The Impact on and use of the UK’s National Health Service by New Migrants

The completed thesis is available to download

Background: The UK is witnessing a new era of immigration, yet little is known about the implications for the UK’s National Health Service (NHS). There is speculation that migrants, particularly from resource-poor countries, place a disproportionate burden on services; the Government has responded by announcing more restrictive policies to control and limit free access to the NHS. These and other factors may influence how migrants use health services. The overall aim of this thesis is to provide information about the impact on and use of health services by new migrants.

 Results: Increasing immigration is impacting on the NHS. The hospital-based studies found a diverse range of migrants, from both resource-rich and resource-poor countries, who present a substantial workload (40-50% of presenting patients). At the Infectious Diseases Department migrants presented with a broad range and more severe spectrum of diseases than UK-born patients. New migrants use services in ways that differ from UK-born patients, some reporting very low levels of GP registration (32%). This may be explained by the different approaches adopted by GPs: 66% of practices surveyed operated identification systems, which may result in exclusion of new migrants from registration. The qualitative work highlighted that new migrants face unique barriers to care, of which a lack of entitlement to free health care is perceived to be a growing issue, and these factors have important influences on service use and health outcomes.

Conclusions: Use of services by new migrants is influenced by a range of personal and organisational barriers. Strengthening community-based approaches and the delivery of more appropriate services to new migrants could alleviate pressures on hospital services and improve health outcomes.