Hard to reach groups

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Hard to reach groups

• Access to health care
• Paul Williams General Practitioner
• Preparing for practice December 2005

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Hard to reach groups

• BTEOTSSWH
• Thought about what groups of people might have
  difficulty accessing health services
• Looked at the different types of barriers to
  accessing health care
• Linked access to existing knowledge on health
  inequalities
• Looked specifically at access to health care for
  people seeking asylum/refugees

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• The health service is largely designed around the
  needs of the majority

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You can be the best HIV specialist, be a top
breast cancer surgeon or run a public health
campaign to detect testicular cancer
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but if people in need are not accessing the
service you offer you arent achieving as much as
you could
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The inverse care law

• The availability of good medical care tends to
  vary inversely with the need for the population
  served

1 care
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Barriers to accessing health care
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What are the barriers to accessing health care
for these people?
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Barriers to accessing health care

• Geography
• Language and communication
• Literacy
• Discrimination
• Fear
• Confidentiality
• Culture
• Cost

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Geography

• Transport
• Cost of travel
• Time taken to travel
• Rural v urban divide
• Inverse care law

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Language and communication

• Literacy
• Access to telephones
• Disability (hearing or sight-impaired)
• Languages spokenor read

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Prejudice
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Duties of a doctor

• make the care of your patient your first concern
  
• treat every patient politely and considerately
• respect patients' dignity and privacy
• listen to patients and respect their views
• give patients information in a way they can
  understand
• respect the rights of patients to be fully
  involved in decisions about their care
• keep your professional knowledge and skills up to
  date
• recognise the limits of your professional
  competence
• be honest and trustworthy
• respect and protect confidential information
• make sure that your personal beliefs do not
  prejudice your patients' care
• act quickly to protect patients from risk if you
  have good reason to believe that you or a
  colleague may not be fit to practise
• avoid abusing your position as a doctor and
• work with colleagues in the ways that best serve
  patients' interests.

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Barriers to accessing health care

• Geography
• Language and communication
• Literacy
• Discrimination
• Fear
• Confidentiality
• Culture
• Cost

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Culture

• Time-obsession
• Religious festivals
• Suspicion about health care providers

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Cost
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Strategies for reducing barriers to access

• Example of Arrival practice for refugees

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Barriers for refugees

• Understanding the system
• 10 minute appointments
• Receptionists
• Confidentiality
• Interpreters

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Receptionists

• Communication
• Confidentiality

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Barriers for refugees

• Understanding the system
• 10 minute appointments
• Receptionists
• Confidentiality
• Interpreters

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Hard to reach groups

• BTEOTSSWH
• Thought about what groups of people might have
  difficulty accessing health services
• Looked at the different types of barriers to
  accessing health care
• Linked access to existing knowledge on health
  inequalities
• Looked specifically at access to health care for
  people seeking asylum/refugees