Travellers have been a part of British society for centuries. There are around 300,000 Gypsies and Travellers in UK (Matthews 2008).  Between 90,000 and 120,000 live in caravans in England and up to three times as many live in conventional housing (CRE 2006 cited in NEEDP 2008).

In North East England, the number of caravans has remained stable in recent years and this is similar for the Stockton Borough.  However, the future need for accommodation pitches with this community is expected to increase. Anecdotal information suggests that there are many in-house Gypsies and Travellers who live in Thornaby, Stockton-on-Tees.

A report into the health status of Gypsies and travellers in England finds that these communities have significantly poorer health than the general population (Parry et al 2004, Race Equality Foundation 2008).

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1. What are the key issues?

The Gypsy and Traveller community has worse health outcomes than the general population including:

  • Higher rates of self-reported anxiety, depression and low self-esteem
  • High suicide rates
  • High levels of stigma around mental health
  • High level of alcohol consumption in connection with mental health issues
  • Increased level of drugs use amongst men
  • Lack of knowledge of healthier lifestyles including alcohol units and diet and nutrition
  • High infant mortality
  • Life expectancy is 10 years less than for the general population.

These communities have poorer access to and uptake of services compared to the general population including: 

  • Lower uptake of immunisation and screening programmes
  • Lack of confidence and knowledge about how to access local services
  • Lack of cultural awareness among service providers.

Social issues are more common in these communities, such as:

  • Employment rates are low; and poverty high.
  • High levels of illiteracy due to poor school attendance and low education attainment.
  • Harassment and discrimination is common due to negative stereotypes and ingrained cultural prejudices.

Domestic violence is an issue locally, mainly in the form of verbal and emotional abuse.

There is a shortage of appropriate accommodation, including short-term tenancy pitches.

There is no reliable estimate of the number of people in the Gypsy and traveller community in Stockton.


Last updated: 24/08/15

2. What commissioning priorities are recommended?

Following re-assessment of need in 2015, no new strategic commissioning priorities have been identified.  However, while some progress has been made with previously identified commissioning recommendations, others remain a priority, as indicated.

Tackle wider determinants of health and well-being, in particular by addressing accommodation needs, employment and education.
Partially completed – education is supported via education improvement service with Stockton borough council and work to address accommodation needs is under development.

Avoid a ‘single provider’ approach and encourage the Gypsy and traveller community to access mainstream services, particularly screening opportunities and childhood immunisation services.  This could be achieved by having an individual with a Gypsy or traveller background providing advocacy support for the Gypsy and Traveller community.  Remains a priority.

Improve community knowledge of mental health issues
and reduce mental health stigma. Remains a priority.

Develop awareness of Gypsy and traveller cultural issues
within health and social service providers. Remains a priority.

Ensure continuity of substance misuse and mental health services
Completed – part of the care pathway.

Tackle domestic violence issues
within these communities. Remains a priority.


Last updated: 24/08/15

3. Who is at risk and why?

Evidences show that Gypsy and Traveller (GT) communities have worse health than that of the general population (Parry et al 2007; Race Equality Foundation 2008; EHRC 2009).

In General:

  • Life expectancy for GT is 10 years lower than the national average and infant mortality is twenty times higher than in the rest of the population.
  • Those living in a trailer on a council site or in a house are more likely to have long-term illness than those on a private site or on empty land. Chest pain, asthma and bronchitis are significantly higher.
  • GTs are more likely to be caring for a dependent relative as they would be ashamed to give any impression that they were unable or unwilling to look after their older generations.
  • More likely to experience social exclusion.



Children and young people:

  • The average age GT children drop out of school is 11 to 13 years olds. Reasons for drop out could be family mobility, gender roles, expectations, different views on age of maturity, concerns about sex education and peer influences (The Children Society, 2007). 
  • Fewer than 10% of GT children obtained five GCSEs A*-C grades including English and Maths, compared to a national average of 53%.
  • There is a rising trend of elective home education amongst Irish Travellers.
  • The GT expectation for adolescent males to be economically active at an early age and young females to care for the home and children.
  • They are also more likely to be identified as having special educational needs (SEN), and are four times more likely to be excluded form school as a result of their behaviour (DCSF, 2009; DE 2010).
  • Nearly two-thirds (63%) of young Travellers are bullied or attacked due to their identity (The Children Society 2007). Victims of race hate crime are largely unreported.
  • Low levels of immunisation for children due to high mobility and lack of continuous care or specialist health visitors for GT community.



