New JSNA: This is the test site for the new Joint Strategic Needs Assessment

Gypsies & Travellers

Introduction

Reading has a very small population of gypsies and travellers and there is limited information about their needs as a community. Gypsies and Travellers experience some of the poorest health outcomes and more self-reported symptoms of ill-health than other UK residents and Reading residents are therefore likely to have disproportionately high needs.

What do we know?

There has been very little research before 2004 into the needs and inequalities of the Gypsy and Traveller community, making it difficult to fully determine the development of trends or long-standing needs in Reading. The national Count of Traveller Caravans England, now administered by the Department for Communities and Local Government (DCLG), has historically been the principle source of information and has been carried out bi-annually since 1979. The most recent national data (July 2015) reports a total number of 21,084 caravans, an increase of 1,126 since July 2014, consistent with an ongoing increasing trend in the number of caravans. The total number of caravans has increased by 29% since 2006. Increasing proportions are on authorised private sites, rising from 36% in 2006 to 54% in July 2015.Overall 85% were estimated to be on authorised land and 15% on unauthorised land.

The increasing trend is not replicated in Reading, where numbers have remained fairly stable (consistently between 3 and 6 caravans at each count) since at least 2010, with the exception of July 2014, when 22 caravans were recorded as they came to Reading in relation to the death of a member of large extended family.

Research into the inequalities and health needs affecting gypsies and travellers highlight significant discrepancies in health status, with much poorer health and lower life expectancy amongst gypsies and travellers compared to the general population (Parry et al, 2004; Cemlyn et al, 2009; Greenfields and Brindley, 2016).

Research also suggests an impact of accommodation security on physical and mental health (Greenfields and Brindley, 2016; Cemlyn et al, 2009), particularly the relationship between anxiety and depression and either insecure planning status or accepting 'bricks and mortar' accommodation for all or part of the year, usually in a deprived neighbourhood, in the absence of a pitch on a traveller site. This appears to be compounded by experiences of racism and discrimination (Cemlyn et al, 2009; Greenfields and Brindley, 2016).

These factors may also have an impact on access to healthcare, with racism or anticipated racism affecting communication between health workers and gypsies and travellers (Parry et al, 2004). Despite being more likely to report symptoms of ill health, gypsies and travellers also appear less likely to seek health services, especially where they fear diagnosis of a terminal condition (Parry et al, 2004).

The 2011 Census identified 90 Gypsies and Travellers living in the Reading Borough. Most remain within 25 miles of their birth place and cite deep rooted family connections to their local areas. They may also receive visits from travelling family members.

The department of education also carries out a census count of pupils by ethnicity each January. One category used identifies children as Gypsy or Roma and another identifies children who are Travellers of Irish Heritage. As shown in Figure 1. Reading has a significantly lower percentage of children in both primary and secondary school who were identified as either Gypsy or Roma or a Traveller from Irish Heritage in comparison to the England and South East England. In 2015, there were less than 10 students in primary school identified as GRT and only one student in secondary school. This may reflect a low number of gypsy and traveller residents in Reading (Reading has no authorised encampment areas) or a low proportion whose ethnicity is truly reflected in the data.

Figure 1. Percentage of total school population who are Gypsy/Roma or Traveller of Irish Heritage January 2015.

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Source: Department of Education

Services available for the Gypsy and Traveller Community

A multi-disciplinary group now meets quarterly to share information and work collaboratively to meet the needs of the Gypsy and Traveller Community. The group includes local third sector organisations who work with this community.

An Education Welfare officer, employed by Reading Borough Council, is responsible for engagement with the traveller community in Reading, including attending encampments and helping to ascertain the educational needs of all school aged children on sites, including, in some circumstances, 'unauthorised' sites. The officer is able to liaise with families and school admissions to obtain school places and can arrange and assist in the attendance of an admission interview. If a child or children in school has poor attendance, the officer is also able to engage and support the family.

The Berkshire Healthcare NHS Foundation Trust (BHFT) provides a Specialist Health Visitor for Vulnerable Families who supports RBC to manage the identified health needs on encampments, including promoting and facilitating access to appropriate local health care services. The Specialist Health Visitor also advocates on behalf of groups in the support of education of others around health needs of travellers. The core focus of the SHV is when travellers are on 'unauthorised' encampments. However where a traveller is in settled accommodation, registered to a GP, post natal care, immunisation and core health needs have been addressed then their care is passed to the generic Health Visiting Team.

