Access to heath care

This section focuses on peoples’ use of health care services, as well as any particular health care needs that they, or members of their family had.

Services used

Respondents were asked if they currently used/accessed any of the following health care services:

• GP/Doctor;

• dentist;

• Accident and Emergency (A & E);

• health visitor;

• midwife;

• NHS walk-in centre; and

• NHS Direct

A GP/Doctor was the most common service that was currently being used (83% of respondents), followed by a dentist (see Table 67 below). The sample shows that 17% of people had used Accident and Emergency (A & E).

Table 67: Use of health services

No. %

GP/Dr 194 83

Dentist 117 50

Walk-in Centre 46 20

Accident and Emergency (A & E) 40 17

Health Visitor 25 11

NHS Direct 15 6

Midwife 13 6

Other 4 2

With regards to the four respondents who indicated that they accessed some other form of health service, one person indicated that they were a member of BUPA; one person stated that they accessed an optician; while two people simply stated

“hospital”.

The level of use of health services is higher than expected given that previous research has suggested relatively low levels of use (see Chapter 3 with reference to previous research in Scotland).

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We asked those who currently did not access a GP/Doctor or dentist to indicate where they would go if they had any health or dental problems. The majority of respondents (44%) indicated that they would access health/dental care in their home country. Following this, people made reference to going to hospital or A & E (9%) or going to an NHS walk-in centre (9%).

One person said they would contact NHS Direct, one accessed a pharmacy, while another indicated that they would access an emergency dentist if they required dental treatment. Nearly a quarter of respondents suggested that they had not yet had any problems that required medical or dental services, some of whom suggested that if they did require health care they would register with a GP or dentist.

Particular health needs

We asked respondents to indicate overall how healthy they considered themselves to be (see Table 68 below).

Table 68: How healthy do you consider yourself to be? No. %

In good health 171 73

In fairly good health 61 26

In poor health 2 1

No response given 1 <1

Total 235 100

As can be seen, nearly all respondents (99%) felt themselves to be either in good health or in fairly good health. Just two people stated that they were in poor health This perhaps reflects the age of the respondents and the fact that they were primarily under the age of forty (see Table 15).

We also asked respondents if they, or any members of their family who were living with them, had any particular health problems or disabilities; twenty-two respondents (9%) said yes. These respondents were asked to elaborate on what health problems they, or members of their family, had. The responses given were: allergies (three respondents); sensory problems (three); Down’s Syndrome (two); Epilepsy (one); stress (one); heart problems (one); headaches/migraines (one); Autism (one);

Asthma (one); Diabetes (one); back problem (one); knee problem (one); leg problem (one); and, missing a hand (one).

Of those who indicated that they, or a member of their family, had a particular health problem/disability, eleven respondents indicated that they received help or support for this while eleven did not. With regards to where people got help and support from, respondents were ask to choose all that applied from the following range of options:

• GP/Doctor/hospital;

• family and friends;

• church and community group; and

• Nottingham City Council

97 Table 69: Where do you get help or support from?

No.

Doctor/GP/Hospital 8

Family/friends 5

Nottingham City Council 2

As can be seen, although the majority of people accessed professional health care services for help and assistance, there was also a reliance on assistance from family/friends as well. None of the respondents sought help from church or community groups.

Health care issues from a stakeholder perspective

Stakeholder consultation suggested that migrant workers, on the whole, did not experience a lot of health issues, particularly those of a long term nature. There were, however, a number of pertinent issues raised in relation to cultural differences, expectations of healthcare in the UK and maintaining consistency in treatment. One stakeholder highlighted the following issues:

“Some [people] come with medicines from their home country and want us to prescribe the same and sometimes it’s obvious what they are and we can continue the prescription, but in other cases we either do not have them here or would not advise their use.”

“…Some people have been advised to have a test or X-ray/scan by us, but then they go home on holiday and have it there. They then bring the result back in their [own] language and expect us to act on it.”

“…We may be monitoring a condition here, but they go back to their [home] country for several months and we are not aware what has been happening there, whether they can obtain the same medicine there or are advised to manage their condition differently by doctors there. They then return and we have to start again.”

As might be expected, language barriers were also an issue, particularly in relation to migrant workers who have family living with them. Stakeholder consultation revealed that migrant communities (including both migrant workers and asylum seekers) often require double appointments, which impacts the number of appointments that are available but also has resource implications:

“…Most migrant workers can speak enough English to manage in

consultations with healthcare professionals, but their families often cannot speak any English and we need interpreters for them. This means we have to book double appointments for every time we need an interpreter and these often overrun because not only are we dealing with the present [health]

problem but also [we have] to address [people’s] lack of understanding of how to arrange a blood test or get a prescription from the chemist, whether they are entitled to free prescriptions, etc. We are paid an extra sum of money by the PCT for registering asylum seekers because of the acknowledgement that they need double appointments for interpreters, but [we] do not get any

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families…There are inevitably less appointments for [people] to see the doctors and nurses in our practice because of an increase in those needing double appointments. We have tried to increase the number of doctors and nurses employed… but the exact balance of staff hours versus need for appointments is not easy to predict and manage especially as the influx of [migrant] workers and asylum seekers is unpredictable.”