Working with other services

In an earlier lesson (see Client Work module) we covered how to make a ‘map’ of the services available to your clients. This topic covers some of the basic knowledge you might need when working with other services.

Referral letters and intake forms

Most services have an intake process involving forms that need to be completed, and some services require a referral letter as well. Clinical services often require a letter from the client’s GP, but there is no reason you can’t write a referral letter as well in your role as the client’s HIV peer navigator. This is an opportunity to introduce yourself as part of the client’s care team and provide background on what kind of support has been provided to date.

A good referral letter does the following:

• Provides context – I’m writing as an HIV peer navigator at (service name) where (client name) is my client…
  
• Introduces the client briefly
  
• States the reason for making the referral
  
• Provides relevant background information
  
• The client has given permission for me to discuss their care with you.

You might also spend some time helping the client understand and complete the intake paperwork. Depending on the client’s comfort with reading and writing, you might fill it out yourself with input from the client.

Sometimes it may be necessary to read the intake criteria for a service and assist the client to advocate for access to that service. This may involve working out which aspects of their experience they need to emphasise when they communicate with the service. It can be important for the experiences the client presents during the intake process to match the details in referral letters from yourself and/or the client’s GP or clinician.

Attending appointments and case conferences

Your clients can bring a support person to their appointments with clinicians and other services. This can be an HIV peer navigator! In playing this role, you need to find a careful balance between assisting your client to tell their story, and taking over the narrative from the client. It is appropriate in this situation to advocate for the client, e.g. if you think the other care provider has not heard what is being said: ‘What I heard (client) saying is… (restate their experience.)’

Memorandum of understanding

A memorandum of understanding or “MOU” is a document agreed between two or more organisations. It is like a contract but it is non-binding, i.e. there are no legal consequences if the agreement is broken.

MOUs are often used to express a commitment to working together. Ideally, an MOU may also specify a referral pathway from your organisation to the partner agency or service. For instance, this might say that an HIV peer navigator can make a referral directly to the service and that referrals will be accepted within a given time period.

An MOU may also provide a complaints process (or a commitment to working together to resolve complaints). This can be an opportunity to advocate for a client who has struggled to gain access to a given service. However, complaints are usually initiated by the leadership of your own organisation, rather than directly by HIV peer navigators. So you may need to advocate within your workplace for a complaint to be made, providing details on the relevant circumstances.

Professional communication

In an earlier topic we discussed the tone issues that come into play during professional communication. When working with other services it is vital to adopt a tone of ‘friendly formality.’ At any point it may be necessary to forward earlier correspondence, e.g. an ’email trail’ that contains prior discussions and background information. Always remember that what you write may have a broader audience than you initially intended.

As well, you might have conversations by phone with busy professionals. It is wise to send an e-mail after such conversations with brief dot-points on what was discussed and agreed upon. ‘Just confirming details of our phone conversation’ is an appropriate framing for this e-mail. Doing this can help if there’s a dispute later down the track about what was discussed and agreed upon.

Exercise

Scenario: You take part in a telehealth phone call with your client Rita and her general practitioner (GP). The purpose of the call was to discuss Rita’s request for a letter explaining her need for reasonable adjustments to a new employer. The GP asks if you can send through some dot points on what the letter should cover. Rita is living with HIV and a mental health condition that occasionally cause what she calls ‘brain fog’, and Rita would like to request flexibility around working hours and deadlines for written work. The websites Healthline and WebMD both mention difficulty concentrating as a potential symptom of this condition. However, Rita has also completed a cognitive evaluation that indicates she is capable of working at the level required by the position.

• Using friendly but formal language, write a short (1-2 paragraph) e-mail confirming the key details from this scenario.