principle by ensuring in supporting Reshma and Ahmed, fairness, equality, and entitlement is considered. They should not be subjected to translation fees if they are not employed. It is the mandate of such agencies to make sure they can access essential health services (Phillips, Padfield and Gelsthorpe, 2018). The principle of justice fight for equal access to healthcare services for people.  Effective Leadership, therefore, would prevent instances of prejudices and discrimination of the couples based on their culture, social status, and ethnicity. However, this is not the case since most health care service providers are always cautious when giving services to care receivers.

Principle of non-maleficence

Nonmaleficence is an ethical principle that cautions people against inflicting intentional harm for financial benefits. Interagency in the case of Ahmed and Reshma should consider their policy and the way that they work o avoid inflicting damage to them.  Although the primary goal of many inter-agency’s collaboration is to enhance their services maximumly, some activities may have adverse outcomes for some people (Motloba, 2019). For example, by considering Ahmed's cultural background, there are activities he cannot engage in. The reasons may be due to religion or his cultural setting. Therefore, in supporting Reshma and Ahmed, these four principles should guide the inter-agencies to ensure their dignity is upheld.

In this section, one may ask what type of effective leadership may be used by multi-agency to perform their functions.

There are many leadership styles to imitate, but this section will consider the styles of leadership

Transformational leadership

This type of communication engages other people in ineffective communication (Hughes, 2016). Leaders, therefore, join others in identifying the goal and vision of the Inter-agency (Abbasi, 2017). Before giving support, the leaders may ask Ahmed and Reshma about their views and decision

Autocratic leadership

This is an extreme transformational leadership in which a leader has total control and say in decision making and other people (Harms et al., 2018). Generally, this type of leadership doesn’t enquire about other believes and decisions.

Barriers faced by Reshma and Ahmed in accessing healthcare

Laissez-faire leadership

This style of leadership allows others to make a decision. It is a delegative kind of leadership. The style cannot apply because productivity and service delivery will be lower (Iszatt-White and Saunders, 2017). Besides, people like Ahmed and Reshma may take advantage of the freedom the leadership provides to create their demands

Democratic leadership

Democratic leadership involves others in decision making before coming up with a final stand. Reshma and Ahmed may benefit from this method since their values, decisions, and morals may be taken into consideration when giving them support (Marc Pare?s Franzi, Ospina and Subirats, 2017).

Bureaucratic leadership

Bureaucratic leadership focuses on control and management. Therefore, bureaucratic leadership is not only concerned with the results but the work process. It adheres to the rules and regulations. Therefore, inter-agency can work within their established rules and regulations.

This leadership style follows three different approaches. The trait approach, functional approach, and behavior approach. The trait approach states that leaders are born and not made. That an effective leader has certain inherent characters through birth (Owen, 2015). The second approach, the functional approaches, states that leaders are made and developed. Therefore, this approach can be used by the multi-agency to focus on responsibilities, accountability, and their role of supporting people like Reshma and Ahmed (P?ciak, 2016). In the last method, the behavior approach looks into the behaviors of leaders and their performances. It thus focuses on the people and also service delivery

Depending on the leadership styles used, the impact may be harmful or positive. The effect may be seen in the morale of multi-agency, productivity in agencies services, decision-making processes, and metrics. In decision making, for example, an agency should incorporate democratic leadership styles, which give people the chance to table their views and ideas. (Owen, 2015) On the productivity of services, multi agencies may use a participative method of leadership that engages other peoples and thus enabling the agencies to attain their support goals.

The case study provides some policies that have affected Ahmed and Reshma, the family income policy

This is life insurance, which offers a family with regular tax-free income. As seen from the case study, their income has been reduced by the government.  Without this money, they cannot afford to live in the United Kingdom. Their language also escalates the problem. They cannot speak English, and this makes them not to secure formal employment. The family income policy is usually active for a given amount. It thus provides a constant flow of money for a time, but with the reduction of the amount, they cannot be able to afford the economic pressure in the United Kingdom. This decrease, however, is usually evident with most family income policies. It is only beneficial in an even of death. In the case study, both Ahmed and Reshma are alive. Therefore, the policy disadvantage to them is its decreasing value.

