Improving uptake and delivery of health services to reduce health inequalities experienced by Gypsy, Roma, and Traveller people

LTP Priority: Improving access and outcomes for inclusion health groups

Population Intervention Triangle: Segments (link to Section 1 PHE PBA): Service

Type of Interventions: Improving uptake and delivery of health services to reduce health inequalities experienced by Gypsy, Roma, and Traveller people.

Major driver of health inequalities in your area of work

Gypsy, Roma and Traveller communities’ experiences some of the poorest health outcomes, including:

  • significantly lower life expectancy (study in Leeds found the difference was 28 years)
  • higher maternal and infant mortality (The All Ireland Traveller health study found that the infant mortality rate for Travellers in Ireland was almost four times higher than in the general population)
  • higher rates in GRT children of accidental injury and infections; high rates of accident and emergency department attendance; low/variable uptake of childhood immunisations; significantly increasing risk of vaccine preventable disease
  • poor dental health, high unmet need and low dental registration

The above come from a range of studies on the GRT communities. See the following paper for links to references:

McFadden, A., Siebelt, L., Jackson, C., Jones, H., Innes, N., MacGillivray, S., Atkin, K. (2018). Enhancing Gypsy, Roma and Traveller peoples’ trust: using maternity and early years’ health services and dental health services as exemplars of mainstream service provision. Dundee: University of Dundee.

Target groups

  • Rough sleepers and Homelessness
  • Gypsy Roma Traveller people and communities
  • Vulnerable migrants
  • Sex workers

Intervention

Improving uptake and delivery of health services to reduce health inequalities experienced by Gypsy Roma Traveller people.

Description

The following interventions have been judged to be acceptable and feasible methods to improve uptake and delivery of health services and thereby reduce health inequalities for GRT people.

  • Develop minimum standards of courtesy for all health service personnel including first points of contact e.g. receptionists, helpline staff
  • Simplify GP and dentist registration, for example by allowing c/o addresses, flexible requirements for proof of address; and develop less punitive approaches to dealing with non-attendance or arriving late for appointments;
  • Introduce literacy help cards throughout NHS (cards that can be presented to front line staff or receptionists to ask for discreet help with form-filling etc.) and provide alternatives to written information;
  • Enhance GRT people’s health literacy: e.g. awareness of health service-user rights, tips on how to communicate with healthcare professionals and confidence to ask questions
  • Provide flexible services e.g. flexible times/’drop-in’ services/multiple access routes, one-stop shop
  • Use engagement with routine maternity and child health services to deliver wider health messages, especially relating to child oral health
  • Increase collaborative working with those that already have trusted relationships with GRT communities, e.g. third sector organisations.

Evidence

The evidence for this package of interventions to improve uptake and delivery of health services for GRT people is based on a multi-method 30 month study comprising of literature reviews, online consultations, case studies and cross-sectoral facilitated workshops.

Source: McFadden, A., Siebelt, L., Jackson, C., Jones, H., Innes, N., MacGillivray, S., Atkin, K. (2018). Enhancing Gypsy, Roma and Traveller peoples’ trust: using maternity and early years’ health services and dental health services as exemplars of mainstream service provision. Dundee: University of Dundee.