The perceptions of general practice among Central and Eastern Europeans in the United Kingdom: A systematic scoping review

Abstract

Background: Around 2 million people have migrated from Central and Eastern Europe to the UK since 2004. The UK Central and Eastern European Community (UK-CEE) are disproportionately exposed to the social determinants of poor physical and mental health. Their health and healthcare beliefs remain under-researched, particularly regarding primary care. Objective: This review explores UK-CEE community members' use and perceptions of UK general practice. Methods: A systematic search of nine bibliographic databases identified 2094 publications that fulfilled the search criteria. Grey literature searches identified 16 additional relevant publications. Screening by title and abstract identified 201 publications of relevance, decreasing to 65 after full-text screening. Publications were critically appraised, with data extracted and coded. Thematic analysis using constant comparison allowed generation of higher-order thematic constructs. Results: Full UK-CEE national representation was achieved. Comparatively low levels of GP registration were described, with ability, desire and need to engage with GP services shaped by the interconnected nature of individual community members' cultural and sociodemographic factors. Difficulties overcoming access and in-consultation barriers are common, with health expectations frequently unmet. Distrust and dissatisfaction with general practice often persist, promoting alternative healthseeking approaches including transnational healthcare. Marginalized UK-CEE community subgroups including Roma, trafficked and homeless individuals have Health Expectations.

Central and Eastern European Migrants in the United Kingdom: A Scoping Review of the Reasons for Utilisation of Transnational Healthcare

“…EU citizens who were ordinarily resident (a person is ordinarily resident if they are living in the United Kingdom lawfully, voluntarily or for settled purposes [ 4 ]) in the United Kingdom before Brexit are entitled to ‘free at the point of use’ care within the UK National Health Services (NHS), the same as UK nationals [ 5 ]. Despite having access to healthcare services in the United Kingdom, it has been documented that CEE migrants frequently and voluntarily travel back to their country of origin (CoO) to access healthcare [ 6 , 7 , 8 , 9 ]. There is evidence that CEE migrants are at a higher risk of poorer physical health outcomes, including obesity, cardiovascular disease, cancer and sexual health [ 9 , 10 , 11 ].…”

Disrupting patterns of exclusion in participatory spaces: Involving people from vulnerable populations

“…There are papers with lead authors from seven countries: the United Kingdom, 22–28 Australia, 29–33 Canada, 34–38 the United States, 39,40 the Netherlands, 41,42 France 43 and Ecuador 44 . There are important examples involving people who experience homelessness, 22,23,34 people who have disabilities, 26,41,42 people who live in socioeconomically disadvantaged circumstances 35,37 and people who are migrants and/or from ethnic minority groups 25,31,36 . There are also papers involving people with diabetes who experience stigma because of their condition 30 and COVID vulnerable populations, such as those with genetic, undiagnosed and rare disorders 39 .…”

“…First, we consider who is in spaces for sharing decisions about research, services and policy in this special issue. There are papers with lead authors from seven countries: the United Kingdom, [22][23][24][25][26][27][28] Australia, [29][30][31][32][33] Canada, [34][35][36][37][38] the United States, 39,40 the Netherlands, 41,42 France 43 and Ecuador. 44 There are important examples involving people who experience homelessness, 22,23,34 people who have disabilities, 26,41,42 people who live in socioeconomically disadvantaged circumstances 35,37 and people who are migrants and/or from ethnic minority groups.…”

“…44 There are important examples involving people who experience homelessness, 22,23,34 people who have disabilities, 26,41,42 people who live in socioeconomically disadvantaged circumstances 35,37 and people who are migrants and/or from ethnic minority groups. 25,31,36 There are also papers involving people with diabetes who experience stigma because of their condition 30 and COVID vulnerable populations, such as those with genetic, undiagnosed and rare disorders. 39 This shows that hard-to-reach groups can, of course, be included in participatory spaces.…”

“…Second, what kind of methods are used in projects based on these partnerships? The papers report systematic reviews, [23][24][25] original research using qualitative, quantitative and mixed-methods studies 26,[29][30][31][34][35][36][37][39][40][41][42] and reflective practice. 22 This resonates with a key finding in the wider literature about meaningful partnerships 3,4 : collaborative research orientation is the core issue rather than the nature of the methods being used.…”