GPs improve healthcare for Travellers

A GP practice in Yorkshire has turned around healthcare provision in one of the UK's most vulnerable populations.

Inovating in Traveller health (l to r): executive practice manager Lisa Ripley, service delivery manager Lesley Ray, GP Dr Vijay Kumar and Gypsy/Traveller community liasion staff member Anita Jackson

Over the past decade, GP Dr Vijay Kumar has spearheaded a 'designer-made healthcare system' for Doncaster's Gypsy and Traveller community, which has seen immunisation rates increase nearly 20-fold.

Dr Kumar was invited to speak at last month's Operation Traveller Vote conference to discuss how health services for Traveller communities can improve.

Speaking after the event, he told GP: 'We have been working on this for a long, long time. There was no previously trodden path to take. We had to find our own way of doing it.'

Dr Kumar's practice targeted five major areas for improvement: childhood immunisations, cervical smears, mammograms, men's health and palliative care.

The programme has seen immunisation levels in the community leap from 4% in 2003 to 70% today, and more than half (55%) of women now receiving cervical smear tests, while none did 10 years ago.

How GPs can support Traveller health

  • Send welcome notes to visiting Gypsy and Traveller groups, inviting them to visit the practice
  • Offer access to evening appointments
  • Give patients copies of parts of their medical records, to show the next GP they visit
  • Provide specific details and addresses of GP practices in the area where they plan to go to next

People from Gypsy and Traveller populations tend to die 10-12 years younger than the general population, largely owing to lifestyle factors.

Dr Kumar said the UK healthcare system is not doing enough to help them. 'The founding principle of the NHS is to provide equitable care for all - but is it currently catering for this community? I don't think we are.'

The key is to champion 'reverse commissioning', he says. 'It's not me telling them what they'll have; it's them telling us what they'd like.'

Improving care in Traveller communities often requires specialised solutions and tact, says Dr Kumar.

His practice offers to immunise children and babies outside traditional baby clinic times, for example, during women's welfare clinics, to maximise uptake.

GPs should capitalise on opportunities when Travellers come for appointments, he added. 'They may have come for something else entirely, but use it as an opportunity to spread public health messages or take blood tests.

'Check that children are immunised - if they're not, offer a vaccination there and then. Don't tell them to come in at a later date or whenever the next baby clinic is. Try to do as much as you can within the consultation.'

Practices could consider offering 15-minute instead of 10-minute appointments, Dr Kumar added.

'These very small and very achievable measures will pay dividends to the NHS in terms of cost-benefit and patient satisfaction,' he said.

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