A pilot study by the University of Birmingham has identified major barriers to healthcare access for migrants, including denial of entitlements, administrative issues, lack of understanding, language barriers and fears of being arrested.

Funded by the Nuffield Foundation, the 'Vulnerable migrants and wellbeing’ pilot study, is led by Dr Laurence Lessard-Phillips from the Institute for Research into Superdiversity (IRiS).  The team investigated gaps in knowledge regarding the relationship between vulnerability and wellbeing, by analysing six years of data provided by Doctors of the World UK (DOTW UK), a registered charity that provides medical care and support to excluded people.

Most of the service users of DOTW UK faced vulnerability and had difficulties accessing the NHS and other statutory services. The principal aim of this project was to build an evidence base to study the wellbeing status of migrants living in the UK who experience vulnerability, and explore factors that may contribute to shaping this.

Key findings of the study are:

• Access to healthcare is a major issue for service users, with large numbers reporting that they did not even attempt to access healthcare. When service users who are not registered with a GP seek to access care, they tended to use Accident and Emergency and Walk-in Centres.
• The most frequently mentioned barriers to healthcare access include administrative issues, lack of understanding, language barriers, fears of being arrested, and denial of entitlements.
• The majority of service users were living below the poverty line, with a small proportion of service users reporting an activity that allowed them to earn a living.
• In terms of living conditions, over a third of service users reported that their accommodation was not stable.

Research lead Dr Laurence Lessard-Phillips said ‘the data from DOTW gives us a unique opportunity to explore issues related to vulnerability and wellbeing, especially over a period that has seen increased restrictions in terms of access to services. Our preliminary analyses highlight areas of relevance for research, policy, and practice that we are keen to explore further’. 

The data covered the period from 2011 to 2016 which comprised a total of 8,489 unique consultations across the years, with most service users visiting DOTW UK clinics once.  The most frequently mentioned reason for the visit was for administrative, legal, or for social issues. 48.3% of service users were female, and 51.7% male, with an average age of 35.6 years, with most users living in the vicinity of the DOTW UK clinics. With regards to immigration status, a large proportion of service users were undocumented, having been in the UK for an average of 5.6 years since last arrival, and had claimed (or planned to claim) asylum.

Lucy Jones, Director of Programmes at DOTW explained ‘Doctors of the World’s medical volunteers are seeing every day patients who are turned away from the NHS or too worried to not present for care at all as a result of government policy.  This new report gives even more evidence of a rising problem resulting in vulnerable people including those who have been through the asylum process or are victims of trafficking not getting treatment, the government needs to take immediate action to stop further unnecessary harm.’

The results presented in this report highlight the richness of the data collected by DOTW UK.  This data warrants further analysis, especially with regard to exploring some of the results in more detail for the various groups, demographics and wellbeing indicators.

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• The study was led by Dr Laurence Lessard-Phillips with Professor Jenny Phillimore and  Dr Antje Lindenmeyer, Institute for Research into Superdiversity, University of Birmingham. The team worked with Dr Fozia Hamid, Volunteer Doctor and Ms Lucy Jones, Director of Programmes, Doctors of the World UK.
• The Institute for Research into Superdiversity (IRiS) is one of the leading institutions framing the study of superdiversity, drawing together academics from across the UK and the rest of the world to consolidate expertise and generate new thinking in the field.
• The University of Birmingham is ranked amongst the world’s top 100 institutions, its work brings people from across the world to Birmingham, including researchers and teachers and more than 5,000 international students from over 150 countries.
• The Nuffield Foundation is an endowed charitable trust that aims to improve social wellbeing in the widest sense. It funds research and innovation in education and social policy and also works to build capacity in education, science and social science research. The Nuffield Foundation has funded this project, but the views expressed are those of the authors and not necessarily those of the Foundation. More information is available here.
• Doctors of the World is an independent humanitarian movement working at home and abroad to empower excluded people to access healthcare. Through 400 programmes in 80 countries run by more than 3,000 volunteers we provide medical care, strengthen health systems and address underlying barriers to healthcare.