GRT communities struggle to register with GP practices due to negative perceptions

Gypsy, Roma and Traveller (GRT) communities experience difficulties in registering with a GP practice due to a perception that they will be ‘expensive patients’, NHS England has warned.

As part of a framework to help improve health services for people ‘who are socially excluded’, the commissioner said that people in these communities tend to have negative experiences accessing GP care due to ‘barriers created by service design’.

It said that many individuals report negative experiences when using services ‘often relating to the attitudes of staff’.

The framework, which was developed by NHS England with the Office for Health Improvement and Disparities (OHID), the UK Health Security Agency (UKHSA) and voluntary, community and social enterprise organisations, said: ‘These negative experiences can lead to people in inclusion health groups avoiding future contact with NHS services and being least likely to receive healthcare despite have high needs.

‘This can result in significantly poorer health outcomes and earlier death among people in inclusion health groups compared with the general population.’

It added: ‘They highlight that discrimination and stigmatisation discourage them from engaging with services. For example:

• Gypsy, Roma and Traveller communities report difficulties in registering with a GP because of a lack of cultural awareness and a perception that they will be “expensive patients”. GPs may also be reluctant to visit sites.’

Gypsy, Roma and Traveller communities also report issues when attempting to register with a GP due to low literacy levels and report difficulty completing GP registration forms and ‘a lack of support from professionals to help’.

According to the document, a recent cost-benefit analysis based on current experiences of Gypsy, Roma and Traveller families showed that an improved Dementia and Carer stress or depression pathway was estimated at less than half the cost of the current pathway, from £20,298 down to £8,884.

The analysis also highlighted that ‘up-front investment’, for example in appropriate social work engagement, or in GP outreach work, ‘can pay for itself many times over in the longer term’.

It added: ‘General practice has an essential role to play in addressing inclusion health, working in partnership with other system partners to prevent ill health and manage long-term conditions amongst socially excluded groups.’

The framework also said that vulnerable migrants report limited access to translation services, which greatly impacts their capacity and confidence to engage with care and support.

Last week, Healthwatch said that GP funding should be reviewed to make sure resources can be adjusted depending on patients’ need for translation or interpreting support.

In April, a report by the Healthcare Safety Investigation Branch warned that patients who do not speak English are at risk of delayed diagnosis because hospitals do not provide appointment letters in other languages.