Poverty Proofing health care: a qualitative study of barriers to accessing health care for low income families with children in Northern England

Poverty impacts negatively on children’s health and future life chances. Access to the UK’s National Health Service (NHS) is based on clinical need rather than the ability to pay but horizontal inequities in access exist. Children North East, a charity supporting children experiencing poverty, wanted to develop a Poverty Proofing© Health tool to help NHS services reduce the impacts of poverty on access. This study aimed to understand barriers to healthcare access faced by families living on low incomes to support development of the tool. Twenty parents and seven Voluntary Community Social Enterprise sector staff participated in qualitative interviews or focus groups. Data were analysed thematically, and three main themes were identified as impacting access to health care: hidden costs, securing appointments and developing relationships with health care providers. We conclude that low-income families experience both financial and other barriers to accessing NHS health care and that these barriers are exacerbated for low income families living in rural areas.