Inter-agency working and its positive impact on wellbeing

Initially, these services were provided at a free cost. But due to change in economic times, Ahmed is supposed to pay for the services. His welfare doesn't even allow him to pay for the service. Considering they are marginalized, the minority in their neighborhood, and the language barrier that affect their day to day life. According to national health services, the policy is put in place to assist people in the United Kingdom who cannot speak English. The change in the policy have therefore affected their lives and welfare while they are in the United Kingdom

According to my preference for inter-agency style of leadership, I would choose the democratic and bureaucratic leadership. Democratic leadership is consultative, collaborative, and affiliative. Therefore, by adopting this method of leadership, participation, and decision making will be encourage (Saini, 2015). The style would help Ahmed and Reshma to air their ideas to get a consensus and a better solution. Furthermore, this style of leadership works perfectly, where community engagement is needed. The problem facing Ahmed and Reshma are social and economic. Second, the bureaucratic style will be helpful too. The method of administration focuses on the need of the companies and their goals. The law and regulations are not flexible, and thus, members of the multi-agency will be able to govern themselves well (Saini, 2015) l.  The approach to use for the two leadership styles will be the behavior approach. People will be able to understand the behavior and performances of their leaders, especially in decision making and matters that affect societies. Additionally, the approach highlight that leaders can be made if they can be made; they can support Ahmed and Reshma. I would recommend this style.

This is the last part of the assignment. In this section, the paper will focus on the characteristic of multidisciplinary collaboration in giving healthcare

Multidisciplinary comprises various healthcare workers who work in different areas. The aim is to apply knowledge, skills, and competence from multiple disciplines to shape and reframe social welfare delivery matters. (Butler and Grobbelaar, 2017) They're committed to providing specific services to the person in need.

The following are the characteristic of a multidisciplinary team according to National Hospital service The team

The team comprises of many aspects. Attendance, membership, leadership, personal development, and teamwork and culture

Attendance of meeting by the members whereby they have to dedicate their time to attend MDTs meetings. These meetings are dedicated and serious and keeping a register of those in attendance and those who didn't attend

Characteristics of multi-disciplinary teamwork in healthcare

Membership comprises all the professionals in a different discipline. Mostly at the top are the MDT coordinators. Members of the team are equipped with needed proficiency and specialization.

Leadership. In leadership, there is an outlined hierarchy of authority with the chair and the deputy at the top.  Each, level there is assigned function and role that members focus on to avoid confusion.

The last section on the team is team work and culture. This section means each member of the MDT knows what he or she is supposed to do (Prides et al., 2015). On the same, there are etiquettes and values to adhere to.

Personal development requires members to continue building themselves with constant learning and acquisition of knowledge.  Therefore, it encourages training and networking.

Infrastructure for assemblies

All members meet in a comfortable suitable room during their discussion. The rooms are equipped with the necessary equipment to enhance information sharing with other multi agencies. The equipment is continuously updated to avoid affecting the meeting process.

Meeting organization and logistics

Meeting for MDTs is scheduled annually, and they happen in moments that don't interfere with healthcare duties. These moments are referred to as core hours. For an effective meeting, the preparation is done early. An effective MDT considers seriousness and commitment; therefore, the use of a mobile phone is disallowed (Prides et al., 2015). Mobile phones remain off during the meeting processes.

Decision making

Decision making of MDT is patient-centered. There considers a personal situation and considers clinical inquiries that need to be resolved. In their decision making, they understand the concept of autonomy and therefore respect person independence. They acknowledge the views of the wishes of the patients. In making a decision, the MDT follows a detailed process of decision making. They consider the treatment options that are available and also look at the patient or client demographic details to avoid barriers in health care (Prides et al., 2015). The demographic information includes age, ethnicity, and the sex of the client who needs the health services.  After making a decision, the MDT comes up with a recommendation that they pass to the health care seeker. These recommendations are in advantage of the patient to avoid interfering with the patient's right to autonomy.

