Refugee and Immigrant Community Health Champions:a Qualitative Study of Perceived Barriers to Service Access and Utilisation of the National Health Service (NHS) in the West Midlands, UK

There has been much discussion recently that better healthcare systems lead to increased service access and utilisation. However, there are still concerns raised among the refugee and immigrant communities about barriers to access and utilisation of primary healthcare services in the UK. This study aimed to explore with refugee and immigrant community health champions (CHCs) their perceptions about such barriers based on feedback in their own discussions with fellow refugees, asylum-seekers and immigrants in the West Midlands, UK. A total of 42 refugees and immigrants were recruited. Qualitative design-focused group discussions were conducted among purposively selected participants. These discussions were conducted between May and September 2019, and data were analysed using thematic analysis. The barriers to service access and utilisation are categorised into four themes: (i) knowledge about health issues that most affected refugees and immigrants; (ii) community indications of factors that obstructed service access; (iii) challenges in identifying local teams involved in service provision; and (iv) accurate knowledge about the different teams and their roles in facilitating access. This study higlighted that the levels of service access and utilisation would depend on the competence and effectiveness of the health system. Urgency and seriousness of individuals’ healthcare needs were the factors that were perceived to strongly influence refugees and immigrants to seek and utilise local services. We identified a number of potential barriers and challenges to service access and utilisation that should be overcome if primary healthcare service is to be planned and delivered effectively, efficiently and equitably in the West Midlands

The TInnGO Observatory and the DIAMOND toolbox:self-assessment for service operators on fairness and inclusivity.

This paper summarises the contributions of both projects towards bring the community together, as presented in Session IX of the final conference/TDM Symposium 2021. This session featured a series of presentations from both projects on the steps and outputs that together contribute to the legacy ofSession X: Bringing the community together our projects. Both projects addressed the challenge outlined in the call MG-4-3-2018: Demographic change and participation of women in transport. Through our work we have understood the challenges and barriers to creating a fairer transport system. Here we present practical contributions, tools and strategies which can be built on by other researcher