1. Making Bath & North East Somerset an even better place to live, work & visit Gypsy and Traveller Health Needs Assessment Denice Burton Assistant Director – Health Improvement

2. Making Bath & North East Somerset an even better place to live, work & visit Aims of the study Making Bath & North East Somerset A better place to live, work and visit 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

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