MDT encourages Team governance.

In governance, the MDT highlights its purpose in clinical management. They lay down policies and guidelines on how to operate and communication process with the patient.  They have laid various mechanisms and strategies in place, especially in patients' matters (Prides et al., 2015).  They also access their annual performances to make changes and compare their effectiveness with other government organizations.  The main goal is to enhance transparency, credibility, and competence. By doing so, MDT engages the public in their functions and day to day activities. By doing so, they enhance independence and focus on providing care to the people who need it.

Funding issues in inter-agency collaboration

Application of MDTs in Reshma and Ahmed.

Ahmed and Reshma are faced with many social needs and security needs. For example, the neighborhood policing. Looking at their surroundings, they are surrounded by an insecure society where cases of drugs peddling.  MDTs, therefore, may help in community sensitization that includes minorities in matters that affect them (Prades et al., 2015). Neighborhood policing requires a tailored-evidence activity in reducing the effects of harm or community disturbances (Harrison, 2015). Minorities like Ahmed, who lives in the council house, they can get the help of the police through the agency to air their views about the state of the neighborhood (Harrison, 2015). On schooling for their children, according to the UK policies, children s of immigrants are allowed to access education services. However, this doesn't guarantee their stay in the United Kingdom. In this case, Reshma and Ahmed have secured an education institution. The evidence from the case study state that Ahmed is only seen taking his children to school and when going to bring them home.  The vital issue is primary care. As understood, their language remains a barrier to many accessible services in the UK. Additionally, their educational background is a limitation. Therefore, accessing primary health care may be a problem. MDTs, therefore, can incorporate carious specialists and stakeholders to ensure that Ahmed and Reshma culture are respected and their independence is adhered.

To conclude, the paper has extensively looked at the challenges facing inter agency and the opportunities they have in supporting people like Ahmed and Reshma. Furthermore, this assignment has also looked at the principles of ethics, which is the cornerstone of health care providers. These principles caution and maintain boundaries between patients and health practitioners. The most conflicting policy is the principle of beneficence and autonomy. As seen in the case studies, Ahmed and Reshma are faced with various challenges as they strive to get care in the United Kingdom. From the language barriers to their cultural background.  The inter-agency, therefore, have to employ various mechanisms and strategies to help them live a healthy life. The last parts look at the different leadership styles and approaches and how they can be used to assist in multi-agency collaboration and service delivery for socially excluded people. Lastly, the paper has examined some characteristics of multidisciplinary teams in their work and the way they can help Ahmed and Reshma to cater for their needs.

Language barriers and the need for adaptation

References

Abbasi, B. (2017). Transformational leadership and change readiness and a moderating role of perceived bureaucratic structure: an empirical investigation. Problems and Perspectives in Management, 15(1), pp.35–44.

Amin, S. (2019). Diversity enforces social exclusion: Does exclusion never cease? Journal of Social Inclusion, 10(1), p.4.

Aouam, T. and Vanhoucke, M. (2019). An agency perspective for multi-mode project scheduling with time/cost trade-offs. Computers & Operations Research, 105(1), pp.167–186.

BUSUIOC, E.M. (2015). FRIEND OR FOE? INTER-AGENCY COOPERATION, ORGANIZATIONAL REPUTATION, AND TURF. Public Administration, 94(1), pp.40–56.

Butler, D.P. and Grobbelaar, A. (2017). Facial palsy: what can the multidisciplinary team do? Journal of Multidisciplinary Healthcare, Volume 10(2), pp.377–381.

Cheong, H.-J. and Park, J.-S. (2018). Interpreting and translation policy research as legitimate and necessary realm of research in Translation Studies. Interpretation and Translation, 20(3), pp.105–140.

Comelles, J.M. (2016). Shelp: “Beneficence and Health Care.” Arxiu d’Etnografia de Catalunya, 1(2), p.189.

Daly, M. and Ferragina, E. (2017). Family policy in high-income countries: Five decades of development. Journal of European Social Policy, 28(3), pp.255–270.

