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Migrant access to primary care worse during the pandemic

Migrant access to primary care worse during the pandemic

Researchers have found that migrants’ use of primary care in England was disproportionately impacted by Covid-19.

A study by University College London (UCL) has shown that international migrants were less likely to use primary care than non-migrants before the pandemic, and the first year of the pandemic exacerbated this difference.

The widening gap in consultation rates seen during the pandemic was greater in migrant children, certain ethnic groups and migrants whose first language was not English.

Telephone appointments were also more heavily impacted than face-to-face appointments, particularly in London.

The findings, published in The Lancet Regional Health, call for GP practices to improve services and ensure primary care is accessible and responsive to migrants’ healthcare needs, particularly if remote and hybrid models of service delivery are retained.

The UK is home to the fifth largest number of international migrants in the world. Despite primary care being free to access for all, low registration rates are typical amongst migrant communities. For migrants who register with a GP practice, there are barriers to accessing care, including insufficient translation support, discrimination, and transportation costs.

Using data from the Clinical Practice Research Datalink (CPRD) GOLD, the researchers identified 130,000 international migrants and examined how they accessed primary care, as well as the frequency of access, before and during the Covid-19 pandemic.

The researchers found that pre-pandemic migrants had an overall 6% lower rate of appointments than non-migrants. During the pandemic, this gap widened, with migrants having 14% fewer face-to-face appointments and 24% fewer telephone appointments than non-migrants.

The findings also highlighted the differences in primary care utilisation by migrants of different ethnicity and age groups. Migrant children aged fifteen and under saw a 27% reduction in the pre-pandemic ratio of consultation rates between migrants and non-migrants.

Migrants in London were also more affected than other migrants in the UK, as were migrants of White British, White non-British and Black/African/Caribbean/Black British ethnicities.

Professor Robert Aldridge from UCL said: ‘As GP practices continue to use remote appointments, concerted efforts are needed to ensure all GP services are accessible to migrants.’

He added: ‘Clinical commissioning groups should address factors such as professional interpreting and translation services, and culturally responsive service delivery plans – alongside improving migrants’ knowledge of their healthcare entitlements and supporting migrants to make informed decisions about healthcare use during the pandemic and beyond.’

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