Eastern European migrants and ambulance care in Lincolnshire - barriers, facilitators, and experiences: A multi-method, stakeholder-informed study
Creators: name: Phung, Viet-Hai
Publisher: name: University of Lincoln
Year: 2025
Subjects: B990 - Subjects allied to medicine not elsewhere classified

description: Introduction Economic factors mainly drove Eastern European migration to the UK, which increased  significantly after EU Accession from 2004 onwards. Lincolnshire, a predominantly rural  county, with large agricultural, and hospitality industries, has experienced significant Eastern  European immigration, with a need among this population for high quality public services,  including ambulance care. Increasing Eastern European immigration necessitated legislative  (The 2010 Equality Act), and policy responses (Equality Delivery System (EDS)).  The study aimed to understand the ambulance care experiences of Eastern European patients  in Lincolnshire. We firstly established an evidence base, through a systematic scoping review  of the healthcare experiences of Eastern Europeans in the UK. Subsequently, through  interviews with ambulance staff, as well as service users, and non-users, the thesis explored  the experiences of both key stakeholder groups to identify the barriers and facilitators to high  quality ambulance care.  There have been studies identifying the healthcare needs of Eastern European migrants in the  UK. However, the research has not focused on a specific aspect of healthcare. This study fills  the gap by focusing on ambulance care. It is also novel by using the experiences and  perceptions of two key stakeholder groups to inform potential service delivery improvements.  Paradigm, methodology, and methods Consistent with post-positivist critical realist ontology, the thesis explored the causal  mechanisms that influenced how ambulance staff delivered prehospital care and how Eastern  European patients experienced it.  Values were integral to this research process. The thesis also conformed to constructivist  relativist ontology in that participants shared multiple, equally valid, socially constructed  realities.  ii The systematic scoping review informed the subsequent staff and patient interviews. While the  staff interviews were all conducted one-to-one and face-to-face, we conducted the patient  interviews in multiple formats. Some were with couples, while most involved an interpreter.  Due to the COVID-19 pandemic, we conducted the final patient interviews over the telephone.  Results The systematic scoping review searched nine databases. After searches by title, abstract and  full text, there remained 13 publications, which were quality assessed. The main themes were:  expectations and understanding of the healthcare system; accessing healthcare; language  barriers and communication problems; and medical travel.  We interviewed 15 ambulance staff and 12 Eastern Europeans in Lincolnshire, UK. Staff felt  that medical travel complicated how they delivered ambulance care. By contrast, patients  travelled to overcome perceived systemic problems, such as long waiting times, and limited  availability of antibiotics. Language barriers, as well as a mismatch between expectations and  experiences were key barriers to high quality ambulance care. Patients suggested leaflets in the  relevant languages to explain how the ambulance service works would help to address both  these problems.  Conclusion The systematic scoping review methodology could be adapted for different population groups,  geographical locations, and healthcare settings. Staff and patient experiences informed their recommendations for service delivery improvements. The extent to which staff and patient  recommendations become a reality depend upon external factors, such as receptiveness of  ambulance services and the long-term financial consequences of COVID-19 and Brexit.