Access to Primary Care
AMR: 95% were registered with a GP. 5% had been refused registration and did not know why. 36% had a general health check. Of those who had not, 82% would like one. 74% eligible had cervical screening and 100% mammograms, as part of routine NHS programmes.
TSW: 70% reported difficulties in registering clients with a GP. The reasons included surgeries asking for proof of ID/address when none was available (40%), language barriers (20%) and practices not being aware of entitlements to care (20%).
Understanding Rights to Care and the Local Healthcare System
AMR: 95% knew that they had a right to free primary care. Only 36% knew how to access a GP out of hours. 41% had called 999 (UK emergency service for acute serious problems) and 36% had been to Accident & Emergency, higher than the general population.
TSW: Only 30% felt confident in their knowledge of AMRs’ rights to care. Only 10% were correct in who can access free primary care. 90% felt that AMRs use of GP services was ‘frequent/very frequent’ compared to the general population and 50% rated use of A&E as ‘frequent/very frequent’. One TSW commented: “I know people who have given up on their GPs and who fail to seek care even when they really need it. This has sometimes ended in needing to go to A&E.”
Experience of Primary Care
AMR: 79% reported their GP experience as ‘good/very good’. Regarding ‘what was good?’ AMRs commented on GPs being friendly and kind with good listening skills. On ‘what could have been better?’ comments included doctors having a greater awareness of other cultures, giving medicine, access to interpreting services and with the doctor being more patient. 32% agreed with the statement “The GP had problems understanding me”, 18% felt “the GP did not understand my cultural background” and 32% did not “fully understand the advice or treatment given”.
68% AMRs reported needing someone to help translate and 82% of the time this was a relative. Only 27% AMRs reported a professional translator being available.
36% AMRs felt their health was better than when they had arrived in the UK but 36% felt it was worse. 23% reported having longterm physical illnesses and 60% felt they were receiving help. 23% reported having mental health problems and only 40% reported receiving help.
TSW: 60% felt that AMRs’ health needs were met in GP consultations most or all of the time. Physical (60%) and social needs (60%) were more likely to be met than mental health needs (10%). Regarding ‘what was good?, TSWs reported that GP staff were generally helpful and welcoming, some gave extra time and spoke slowly. However, many aspects could have been better: doctors addressing the client rather than TSW; access to translators; more time. TSWs were specifically asked about a range of challenges highlighted in previous literature (see Table 1).
90% of TSW said an interpreter was required and in only 10% cases a professional translator was available. 100% felt that GPs needed more education and AMRs needed more information about how the NHS works, as well as professional translators. 90% agreed it would be useful to have a local GP with specialist knowledge of refugee health. Other suggestions included: female doctors for female patients; women’s health clinics, antenatal classes, improved access to mental health services; better understanding, diagnosis and treatment on the first visit rather than “brushing them off with a prescription”; specialist referrals before a problem deteriorated; multilingual doctors.