Gypsy and Traveller Health Needs Assessment

1. Gypsy and Traveller Health Needs Assessment Denice Burton Assistant Director – Health Improvement

2. 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 A better place to live, work and visit

3. Background • Commissioned from Buckinghamshire new University • Carried out between Sept 2012 and Spring 2013 Making Bath & North East Somerset A better place to live, work and visit

4. 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 A better place to live, work and visit

5. Sample • 5 English gypsies • 6 Irish travellers • 1 Scottish / Welsh traveller • 21 new travellers • 2 showmen • 30 boaters • 1 other Making Bath & North East Somerset dA better place to live, work and visit

6. 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 A better place to live, work and visit

7. 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 A better place to live, work and visit

8. 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 A better place to live, work and visit

9. 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 A better place to live, work and visit

10. 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 A better place to live, work and visit

11. 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 A better place to live, work and visit

12. 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 A better place to live, work and visit

13. Links: Joint Strategic Needs Assessment: www.bathnes.gov.uk/jsna Making Bath & North East Somerset A better place to live, work and visit