East of England Gypsy Roma Traveller Health Community of Practice (GRT Health CoP)

Why was the research needed?

In the UK, Gypsy, Roma, and Traveller (GRT) communities tend to die 10 years younger than the general population. Many have faced direct stigma and discrimination due to their ethnicity whilst others are acutely aware of the poor treatment peers have received. Consequentially, levels of trust are extremely low, delaying and preventing attempts to access necessary treatment and care. When people do reach out for help, communication and understanding with health professionals is often poor.

What did we do?

To help address these barriers, we brought together community members, health professionals and decision-makers through the East of England GRT Health Community of Practice to identify solutions to address inequalities through improving understanding of barriers to access for GRT communities and strengthen GRT involvement in healthcare decisions and research. Since forming in 2024, the Community of Practice has continued to facilitate discussions between community members, health practitioners and decision-makers locally, regionally and nationally, mobilising knowledge gained during research to affect change. The network has grown to more than 260 members and has been described by partners as "a catalyst for meaningful change".

As part of this work, we conducted participatory action research with GRT community members, healthcare practitioners and decision-makers to identify strengths, barriers and solutions to improve equitable access to healthcare for people with different histories, lifestyles and backgrounds. The Community of Practice also consulted community members on NHS reform, including the NHS 10-Year Health Plan, and is analysing interview data and co-producing evidence-based, community-driven action plans aligned with NHS reforms. The aim is to improve understanding of barriers to access, reduce health inequalities, and find new and better ways to involve Gypsy, Roma and Traveller communities and healthcare practitioners in shaping health research, policy and practice.

What did we find? 

This research laid the foundation for more inclusive healthcare practices and future initiatives to improve access and outcomes for Gypsy, Roma and Traveller communities. It has made important progress in addressing health inequalities by identifying key barriers to healthcare access, developing practical solutions, fostering collaboration across communities and organisations, and creating pathways for implementing findings.

The research identified two potential long-term solutions for future testing and led to the co-production of nine whole-system action plans to improve healthcare access for Gypsy, Roma and Traveller communities. These plans set out a series of high-impact, achievable actions that provide organisations with a framework for taking urgent steps to address inequalities in access to healthcare. Work to implement and develop these action plans is ongoing.

How did we work with communities, services and organisations?

We worked with community members, health professionals, NHS organisations and decision-makers through the East of England GRT Health Community of Practice, using consultation, shared learning and co-production to bring together diverse perspectives and experiences. This included collaboration with Gypsy, Roma and Traveller community organisations, healthcare professionals, and voluntary and community sector partners, including COMPAS, GATE Essex, One Voice 4 Travellers and Oblique Arts.

What will the impact and benefits of this research be? 

Through collaboration, shared learning and co-production, the group has helped ensure that GRT voices are heard in healthcare planning, including informing discussions around the NHS 10-Year Health Plan. The partnership also produced an Urgent Actions Framework, setting out nine whole-system workplans to improve healthcare access for GRT communities. The framework has informed local strategies and contributed evidence to national policy discussions, including submissions to the UN Committee on Economic, Social and Cultural Rights and the All-Party Parliamentary Group for Health inquiry on improving access to primary care.

The work is already influencing change across health systems. Local NHS organisations have begun introducing policies that directly recognise GRT communities, strengthening equality frameworks, improving ethnicity recording, reviewing interpretation services and identifying cultural competency training needs for staff.

How will we share and apply the findings? 

Building on this work, we plan to seek funding to build on the Community of Practice's progress and drive measurable improvements in access, equity and culturally competent care. This includes trialling a GRT Community Access Hub, where salaried GRT health champions would support access to healthcare through appointment booking, interpretation and issue resolution; exploring how to increase the number of trusted practitioners; and scaling up shared learning and collaboration through networking events and a dedicated NHS Futures space to support ongoing knowledge exchange and co-production.

This project was supported by the NIHR through the Research for Patient Benefit scheme, see award (NIHR 204503).