Gypsy, Roma & Traveller Engagement Project
2026
Independent evaluation of NELCA's Gypsy, Roma and Traveller Engagement Project, a pilot pairing community Health Champions with cultural awareness training for NHS staff
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Full reportWe evaluated the North East London Cancer Alliance's (NELCA) Gypsy, Roma and Traveller (GRT) Engagement Project, a pilot delivered with Friends, Families and Travellers and the Roma Support Group. GRT communities experience some of the most severe health inequalities in England, with life expectancy up to 12 years lower than the national average, lower cancer screening uptake, and later diagnosis. Barriers include discrimination, digital exclusion, literacy, and difficulty registering with a GP. The pilot took an evidence-based dual approach: training Community Health Champions from Roma, Irish Traveller, and New Traveller communities, and delivering cultural awareness training to NHS and healthcare staff across North East London.
Our Approach
The evaluation combined quantitative and qualitative methods to understand impact on Health Champions, their communities, and healthcare professionals.
Quantitative Data Sources:
Pre/post surveys with Health Champions (n=13)
Pre/post surveys with healthcare professionals attending cultural awareness training (n=92 before, n=32 after)
Qualitative Data Collection:
A feedback workshop with Health Champions
An artist-led co-design workshop with Health Champions, resulting in an artwork celebrating their work, led by Robert Czibi, a visual artist of Roma heritage
In-depth interviews with healthcare professionals (n=6)
A reflection workshop with the delivery team (FFT, RSG, NELCA)
A literature and evidence review
This combination let us measure change in knowledge, confidence, and practice, while capturing the personal and often unrecognised value of peer-led engagement for both Health Champions and the professionals they worked alongside.
Key Findings
Thirteen Health Champions, three accredited courses
Thirteen Health Champions were recruited across Roma, Irish Traveller, and New Traveller communities, with FFT and RSG essential to recruitment and access. All 13 completed Level 1 and Level 2 RSPH-accredited training in health improvement and behaviour change (equivalent to a GCSE), plus cancer awareness training covering breast, bowel, cervical, and lung cancer. Champions rated the training highly, valuing the culturally safe environment and the chance to learn alongside people from different GRT backgrounds: "Even though we're different, I saw how much we have in common and learned a lot from others."Substantial gains in health knowledge and literacy
Champions' awareness of health services with high or very high ratings rose from 25% pre-training to 92% post-training. Correct knowledge of cancer screening eligibility rose sharply too: from 50% to 92% for cervical screening, 25% to 92% for breast, and 0% to 73% for bowel. All 13 Champions felt able to make positive lifestyle changes after training, and several reported real changes of their own, including weight loss and cutting down on smoking and energy drinks.A "community multiplier effect"
Champions didn't just gain knowledge, they spread it. Confidence discussing cancer screening with others rose from 58% to 92%, and confidence helping someone access a screening service rose from 50% to 92%. Champions supported family and community members with lifestyle changes, GP registration, and understanding their rights, and in some cases directly challenged discriminatory practice.Recognition, confidence, and professional identity
Being paid, trained, and accredited had a marked effect on how Champions saw themselves. Delivery partners described them as gaining "the positive self-perception of being a HC," and Champions spoke of feeling treated, and therefore feeling, like professionals. Skills gained included public speaking, advocacy, and practical working skills such as invoicing. Sustainability remains a challenge: Champions and partners flagged limited NHS pathways to keep them engaged after the pilot ends.Healthcare professionals: real shifts in awareness and practice
92 healthcare professionals, from GP receptionists to nurses, social prescribers, and public health practitioners, took part in cultural awareness training delivered by FFT and RSG alongside Health Champions. Awareness of the issues faced by GRT communities rated "good" or "expert" rose from 5% to 56%, while minimal awareness fell from 53% to 16%. Nearly three-quarters rated the training "excellent," and Champions' lived-experience contributions were consistently named as the most valuable part: "Champions helped us understand the reality behind the statistics." Professionals reported concrete intentions to change practice, from giving patients more time to consult family before consenting to immunisations, to sharing what they'd learned with colleagues.Health Champions as bridge-builders
Professionals described Champions as bridge-builders, trust-holders, navigators, and cultural intermediaries, people who could translate not just language but context, and who signalled that the NHS was serious about engaging GRT communities. The main barriers to sustaining this were structural: unclear role definitions, no dedicated coordination time, and limited long-term visibility for the role.
Recommendations
For Health Champions: sustain and formally recognise the role through paid positions, supervision, and pathways into permanent NHS roles; provide refresher training and cross-community peer learning; embed the role in NHS or community initiatives with clear guidance on confidentiality and expectations; and document impact systematically (behaviour change, community engagement, health literacy).
For GRT communities: expand peer-led engagement, using Champions as trusted intermediaries for screening, prevention, and rights awareness; co-design culturally relevant resources (leaflets, videos, events); address structural barriers such as mobility, digital exclusion, and literacy; and track the multiplier effect, including lifestyle change and healthcare engagement beyond the Champions themselves.
For health professionals and the system: embed Champions in NHS pathways with clear referral routes and role boundaries; include GRT history, culture, and structural barriers in vocational and CPD training; secure multi-year funding and coordination support rather than one-off delivery; and implement GRT ethnicity coding to properly monitor service access, screening uptake, and reach.
“To realise the scale of what these communities have endured. No wonder they mistrust services..”
Health professional who took part in the GRT awareness training
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