Roche, R;
Simmons, R;
Crawshaw, AF;
Fisher, P;
Pareek, M;
Morton, W;
Shryane, T;
Poole, K;
Verma, A;
Campos-Matos, I;
et al.
Roche, R; Simmons, R; Crawshaw, AF; Fisher, P; Pareek, M; Morton, W; Shryane, T; Poole, K; Verma, A; Campos-Matos, I; Mandal, S
(2021)
What do primary care staff know and do about blood borne virus testing and care for migrant patients? A national survey.
BMC Public Health, 21 (1).
p. 336.
ISSN 1471-2458
https://doi.org/10.1186/s12889-020-10068-x
SGUL Authors: Crawshaw, Alison Fiona
Abstract
Background
UK migrants born in intermediate to high prevalence areas for blood borne viruses (BBV) including hepatitis B, hepatitis C and HIV are at increased risk of these infections. National guidance from Public Health England (PHE) and National Institute for Health and Care Excellence (NICE) recommends primary care test this population to increase diagnoses and treatment. We aimed to investigate primary care professionals’ knowledge of entitlements, and perceptions of barriers, for migrants accessing healthcare, and their policies, and reported practices and influences on provision of BBV testing in migrants.
Methods
A pre-piloted questionnaire was distributed between October 2017 and January 2018 to primary care professionals attending the Royal College of General Practitioners and Best Practice in Primary Care conferences, via a link in PHE Vaccine Updates and through professional networks.
Survey results were analysed to give descriptive statistics, and responses by respondent characteristics: profession, region, practice size, and frequency of seeing migrant patients. Responses were considered on a per question basis with response rates for each question presented with the results.
Results
Four hundred fourteen questionnaires were returned with responses varying by question, representing an estimated 5.7% of English GP practices overall. Only 14% of respondents’ practices systematically identified migrant patients for testing. Universal opt-out testing was offered to newly registering migrant patients by 18% of respondents for hepatitis B, 17% for hepatitis C and 21% for HIV. Knowledge of healthcare entitlements varied; fewer clinical staff knew that general practice consultations were free to all migrants (76%) than for urgent care (88%). Performance payment structure (76%) had the greatest reported influence on testing, followed by PHE and Clinical Commissioning Group recommendations (73% each). Language and culture were perceived to be the biggest barriers to accessing care.
Conclusions
BBV testing for migrant patients in primary care is usually ad hoc, which is likely to lead to testing opportunities being missed. Knowledge of migrants’ entitlements to healthcare varies and could affect access to care. Interventions to improve professional awareness and identification of migrant patients requiring BBV testing are needed to reduce the undiagnosed and untreated burden of BBVs in this vulnerable population.
Item Type: |
Article
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Additional Information: |
© The Author(s). 2021
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
Keywords: |
1117 Public Health and Health Services, Public Health |
SGUL Research Institute / Research Centre: |
Academic Structure > Infection and Immunity Research Institute (INII) |
Journal or Publication Title: |
BMC Public Health |
ISSN: |
1471-2458 |
Language: |
en |
Dates: |
Date | Event |
---|
11 February 2021 | Published | 14 December 2020 | Accepted |
|
Publisher License: |
Creative Commons: Attribution 4.0 |
Projects: |
|
URI: |
https://openaccess.sgul.ac.uk/id/eprint/112993 |
Publisher's version: |
https://doi.org/10.1186/s12889-020-10068-x |
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