Travellers
Maple Access
We offer Primary Care (GP care) to Travellers in the Northampton area - to those who have settled in the Borough or those moving around or passing through. Obviously some Travellers register with other GP practices around the county - we are not the only "Traveller friendly" practice in the area - but there are not that many surgeries that welcome them.
We work closely with Val Dumbleton (see below) who works mainly out of the Countywide Traveller Unit which has a much wider remit than just provision of primary care.
In the next 12 months we will be renegotiating our contract with NHS Northamptonshire to provide access services to vulnerable groups including care for Travellers which could be framed as a so-called Local Enhanced Service.
We would be glad to hear from others involved in providing Primary Care for Travellers to discuss how they have set their objectives and outcome measurements for Traveller health.
The Countywide Traveller Unit
The aims of the service are to promote, pursue and sustain effective, appropriate and sensitive non judgemental quality and equality of healthcare.
The service provides Health promotion, prevention of illness, practical health and social care. Holistic support, advocacy, advice and access to mainstream services.
The service works closely with the Voluntary and statutory sector and provides cultural information, training and advice to other professional groups.
For help or information contact Val Dumbleton who is the Public Health Specialist for Travellers at:-
Countywide Traveller unit:
Kingsthorpe Housing office, Northampton, NN2 7BB
01604 837231 07802 974738.
Alternatively you can email Val at vdumbleton@northampton.gov.uk
Working with travellers today
Travellers probably suffer more discrimination than any other ethnic minority group in the UK. Most of our local families are Irish travellers but we have some of Romany origin
Many GP surgeries will not register them or will only see them as temporary patients on the supposed basis that they have no permanent address.
We think it is important for travellers to have their medical records based at one local practice in the main area they travel, and have a primary care team that knows them and manages any chronic diseases as well as monitoring disease screening such as cervical cytology.
Also there are some characteristics of traveller communities which, without stereotyping, are important for health care professionals working with them to recognise:
1. Travellers often have not had regular education and many older travellers cannot read or write.
• You need to make sure that they can read the directions on bottles that look similar (we had one patient who mixed up two different liquid medicines that looked the same).
2. Travellers usually have strong religious and cultural traditions and beliefs – you need to understand them.
3. Like many socially excluded groups, they will have had problems with authority figures such as doctors and you will have to work at building trust.
• Most are very grateful for taking them seriously and spending time trying to sort out their problems
4. They have health beliefs and traditions that differ from yours and the concept of treating risk factors and chronic diseases with regular medication can seem alien to them.
• You need to explain the reasons for treatment carefully and the possible benefits - but also be aware how their lifestyle may not make regular treatment easy or advantageous for them
• You need to expect that they may stop taking medication and keep gently reminding them of the possible benefits.
• Don’t get irritated – remember they assess risks and benefits differently from you. Respect their angle on things.
5. Try to win important battles and lose the small ones – such as prescribing antibiotics when they ask
6. Family, cultural and religious pressures may cause problems especially for young Travellers.
7. Travellers can have very stressful lives in the UK today, and have high levels of illness. Mental health problems, physical trauma, chronic disease and premature death are all commoner than in the general population
We have tried to start a system of patient-held records for travellers but so far have not succeeded – but for certain individuals a print-out from the computer will be useful for them to take away with them to show to other doctors they see on their travels