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British Journal of General Practice

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Research

Impact of COVID-19 on migrants’ access to primary care and implications for vaccine roll-out: a national qualitative study

Felicity Knights, Jessica Carter, Anna Deal, Alison F Crawshaw, Sally E Hayward, Lucinda Jones and Sally Hargreaves
British Journal of General Practice 2021; 71 (709): e583-e595. DOI: https://doi.org/10.3399/BJGP.2021.0028
Felicity Knights
The Migrant Health Research Group, St George’s, University of London, London.
Roles: GP academic clinical fellow
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Jessica Carter
St George’s, University of London, London.
Roles: GP and National Institute for Health Research in-practice fellow
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Anna Deal
The Migrant Health Research Group, St George’s, University of London, London.
Roles: PhD student
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Alison F Crawshaw
The Migrant Health Research Group, St George’s, University of London, London.
Roles: Research assistant/PhD student
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Sally E Hayward
The Migrant Health Research Group, St George’s, University of London, London.
Roles: PhD student
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Lucinda Jones
Palladium, London.
Roles: Health analyst
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Sally Hargreaves
The Migrant Health Research Group, St George’s, University of London, London.
Roles: Associate professor
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Abstract

Background COVID-19 has led to big changes in UK primary care, including rapid digitalisation, with unknown impact on migrant groups.

Aim To understand the pandemic’s impact on recently-arrived migrants and their access to primary health care, and implications for vaccine roll-out.

Design and setting Qualitative study involving semi-structured interviews with primary care professionals (PCPs) and migrants in urban, suburban, and rural settings across England.

Method Sixty-four PCPs and administrative staff, and 17 recently-arrived migrants were recruited using purposive, convenience, and snowball sampling. 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. Migrants reported a range of specific beliefs, from acceptance to mistrust, around COVID-19 and potential COVID-19 vaccines, often influenced by misinformation. Innovative opportunities were suggested, including translated digital health advice using text templates and YouTube; these merit further exploration.

Conclusion Pandemic-related changes to primary care delivery may become permanent; some migrant groups are at risk of digital exclusion and may need targeted additional support to access services. Solutions are needed to address vaccine hesitancy in marginalised groups to ensure equitable COVID-19 vaccine uptake.

  • COVID-19 vaccines
  • primary health care
  • delivery of health care
  • Received January 15, 2021.
  • Revision requested March 5, 2021.
  • Accepted April 7, 2021.
  • © The Authors
http://creativecommons.org/licenses/by/4.0/

This article is Open Access: CC BY 4.0 licence (http://creativecommons.org/licences/by/4.0/).

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British Journal of General Practice: 71 (709)
British Journal of General Practice
Vol. 71, Issue 709
August 2021
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Impact of COVID-19 on migrants’ access to primary care and implications for vaccine roll-out: a national qualitative study
Felicity Knights, Jessica Carter, Anna Deal, Alison F Crawshaw, Sally E Hayward, Lucinda Jones, Sally Hargreaves
British Journal of General Practice 2021; 71 (709): e583-e595. DOI: 10.3399/BJGP.2021.0028

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Impact of COVID-19 on migrants’ access to primary care and implications for vaccine roll-out: a national qualitative study
Felicity Knights, Jessica Carter, Anna Deal, Alison F Crawshaw, Sally E Hayward, Lucinda Jones, Sally Hargreaves
British Journal of General Practice 2021; 71 (709): e583-e595. DOI: 10.3399/BJGP.2021.0028
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Keywords

  • COVID-19 vaccines
  • primary health care
  • delivery of health care

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  • National Cancer Diagnosis Audits for England 2018 versus 2014: a comparative analysis
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