Gypsy and Traveller Health Needs Assessment

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Gypsy and Traveller Health Needs Assessment

• Denice Burton Assistant
  Director Health Improvement

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Aims of the study

• Improve understanding of the health needs of
  Gypsy / Traveller/ Boater and Showmen
• Provide reliable information to inform planning
  and commissioning of health services
• Provide recommendations informed by best practice

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Background

• Commissioned from Buckinghamshire new University
• Carried out between Sept 2012 and Spring 2013

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Mixed Methods Approach

• Trained community interviewers conducted 66 face
  to face surveys
• E - survey to 40 health professionals
• Follow up in depth interviews with 3 health care
  professionals and 3 boaters and new travellers
• Focus group with boater community

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Sample

• 5 English gypsies
• 6 Irish travellers
• 1 Scottish / Welsh traveller
• 21 new travellers
• 2 showmen
• 30 boaters
• 1 other

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Summary of Findings

• Marginalised from mainstream healthcare
• Significant barriers to access to services
• Boaters and new travellers had like for like
  exclusion compared with ethic Gypsy and
  Travellers
• Significant adopt the lifestyle for economic
  reasons
• Strong levels of social capital intra community
  cohesion
• Boaters in particular had significant movement
• Levels of distrust and only moderately good
  relations with surrounding population

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Findings

• Low use of optical and dental services
• Low use of screening services
• Limited use of pharmacists
• Lack of services visiting sites and towpaths
• High levels of self treatment and alternative
  medicine
• Low level of reporting / help seeking behaviour
  domestic violence and substance misuse
• Main access was via GP, internet or specialist
  Gypsy and traveller websites
• Uptake of social care bereavement/packages is low

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Findings

• High experience of injuries
• Smoking , anxiety and depression were key
  concerns
• Alcohol misuse and depression over represented in
  Boaters
• Arthritis and asthma over represented

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Findings

• Only use a Doctor / hospital as last resort
• Satisfaction levels with registered patients was
  reasonably good but issues with registration/
  prejudice
• Gender preferences for GP
• Terminal care preferred in the community
• Interest in hand held records

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Findings - professionals

• Concerns re Continuity of care, Compliance with
  treatment
• Lack of Knowledge/ understanding of culture
• Lack of confidence
• Fear ( of dogs or going onto sites)
• Poor knowledge of specialist Health Visitor

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Recommendations

• Delivery of specialist training to a range of
  health professionals
• Awareness training for wider professionals
• Access to specialist/ tailored resources and
  events
• Outreach to sites and towpaths particularly
  pharmacist

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Recommendations

• Convene an advisory group of boaters and new
  travellers
• Develop more intra area working to address
  commissioning / boundary issues
• Increase use of READ codes
• Explore use of hand held records ( app or paper
  format)
• Provision of trained community health advocates
• Lead professionals for specific communities

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Links

• Joint Strategic Needs Assessment
• www.bathnes.gov.uk/jsna