National & Local Strategies (Current best practices)

The Royal College of General Practitioners' commissioning guide for Clinical Commissioning Groups and Health & Wellbeing Boards provides best practice information for improving access to health care for vulnerable groups, including Gypsies and Travellers.

Guidelines and briefings produced and published by the National Institute for Health and Care Excellence (NICE) highlight Gypsies and Travellers as a vulnerable group and recommend that Local Authorities take responsibility for promoting engagement with health services. The most recent guidance gave a summary of evidence for local authorities and partners on improving access to health and social care services for vulnerable people (NICE, 2014).

In November 2010, the Secretary of State for Communities and Local Government set up a ministerial working group to tackle inequalities issues, highlighting the importance of improving mainstream services provision for Gypsy and Traveller communities.

Decision making for policy concerning Gypsies & Travellers sits within a complex legislative and national policy framework and this study must be viewed in the context of this legislation and guidance. The following outlines the pieces of legislation and guidance are relevant to policy development:

The issue of traveller welfare when making decisions about evicting from unauthorised sites also needs to be considered. Best practice outlines the need to address urgent welfare needs may require a delay in removal of the encampment. If the site that the travellers are using is particularly hazardous it is recommended that the travellers are asked to move to a more appropriate location in the vicinity. Best practice also outlines that it may be possible to negotiate a date for the encampment to move, for example, after attendance at a pre-arranged hospital appointment. In Reading, the Local Authority's Gypsy and Traveller Procedure provides a protocol for dealing with unauthorised encampments and sets out to ensure that the rights and needs of resident communities and those of gypsies and travellers are balanced. It requires that officers visiting sites to carry out initial assessments also complete welfare enquiries relating to health, education and social needs. Decisions to evict are based on: location, size, behaviour, impact on settled community, mitigating factors and educational needs.

What is this telling us?

It seems likely that the number of gypsy and traveller residents in Reading is very low, however the needs of this community are likely to be disproportionately high. More information is needed to understand the particular experiences of the population in Reading in order to understand what their health needs may be and to encourage their engagement with health and other services.

What are the key inequalities?

Gypsy and traveller communities are more likely to suffer poor health and less likely to access health services than the general population.

What are the unmet needs / service gaps?

More work is needed to fully understand the needs of the local gypsy and traveller population and to put strategies in place to make sure these needs are met.

This section links to the following sections in the JSNA:

Ethnicity

Poverty

References

Parry, G, Van Cleemput, P, Peters, J, Moore, J, Walters, S, Thomas, K, and Cooper, C. (2004) The Health Status of Gypsies & Travellers in England.Report of Department of Health Inequalities in Health Research Initiative and The University of Sheffield, School of Health and Related Research. October 2004. Available at: Department of Health Inequalities in Health Research Initiative (Accessed 20th January 2016).

Greenfields, M and Brindley,M (2016) Impact of insecure accommodation and the living environment on Gypsies' and Travellers' health.A report by the Traveller Movement & Bucks New University. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/490846/NIHB_-_Gypsy_and_Traveller_health_accs.pdf (Accessed 20th January 2016). 

Cemlyn, S, Greenfields, M, Burnett, S, Matthews Z and Whitwell, C. (2009). Inequalities experienced by Gypsy and Traveller Communities: A review. Equality and Human Rights Commission, Manchester. Available at:  http://www.equalityhumanrights.com/sites/default/files/documents/research/12inequalities_experienced_by_gypsy_and_traveller_communities_a_review.pdf (Accessed 22nd February 2016).

Royal College of General Practitioners 2013, Improving access to health care for Gypsies and Travellers, homeless people and sex workers.RCGP Clinical Innovation and Research Centre (CIRC). September 2013. Available at: http://www.rcgp.org.uk/news/2013/december/~/media/Files/Policy/A-Z-policy/RCGP-Social-Inclusion-Commissioning-Guide.ashx (Accessed 27th January 2016).

National Institute for Health & Social Care 2014. Improving access to health and social care services for people who do not routinely use them.NICE advice [LGB14]. January 2014.  Available at: https://www.nice.org.uk/advice/lgb14/chapter/Introduction (Accessed 26th January 2016).

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