Gypsy and Traveller Health
Needs Assessment
Denice Burton
Assistant Director – Health Improvement
Making Bath & North East Somerset an even better place to live, work & visit
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
Making Bath & North East Somerset an even betterMaking
placeBath
to live,
work
visit
& North
East&Somerset
A better place to live, work and visit
Background
• Commissioned from Buckinghamshire new
University
• Carried out between Sept 2012 and Spring
2013
Making Bath & North East Somerset an even betterMaking
placeBath
to live,
work
visit
& North
East&Somerset
A better place to live, work and visit
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
Making Bath & North East Somerset an even betterMaking
placeBath
to live,
work
visit
& North
East&Somerset
A better place to live, work and visit
Sample
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•
•
•
•
•
•
5 English gypsies
6 Irish travellers
1 Scottish / Welsh traveller
21 new travellers
2 showmen
30 boaters
1 other
Making Bath & North East Somerset an even betterMaking
placeBath
to live,
work
visit
& North
East&Somerset
dA better place to live, work and visit
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
Making Bath & North East Somerset an even betterMaking
placeBath
to live,
work
visit
& North
East&Somerset
A better place to live, work and visit
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
Making Bath & North East Somerset an even betterMaking
placeBath
to live,
work
visit
& North
East&Somerset
A better place to live, work and visit
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
Making Bath & North East Somerset an even better
place
to&live,
& visit
Making
Bath
Northwork
East Somerset
A better place to live, work and visit
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
Making Bath & North East Somerset an even betterMaking
placeBath
to live,
work
visit
& North
East&Somerset
A better place to live, work and visit
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
Making Bath & North East Somerset an even betterMaking
placeBath
to live,
work
visit
& North
East&Somerset
A better place to live, work and visit
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
Making Bath & North East Somerset an even betterMaking
placeBath
to live,
work
visit
& North
East&Somerset
A better place to live, work and visit
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
Making Bath & North East Somerset an even betterMaking
placeBath
to live,
work
visit
& North
East&Somerset
A better place to live, work and visit
Links:
Joint Strategic Needs Assessment:
www.bathnes.gov.uk/jsna
Making Bath & North East Somerset an even betterMaking
placeBath
to live,
work
visit
& North
East&Somerset
A better place to live, work and visit