Romanian trust and vaccine project

Healthwatch Waltham Forest and Healthwatch Newham undertook research into local Romanian residents' experience of NHS services, how they make decisions about their own health and attitudes to vaccinations.  They spoke to 104 people.

Key findings

Things that matter to Romanians in the UK

Being able to access care through a straightforward and predictable process; without excessive waiting times, excessive bureaucracy or gatekeeping.

Access to diagnosis and testing procedures (such as blood tests); understanding their health and understanding what their tests results mean.

Reassurance about concerning symptoms; understanding why they have a certain diagnosis and why a certain course of treatment is recommended.

Referrals to specialists; GPs and specialists working well together.

What Romanians appreciate about the NHS

Free service; absence of corruption and of the expectation to pay for services informally. 

Kind and supportive staff. 

Well-resourced hospitals; access to the latest technologies, especially for serious long-term illness such as cancer and heart disease. 

Good quality of treatment.

What concerns do Romanians have about the NHS?

Worry that the diagnosis process is too superficial; and that doctors don’t always know or understand their symptoms well enough. 

Poor communication between medical professionals and patients; and between services (for example, between GPs and specialists). 

Long waiting lists, especially for children’s health. 

User-unfriendly, frustrating booking systems. 

Feeling like they don’t have a choice about what kind of treatment they are getting and from whom; not feeling involved in decisions about their own care. 

Poorly organised services; admin , planning and punctuality.

Vaccinations

Vaccination is a divisive topic for the Romanian community, and some vaccines are trusted more than others: childhood immunisations and vaccines that have been around for a long time are more trusted; the Covid vaccine and newly introduced vaccines, in general, are less trusted.

Social class and education are important determinants of attitudes towards vaccines: people in middle class (ABC1) occupations are more likely to be vaccinated and to have a positive opinion of vaccines than people in working class (C2DE) occupations; and those who speak English are more likely than those who don’t.

Vaccine sceptics are most likely to be aged 35 - 49; parents and either Roma or Moldovan, in working class or gig economy jobs.

Vaccine sceptics are consumers of information that they themselves say they distrust, including online content and social media. They are more likely to attend religious services, but less likely to trust priests or religious leaders when it comes to information and advice about health.

They are more likely than pro-vaccine respondents to shop in local Romanian or Eastern European shops. They are less likely to consume media (TV, news articles) in English. They are more likely to keep in touch with friends and family who live in Romania. They are less likely to trust their GP or the NHS, but do trust Romanian medical professionals.

Key messaging strategies that would work for them include:

• Emphasising personal choice
• Putting a human and personal face on the message
• Combine information about vaccines with other types of health information
• Focus on earning and building trust

Wider determinants of health

• A healthy diet is by far the greatest aspect associated with living a healthy life. Public health measures aimed at supporting healthy diets should take into account the practical challenges faced by Romanians in the UK: 
• The cost of living crisis is affecting food prices; especially for healthy ready meals that don’t require complex or lengthy cooking. 
• Overcrowded housing/living with multiple housemates may make it more difficult to cook at home. 
• Overwork and/or unstable shift work (e.g in construction, warehouses, cleaning, personal care) may make it more difficult to cook and eat at home, increasing dependency on unhealthy fast food.