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Primary Health Care

Question for Department of Health and Social Care

UIN 234719, tabled on 20 March 2019

To ask the Secretary of State for Health and Social Care, with reference to the recommendations in the report, No room at the inn: how easy is it for nomadic Gypsies and Travellers to access primary care, published by Friends, Families and Travellers in March 2019, what steps he is taking to improve access to primary care for (a) Gypsies and Travellers, (b) homeless people, (c) vulnerable migrants and (d) people in contact with the criminal justice system; and if he will make a statement.

Answered on

28 March 2019

Registering with and access to primary medical care services is the same for all patients, whether they are gypsies, travellers, homeless or vulnerable migrants. People do not need to provide proof of address to register with a general practice (GP). NHS England is working with a range of community groups to redesign the patient registration leaflet so that people are aware of this when registering. The free NHS 111 service can assist anyone who has faced difficulty finding a GP or accessing other services in their local area.

NHS England is aware the challenges some individuals have faced when trying to register with a GP and is taking steps to address shortcomings with individual practices, working in partnership with the voluntary sector.

The majority of people in touch with the criminal justice system are in the community and therefore their engagement with primary care services will sit within the responsibility of clinical commissioning groups. For the prison population (approx 86,000) there are primary care services commissioned by NHS England which works to the principle of equivalence and are mandated to deliver a comprehensive health assessment and a treatment pathway for the time an individual remains in custody to ensure that their health needs are identified and met quickly and effectively.

There is a very real recognition by health commissioners that the point of release from custody results in the potential for a person to lose any health gains made whilst in custody due to a change in their health care provider and a failure for a natural pathway for a continuity of healthcare post release.

To this end and included in the NHS Long Term Plan, NHS England Health and Justice commissioners are developing a RECONNECT provision which would support a care pathway being identified for people leaving prison so that the engagement with community health providers are brokered prior to them leaving prison and to support them to access these in the community. This provision is planned to be rolled out across reception and resettlement establishments from 2020.

During the last 12 months NHS England has been undertaking a programme of work into identifying and addressing the health and social care needs of Gypsy, Romany and Travellers (GRT) in the criminal justice system, incorporating lived experience. The primary focus of the work is improving the healthcare of GRT communities who are within the criminal justice system, including access to primary care, addressing long-term health inequalities and exploring issues of exclusion, discrimination and harassment. NHS England is currently developing a range of learning and practice improvement tools for health and other partners and will be followed by learning and improvement events.