A recent meeting about screenings and immunisations got me thinking about the interaction of the health service with vulnerable people and groups. Broadly speaking this was a useful event for all, both for those with a medical or community interest. It does seem that we as a country are relatively strong in the uptake and coverage of immunisations against countless diseases and effective screening against various conditions. There are exceptions however.
Notably, the gaps in take-up are most often those with certain characteristics, such as mental health difficulties, and come from vulnerable or isolated groups. Other examples include asylum seekers, sex workers, children in local authority care and prisoners. Despite the great variation amongst these people, the common theme is about engagement with the health service or rather the obstacles to this. Put simply, those with less positive interaction with surgeries, health visitors, hospitals etc. are less likely to know about, understand, trust or in practice get access to immunisations or screenings.