Dietrich Bonhoeffer, Krauss, R., West, C.C. and Green, C.J. (2015). Ethics. Minneapolis: Fortress Press.

Dorsey, D. (2015). Welfare, Autonomy, and the Autonomy Fallacy. Pacific Philosophical Quarterly, 96(2), pp.141–164.

Ebert, K. and Okamoto, D. (2015). Legitimating Contexts, Immigrant Power, and Exclusionary Actions. Social Problems, 62(1), pp.40–67.

Fatahi, N. and Krupic, F. (2016). Factors Beyond the Language Barrier in Providing Health Care to Immigrant Patients. Medical Archives, 70(1), p.61.

Frattini, T. (2017). Evaluating the Labour Market Integration of New Immigrants in the UK. Social Policy and Society, 16(4), pp.645–658.

Hanssen, I. (2005). From human ability to ethical principle: An intercultural perspective on autonomy. Medicine, Health Care and Philosophy, 7(3), pp.269–279.

Harms, P.D., Wood, D., Landay, K., Lester, P.B. and Vogelgesang Lester, G. (2018). Autocratic leaders and authoritarian followers revisited: A review and agenda for the future. The Leadership Quarterly, 29(1), pp.105–122.

Harrison, A. (2015). Learning from the multidisciplinary team. The Clinical Teacher, 13(4), pp.303–304.

Helseth, H. (2018). When the Personal Is Always Political: Norwegian Muslims’ Arguments for Women’s Rights. Social Inclusion, 6(4), p.59.

Hughes, M. (2016). Leading changes: Why transformation explanations fail. Leadership, 12(4), pp.449–469.

Ingmar Persson (2017). Inclusive ethics?: Extending beneficence and egalitarian justice. Oxford Oxford University Press.

Iszatt-White, M. and Saunders, C. (2017). Leadership. Oxford: Oxford University Press.

Kurzman, C. and Lawrence, B.B. (2015). Muslim Modernities: Interdisciplinary Insights Across Time and Space1. The Muslim World, 105(4), pp.439–445.

Kwibisa, N. and Majzoub, S. (2018). Challenges Faced in Inter-Organizational Collaboration Process. A Case Study of Region Skåne. Journal of Sustainable Development, 11(5), p.34.

Lucas, S. (2017). A children’s space? Participation in multi-agency early intervention. Child & Family Social Work, 22(4), pp.1383–1390.

Marc Pare?s Franzi, Ospina, S. and Subirats, J. (2017). Social innovation and democratic leadership?: communities and social change from below. Cheltenham, Uk?; Northampton, Ma: Edward Elgar Publishing.

Miller, R.E. (2016). Mappila muslim culture. Place Of Publication Not Identified: State Univ Of New York Pr.

Motloba, P. (2019). Non-maleficence - a disremembered moral obligation. South African Dental Journal, 74(1).

Owen, J.E. (2015). Integrative and Interdisciplinary Approaches to Leadership Development. New Directions for Student Leadership, 2015(145), pp.49–58.

P?ciak, R. (2016). The reflections on maxims laissez-faire, laissez-passer genesis. Wspó?czesne Problemy Ekonomiczne, 13(2), pp.123–131.

Phillips, J., Padfield, N. and Gelsthorpe, L. (2018). Suicide and community justice. Health & Justice, 6(1).

Prades, J., Remue, E., van Hoof, E. and Borras, J.M. (2015). Is it worth reorganising cancer services on the basis of multidisciplinary teams (MDTs)? A systematic review of the objectives and organisation of MDTs and their impact on patient outcomes. Health Policy, 119(4), pp.464–474.

Rosen, S. (2017). Inter-Agency Accounts Receivable | Finance Department. [Online] Uconn.edu. Available at: https://health.uconn.edu/finance/bursar/inter-agency-accounts-receivable/ [Accessed 13 Oct. 2019].

Saini, D. (2015). Integral Leadership Style: A New Perspective. International Journal on Leadership, 3(2).

Wilding, J.P.H. (2018). Beyond lifestyle interventions: exploring the potential of anti-obesity medications in the UK. Clinical Obesity, 8(3), pp.211–225.