A critical interpretive synthesis of the constructed identities and experiences of refugees, asylum seekers, and undocumented migrants in relation to accessing primary care services in the UK.

Abstract

Refugees, asylum seekers, and undocumented migrants face significant structural and social barriers when accessing, or attempting to access, primary care delivered by the NHS in the United Kingdom. The aim of this research is to conduct a critical interpretive synthesis of primary research articles, identified via a systematic search of several online databases. This review approach was chosen in order to develop a new synthesis of the constructed identities and experiences of refugees, asylum seekers and undocumented migrants, and contribute to a further understanding of the barriers and facilitators that these populations face in relation to primary care access. This research used an interdisciplinary framework, guided by Penchansky and Thomas' theory of healthcare access, as well as Bhaba's, Spivak's and Berry's post-colonial theories. Differences in social cues, the impact of the past, and the role of communities are examples of the various barriers and enablers that refugees, asylum seekers, and undocumented migrants face in relation to primary care in the UK. This analysis generated a new model, the <i>Tangibility of Access</i>, which theorises that recognising the tangibility of various identities and experiences can provide a deeper insight into persisting barriers of primary care access. These findings highlight the implications of assuming the nature of identities and experiences in research, and identifying how differences in the knowledge of these vulnerable groups between research and policymaking can lead to continued difficulties surrounding primary care access. Further interdisciplinary research is necessary to determine the causal effects of deterrents to approaching primary care, and provide insights into how the quality of primary care can be improved, especially concerning intangible identities and experiences. A holistic perspective is needed to challenge assumptions regarding the identities and experiences of refugees, asylum seekers, and undocumented migrants, which may prove harmful to help-seeking behaviour if not confronted.