Published: 17/03/2005, Volume II5, No. 5947 Page 32 33

Providing for communities with little access to health services is a must. But how do you achieve that for travellers who often have no permanent address?

St Albans and Harpenden primary care trust deemed this worthy of a fulltime staff member who comes in the shape of health visitor Rebecca Holt.

Rebecca, who has worked two days a week with travellers for the past year and a half, starts full time this month.

'Traditionally the work has been with the under-fives, but this post - specialist health worker for travellers - will allow me to work with the whole population, ' she says. 'It is a health visitor role, searching and identifying health needs in the community, but it will also involve more general nursing.' Rebecca quickly expressed an interest when she saw the post advertised. 'It was only when I had my interview it was explained that it would be exclusively working with travellers. I have always been keen to work to reduce health inequalities and work with marginalised groups.' Rebecca estimates there are around 300 travellers in the 10-mile radius in which she works, and they frequently do not have access to health services.

'There is a problem with getting the right treatment and prevention. Part of my new role is to have a very thorough health-needs assessment. We want to promote registration with a GP.' In a Department of Healthcommissioned survey into the health status of gypsies and travellers, published last October, many said they valued the specialist health visitor role highly, and considered them the preferred healthcare advocate.

'The continuity of care can be difficult. If a family is only staying here for six weeks, their medical notes can take time to be moved on. The provision of health visitors for travellers is scant across the country.

'There are issues around their experience of prejudice and discrimination. There is a familiarity with me being seen as somebody who is trusted and has helped them in the past: someone who is not judging them and understands them.'