  • Experience domestic abuse.
  • Have low uptake of screening services, including cervical screening
  • Hhave high rates of maternal death.


  • Reluctant to access services, particularly healthcare services, due to the health belief – self-reliance and staying in control – and attitude of acceptance of ill-health.
  • Have a higher risk of premature death from cardiac disease.


Last updated: 24/08/15

4. What is the level of need in the population?

A twice yearly count of Gypsy and Travellers Caravans that records the number of caravans on both authorised and unauthorised sites across England. The total number of caravans between 2010 and 2014 on authorised and unauthorised sites for Stockton-on-Tees fell from 60 (2010) to 45 (2014).  Sometimes there are a small number of caravans on unauthorised sites.

Total number of caravans on authorised and unauthorised sites, Stockton-on-Tees, 2010-14

Month /Year

Total number of caravans: authorised sites including local authority and private sites

Total number of caravans: unauthorised Sites

Total number of caravans

January 2010




July 2010




January 2011




July 2011




January 2012




July 2012




January 2013




July 2013




January 2014




July 2014




Source: Communities and Local Government, 2014


There is a lack of robust evidence about health outcomes for the local GT population in Stockton borough. Evidence about health needs for the local GT population is derived largely from national studies and local information is often anecdotal.  The Stockton Gypsy and Traveller substance abuse and mental health project identified the following themes:

  • Low self-esteem and depression occurs amongst women, particularly women aged 15-29; some of the reasons include expectations to stay at home and not being able to partake in activities outside GT culture.
  • Male members of the families feel a sense of pressure due to the financial expectation to bring home an income which in some cases results in substance abuse and alcohol abuse.
  • Lack of knowledge of healthier lifestyles including alcohol units and general dietary or nutrition information (easy read information will be recommended for GT due to high level of illiteracy). Younger generation trends to consume fast food rather than cook from basic ingredients. 
  • Advice and guidance for health intervention is not accessed due to lack of knowledge, privacy concerns and disclosure of financial information implications. External agencies in some respects are considered culturally unaware and the issue of mistrust / threat to GT culture have been identified.
  • Fear and a lack of knowledge about statutory services mean that they are often only accessed at a point of crisis.

Domestic violence is also an issues locally – it is mainly in the form of verbal and emotional abuse.


Last updated: 24/08/15

5. What services are currently provided?


  • There is a Specialist Community Liaison Officer within Stockton Borough Council to enable and support access to mainstream and special school provision and aim to improve education achievement of Gypsy, Roma and Traveller (GRT) pupils. The service supports attendance and provides an outreach to unofficial encampments, circus and fairground pupils.
  • Stockton Borough Council’s (SBC) mobile library services provide access to books and library services for all ages at the Bowesfield Travellers site.

Site and Accommodation

  • Stockton Council owns and manages a site for travellers at Bowesfield Lane, Stockton. The site has twenty-seven plots each looked after by a resident warden.
  • The Bowesfield Travellers site warden provides specific support for GT community in relation to accommodation issues.


  • The GP walk-in centre currently provides service for minor illness without an appointment.  If any traveller needs to consult a doctor in Stockton-on-Tees, this service will be accessible.  Stockton Recovery Service provides support to those with drug problems.
  • Lifeline Project provides support to adults with alcohol misuse and young people with alcohol and drug problems.
Last updated: 24/08/15

6. What is the projected level of need?

It is difficult to project the needs of the GT community due to limited evidence and information. However, the local GT Substance Misuse and Mental Health Project has identified a lack of knowledge of healthier lifestyles including alcohol units and general dietary or nutrition information in this community.

The Tees Valley GT Accommodation Needs Assessment (Brown et al 2009) identified an additional 34 residential pitches would be required in Stockton Borough for the GT community between 2007 and 2026.

While the Gypsy, Traveller and Travelling Showpeople Site Allocations Local Development Document (LDD) no longer exists, the Council is still committed to providing for the accommodation needs of Gypsies and Travellers, in line with national planning policy. The Council is to carry out a new comprehensive assessment into the accommodation needs of Gypsies and Travellers in the Borough and will then carry out a new search for sites. A timetable for this work has not yet been set, as it is intended that the Council will await the outcomes of a national consultation on changes to the current Planning Policy for Traveller Sites before proceeding with any further work.


