Engaging in a dialogue with the Luton Roma community on access to healthcare services and co-producing solutions.

Background: Luton, a super-diverse town in the East of England, is home to one of the largest Roma populations in the UK. Roma communities experience significant health inequalities, particularly in accessing healthcare services, contributing to poorer health outcomes. However, there is limited research on effective ways to engage Roma communities and address these disparities. This study aimed to explore the views of the Luton Roma community on accessing healthcare services and to co-develop solutions. Methods: A qualitative study was conducted using eleven focus groups with 64 participants. Discussions were transcribed verbatim and analysed using Thematic Framework Analysis. Findings: Three main themes emerged. First, key health concerns included maternity and child healthcare, dissatisfaction with emergency care, long waiting times, and perceived quality of care. Second, barriers to access comprised limited knowledge of services, language difficulties, the need to travel to Romania for care, and perceived discrimination from providers. Third, suggested improvements focused on raising awareness of services, providing language support, and ensuring culturally competent, compassionate care. Gender and age shaped healthcare experiences. Women emphasised caregiving responsibilities and communication challenges, while men highlighted work-related pressures and system-level issues. Younger participants faced digital literacy challenges, middle-aged adults navigated caregiving demands, and older participants reported cumulative discrimination and distrust. Conclusion: Improving healthcare access for Roma communities requires systemic, rights-based interventions addressing language, discrimination, and structural obstacles, rather than expecting individuals to adapt. Policy actions should include professional interpretation, culturally competent care, anti-discrimination mechanisms, and active Roma involvement in service design. Improving health-seeking behaviours among Roma communities requires attention to age and gender dynamics, as socially constructed gender roles and life-course experiences shape health perceptions, caregiving responsibilities, and engagement with healthcare services. Community-led models, such as Roma health mediators, are essential for building trust, bridging communication gaps, and promoting equitable health outcomes.