Navigating Conflicting Systems Without Compromising Client Care
Clients living with serious injury or complex needs often find themselves caught between systems — healthcare, legal, education, housing, financial support — each with its own rules, pace, and priorities.
Case Managers play a vital role in navigating these systems to ensure they serve, rather than sideline, the client.
The challenge? Ensuring that conflicting processes and bureaucratic delays don’t compromise the client’s wellbeing, autonomy, or access to care.
Navigating Conflicting Systems Without Compromising Client Care
The difficulty often lies in the friction between what individual clients need and what systems are designed to deliver. This mismatch can create delays, distress, or even injustice if not carefully managed. Here are some common systemic challenges and practical strategies to help case managers bridge the gap:
Funding and Resource Limitations
Challenge: Essential interventions can be delayed or denied due to capped budgets, tight eligibility criteria, or long waiting lists.
Strategy: Map out all available funding sources — statutory, charitable, and private. Proactively advocate with commissioners, submit supporting clinical evidence, and build relationships with funding bodies to unlock resources when urgency is clear.
Disjointed Communication Across Agencies
Challenge: When health, legal, and support services work in silos, decisions are delayed and information is lost.
Strategy: Act as the coordination point. Set up regular multi-agency review meetings, use shared digital records where possible, and ensure actions and responsibilities are clearly recorded and shared. Continuity and clarity are key.
Conflicting Goals Within the MDT
Challenge: Team members may advocate strongly for their own discipline’s priorities, inadvertently pulling the plan of care in different directions.
Strategy: Develop and maintain a shared care plan that centres on the client’s goals — not any single service’s agenda. Use regular case conferences to surface differences and refocus on what matters most to the client.
Read our article on ‘What to do when communication breaks down in the MDT’ for more information on this topic here
Bureaucratic Barriers and Delays
Challenge: Layers of administrative process — from referrals to approvals — can leave clients waiting months for services they urgently need.
Strategy: Maintain a paper trail. Escalate early and constructively. When appropriate, leverage the influence of solicitors, medical professionals, or senior MDT members to reinforce urgency. Be persistent and strategic in navigating red tape.
Ethical Dilemmas in Advocacy
Challenge: Tensions can arise when families, external professionals, or funders push for a course of action that conflicts with the client’s autonomy or best interests.
Strategy: Centre the client’s voice. When dilemmas arise, revisit legal and ethical frameworks (such as the Mental Capacity Act) and, if needed, seek guidance from your professional body or a clinical ethics board
Navigating multiple systems isn't just about coordination — it's about protection. The role of the case manager is to advocate, negotiate, and persist so the client isn’t lost in the noise of conflicting agendas. With the right approach, we can keep the client firmly at the centre, even when the systems around them feel anything
If you are experiencing difficulties within an MDT, please feel free to reach out to our team to learn more about our Case Manager Confidential drop-in sessions. These sessions are for Case Managers to get more tailored support when dealing with situations arising in difficult cases. Please contact sarahsawyer@healthyyoultd.co.uk for more information.