What has the impact of COVID-19 been on migrants’ access to primary care in the UK?

Felicity Knights, Jessica Carter, Anna Deal, Alison Crawshaw, Sally Hargreaves

Keywords: #Equity #Access #Vulnerable Groups

Introduction:
COVID-19 has led to big changes in European primary care, including rapid digitalisation, with unknown impact on migrant groups (patients born in one country who live in another). This UK-based qualitative study aimed to understand the pandemic’s impact on recently-arrived migrants and their access to primary health care.

Method:
Sixty-four PCPs and administrative staff, and 17 recently-arrived migrants were recruited using purposive, convenience, and snowball sampling from urban, suburban, and rural settings across England. In-depth, semi-structured interviews were conducted by telephone. Data were analysed iteratively, informed by thematic analysis.

Results:
PCPs and migrants concurred that digitalisation and virtual consultations have amplified existing inequalities in access to health care for many migrants, due to a lack of digital literacy and access to technology, compounded by language barriers. PCPs were concerned that virtual consultations resulted in difficulties building trust and risked missing safeguarding cues. Both PCPs and migrants highlighted challenges around registering and accessing health care due to physical closure of surgeries, as well as indirect discrimination, language and communication barriers, and a lack of access to targeted and tailored COVID-19 information or interventions. Innovative opportunities were suggested, including translated digital health advice using text templates and YouTube; these merit further exploration.

Conclusions:
Pandemic-related changes to European primary care delivery may become permanent. Equity is a key principle of quality care, and we need to recognise that some migrant groups are at risk of digital exclusion and may need targeted additional support to access services. Primary care can maximise the opportunities of digitalisation through engagement by multiple modalities (for example, text, email, letter, and YouTube videos) to provide targeted, translated advice, virtual group consultations, and work with local leaders to access and disseminate information through informal communication channels.

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