In the UK, Traveller Communities are not able to get the health treatment they need. This makes it difficult for TCs to get the care they need and has a negative impact on their health. Solutions to these barriers need to be identified and understood better to ensure that they can get the best healthcare.
Background
In the UK, Gypsy, Roma and Traveller communities[1] are not able to get the health treatment they need. They tend to die 10 years earlier than everyone else. This is often because Gypsies, Roma and Travellers do not or cannot contact health professionals, sometimes because they have faced stigma and discrimination and they do not trust health professionals. This makes it difficult for people to get the care they need and can have negative impacts on their health.
Project Aims and Activity
Our participatory action research identified solutions to these barriers that will enable more equitable access to healthcare for people with different histories, lifestyles and backgrounds.
The research was undertaken with a focus on the inclusive involvement of community members and those who support Gypsies, Roma and Travellers access to health care, both within the NHS and through community organisations supporting families. Health practitioners and community members were involved in all stages of the design of the project and in completing the data collection and analysis.
Community members were given training and undertook peer-to-peer interviews with other community members to understand their experiences of trying to access healthcare in the East of England. Focus groups were held with health professionals to discuss barriers and possible solutions. The focus groups were facilitated by a local GP.
In the final stage of the research, a community of practice was formed from stakeholders who had become involved in the study at various stages of the research. The group included Gypsy, Roma, Traveller charity workers, GPs, nurses, health visitor, Traveller Liaison Officers, System Clinical Lead for Health Inequalities, Equality Diversity Inclusion Lead, Strategy Development Manager, Public Health Inclusion Leads, Pharmacist, and Traveller Health Team members.
This research has made progress in addressing health inequities for Gypsy Roma Traveller communities by identifying key barriers, developing practical solutions, and fostering collaboration among stakeholders. The work has laid a foundation for more inclusive healthcare practices and future initiatives to further improve access and outcomes for communities.
Key Findings
Potential was found for:
- Developing a network of practitioners that community members trust
- Strengthening support to access to healthcare by community members for community members, to promote communications and understanding between patient and practitioner. This could take the form of a Gypsy, Roma and Traveller Community Access Hub where salaried health champions from these backgrounds facilitate access to healthcare through registration, interpretation and directing patients to trusted practitioners, supporting with any issues as required along the way.
The community of practice also co-produced 9 high impact community action plans to improve access to health care for Gypsies, Roma and Travellers in the East of England in the short term. These community action plans detail a set of specific practical actions that involve Gypsies, Roma, Travellers and health care professionals developing communications, relationships, understanding, networks, and new ways of working which will make it easier for people to get the help and care that they need.
The areas covered by these community action plans are:
- Develop a network of community members and health professionals of varying roles from across East of England to improve access to health care
- Raise awareness of Gypsies, Roma and Traveller needs and ensure inclusion in relevant policies and action plans
- Enable inclusion of Gypsies, Roma and Traveller ethnicities in databases
- Enable communication between Roma patients with low English levels and health providers
- Raise health professionals’ cultural competency around Gypsies, Roma and Travellers
- Raise awareness of patients’ right to register with a GP surgery
- Improve communication between health providers and patients with low literacy
- Improve health literacy
- Make appointments more accessible and effective
Each action plan has an identified working group (with community or healthcare lead person) and representation across the groups involved in the research. Work on these action plans is continuing on an ongoing basis. Please contact sally.burrows@essex.ac.uk to get involved.
Next Steps
The researchers plan to expand on this work with two new initiatives:
1. Inclusive Trusted Practitioner Model
Building on existing schemes, this model will incorporate lessons from the current project to strengthen healthcare access and relationships with communities. We have secured additional funding from Cambridgeshire and Peterborough Integrated Care Board to undertake a scoping review of this topic. Work on Trusted Practitioner Models is commencing this year.
2. Community Action Hub Pilot
This proposed project will test the idea of a centralised hub where salaried community members collaborate with health professionals to support individual patients. The hub will coordinate activities, share knowledge, and improve healthcare access.
[1] For the avoidance of doubt, Gypsies, Roma and Travellers are not a homogenous group: there are many differences in cultural practice and lifestyles which are not discussed here.
Papers and resources
To help raise awareness of some key issues and solutions to access, and to stimulate thought and discussion, you can download this poster for free. With appropriate acknowledgements, it is suitable for wall display, online meeting background, and use in presentations:
This report identifies a series of concerns about the level of enjoyment of the right to the highest attainable standard of health among Gypsy, Roma and Travelling communities in the East of England. Evidence gathered as part of this project - in the form of testimonies gathered in 37 peer-to-peer interviews conducted by Compas, GATE Essex, Oblique Arts, and One Voice 4 Travellers between June and August 2023 - has been submitted to the United Nations. The qualitative evidence compiled in this document are the unreserved confirmation that concerns persist in relation to stigma, prejudice, discrimination, lack of informational accessibility and lack of cultural acceptability of healthcare for Gypsy, Roma and Traveller communities. This is reflected in the lack of cultural awareness in availability of suitable health professionals, lack of non-English language provision, problems of trust due to lack of cultural competence, lack of understanding of issues around literacy, and ongoing social exclusion, particularly digital exclusion.
This project can be viewed in a case study format for easy accessibility
Who is involved?
- Professor Ewen Speed, University of Essex
- Sally Burrows, University of Essex
- Professor Gill Green, University of Essex
- Dr Koldo Casla, University of Essex
- Petr Torak, Community Partnership Group (COMPAS)
- Sherrie Smith, GATE ESSEX
- Tanya Blumenfeld, GP
- Shayne Larwood, Cambridge Local Authority
- Beverly Carpenter, Oblique Arts
- Shirley Barratt One Voice 4 Travellers
Contact us
Professor Ewen Speed, esspeed@essex.ac.uk