Last updated: 24/08/15

7. What needs might be unmet?

Some members of the community lack confidence and knowledge on how to access mainstream services.

Harassment and discrimination is common due to negative stereotypes and ingrained cultural prejudges.

Some members of these communities lack appropriate access to and understanding of general lifestyle advice, including the alcohol units and dietary or nutrition information.

It is unclear what the uptake of GT on health and social care service are, including social housing because they are almost entirely absent from ethnic monitoring data collected by Housing Options, Social Care and Health setting.

Last updated: 24/08/15

8. What evidence is there for effective intervention?

Primary Care Service Framework: Gypsy and Traveller Communities, 2009

Department for Education: Improving the Outcomes for Gypsy, Roma and Traveller Pupils: Final Report, 2010

Communities and Local Government: Designing Gypsy and Traveller Sites: Good Practice Guide, 2008

Friends, Family and Traveller: Finding Health Care,  2014


Last updated: 24/08/15

9. What do people say?

Mental well-being is a common issue within the GT community, but due to their personal and collective pride, this subject is almost taboo:
‘If you say mental health to a gypsy man he’ll shut the door in your face! But we do have stress in our day to day life. We don’t know where to go to cope with bereavement.’

The GT community feels consistently stigmatised by wider society due to a lack of understanding of their travelling lifestyle, which they hold so dear. This perceived widespread attitude of ‘mistrust’ creates a barrier to engagement with this community, and they readily admit that ‘strangers’ are not welcome.
‘It’s an everyday occurrence to us (referring to societal prejudice). We’ve had it since being born and bred. It’s hardened the community.’ 

With regards to the continuity of health care, the community suggested ‘issue us with a card. If we move town, we could show the card to a new doctor’.

According to the Tees Valley GT accommodation needs assessment (Brown et al 2009) with a total of 61 respondents, just under half of the sample, wanted to see the development of more transit/short-stay sites in the Tees Valley area.


Last updated: 24/08/15

10. What additional needs assessment is required?

  • Evidence suggests that commissioners should avoid a single provider approach and encourage the Gypsy and Traveller community to access  mainstream services. However, it is unclear whether mainstream providers have the skills and competence to provide services for this population. Assessment is required to quantify the training required and to identify what kind of advocacy is needed in order to support this training.
  • Research is needed to understand about whether the GT lifestyle brings advantages in terms of well-being, and if so, how public services should support it.
  • Research is needed to understand whether it is a lack of services that are specifically provided for GT or a lack of evidence of the need for services for this group.


Last updated: 24/08/15

Key contact: Ruby Poppleton

Job title: Health Improvement Specialist


Phone number: 01642 526697


Brown P., Hunt L., Condie J., and Niner P (2009) Tees Valley Gypsy and Traveller Accommodation Needs Assessment. University of Salford and University of Birmingham

Cleemput V.P., Parry G., Thomas K., Peters J. and Cooper C. (2007) Health-related beliefs and experiences of Gypsies and Travellers: a qualitative study. Journal Epidemiol Community Health 61: 198-204

Communities and Local Government (2014) Traveller Caravans Count

CRE (2006) Common Ground: Equality, good race relations and sites for Gypsies and Irish Travellers. London: Comission for Racial Equality in NEEDP (2008) Equality in the North East: a statistical profile. Newcastle: Northumbria University.

Department for Education (DE) (2010) Improving the Outcomes for Gypsy, Roma and Traveller Pupils: Final Report

Equality and Human Right Commission (EHRC) (2009) Inequalities experienced by Gypsy and Traveller communities: a review. London: EHRC  

Parry, G., Cleemput P.V., Peters J., Moore J., Walters S., Thomas K. and Cooper C. (2004) The Health Status of Gypsies and Travellers in England. Sheffield: University of Sheffield.

Parry G., Cleemput P.V., Peters J., Walters S., Thomas K. and Cooper C. (2007), Health Status of Gypsies and Travellers in England. Journal Epidemiol Community Health, 61: 198-204

Race Equality Foundation (2008) Better Health Briefing 12: The Health of Gypsies and Travellers in the UK. London: Race Equality Foundation

Stockton-on-Tees Borough Council (2010) Traveller site contact

The Children Society (2007) This is who we are:  A study of the experiences of Roma, Gypsy and Traveller children throughout England. Leeds: The Children Society