Leeds GATE

Working to improve the quality of life for Gypsies and Travellers

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Tunnels and Bridges - Accessing GP surgeries

Ben Chastney's picture
By Ben Chastney |  June 22, 2016 |

Leeds GATE have been toying with a concept to explain access to services and thinking about how different routes to these work or don’t work.  We got thinking about this when doing ‘asset mapping’; looking at what assets our members have and how we might use these.  What becomes clear is that some paths are smooth and clear, such as to x and y, and we can call these roads.  Some of the roads are broken though, such as to health services, and here the tunnels and bridges come in as differing approaches to the problem.


GP access is an interesting case, an obvious place where the road is broken for many.  Most notable are those members roadside or living on Council site who use care of addresses, whether of friends or of GATE, for registering with a GP.  This can be recognised as building a tunnel.  It is a tunnel to bypass a problem; that someone could not register at the nearest practice, in some cases any convenient practice, from their current living address. 


One issue created as we have found is that by using a care or address many members may not as reliably received, or opened and read, important correspondence.  We have sadly seen letters, such as about appointments or screenings, lost or picked up late.  It is at the very least inconvenient for members to keep calling or visiting friends or GATE to ensure they keep up with medically related mail. 


Beyond these complications we must recognise that the tunnel built does not directly and reliably get that member directly to the service they require.  True, they have been able to access a GP, but the surgery has not openly and formally taken them on from where the member actually lives.  The tunnel might also lead, quite literally, to a somewhere far away, with the care of address and therefore surgery being located at some distance. 


The bridge that we at GATE have been trying to bridge is to engage with GPs, challenging or encouraging them to register roadside or site based families currently using care of address.  This might be re-registering with the same surgery but allowing someone to use their actual address, or finding a surgery more convenient to the home.  The bridge is built through using other GP practices to support more positive community engagement or using a more challenging approach of noting guidance which demands equitable service provision.


We must lastly recognise that when building a bridge the foundations of the tunnel are damaged.  When a member requests to be correctly registered at their actual address, there is a risk to losing access to that surgery.  It is understandable therefore when someone choses to keep using the tunnel until forced otherwise, recognising that it is far from perfect but provides a route to the service required.  Others though are striving to register where they actually live; a bridge ultimately more equitable and sustainable than the tunnel.


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