Horizon CDT Research Highlights

Research Highlights

Integrating digital technology and co-creation approaches to improve healthcare research and access for marginalised communities

  Jonathan Chaloner (2022 cohort)   www.nottingham.ac.uk/computerscience/people/msxjc24

In 2022, for the first time since the United Nations was established, the global rates of forcibly displaced migrant populations exceeded over 100 million1. Of that population, it is estimated that approximately 388,000 foreign-born people migrated to the United Kingdom (UK) in 2019 seeking asylum and refuge, according to Oxford University’s Migration Observatory 2. As a result of the UK government’s anti-migration policies, known as the ‘hostile environment’ 3, previous research has shown that many of these undocumented migrants experience difficulties, issues and a lack of trust when accessing the most basic healthcare services permitted to them in law, including seeing a general practitioner (GP), also known as a family doctor in other parts of the world or primary care in the medical field. This previous research has indicated that due to these migrants’ precarious legal status, many undocumented migrants don’t feel safe to see their GP due to the potential risks of personal information and data leaks used for immigration enforcement4,5. Other research has found that many GPs also find it difficult to treat these patients due to the extra time and resources required for consultations due to language barriers a lack of trust and importantly lack of health records6. As a major priority of the World Health Organization (WHO) to improve the health of everyone across the globe7, access to primary care is considered an essential need to meet the globally agreed Sustainable Development Goals (SDGs) of ‘Leaving No One Behind’8

With smartphones becoming recognisably more important technologies to help assist migrants access health information and store personal data related to their migration journey9, a small number of other researchers in Europe10,11 have examined the possibility of integrating mobile phone apps and technologies into helping migrants access healthcare. While many of these studies have been important to understanding how mobile phone technologies can be helpful in improving and integrating access to healthcare for migrants on the move, there are currently no studies in the UK which have been conducted focused on improving access to GPs. 

The objective of this research study is to investigate how mobile phone technologies can be integrated into the National Health Service (NHS) to help these undocumented migrants improve access to GP services in the UK. In order to conduct this research, I will be carrying out a mix of research methods including one-to-one interviews and another research method called ‘co-design’, which is the development of an existing health records app designed in collaboration for and by undocumented migrants themselves. 

The main aim of this study is to improve our academic and industrial understanding of how app developers and healthcare systems like the NHS can improve and integrate these underserved communities into technological developments such as app creation using novel research methods such as co-design.

This research is supported by one of the UK’s leading health records providers to GP surgeries, The Phoenix Partnership (TPP) which is currently responsible for over 40% of GP health record systems in the UK.


  1. Taylor D. Number of displaced people passes 100m for the first time, says UN | Global development | The Guardian [Internet]. The Guardian. 2022 [cited 2022 Dec 27]. Available from: https://www.theguardian.com/global-development/2022/may/23/total-displaced-people-now-at-staggering-milestone-of-100m-says-un
  2. The Migration Observatory. Asylum and refugee resettlement in the UK - Migration Observatory - The Migration Observatory [Internet]. Briefings. 2023 [cited 2023 Mar 13]. Available from: https://migrationobservatory.ox.ac.uk/resources/briefings/migration-to-the-uk-asylum/
  3. The Joint Council for the Welfare of Immigrants. The Hostile Environment explained | Joint Council for the Welfare of Immigrants [Internet]. 2022 [cited 2023 Feb 20]. Available from: https://www.jcwi.org.uk/the-hostile-environment-explained
  4. Chaloner J, Baggaley RF, Ryan B, Nellums LB, Pareek M. Deter or dispose? A critique of the relocation of asylum applicants to Rwanda and its public health implications. The Lancet Regional Health - Europe. 2022;18. Available from: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(22)00136-3/fulltext
  5. Nellums LB, Powis J, Jones L, Miller A, Rustage K, Russell N, et al. “It’s a life you’re playing with”: A qualitative study on experiences of NHS maternity services among undocumented migrant women in England. Soc Sci Med. 2021 Feb 1;270:113610. Available from: https://pubmed.ncbi.nlm.nih.gov/33383485/ 
  6. Saleh S, el Arnaout N, Faulkner JR, Sayegh MH. Sijilli: a mobile electronic health records system for refugees in low-resource settings. Lancet Glob Health [Internet]. 2019 Sep 1 [cited 2022 Dec 16];7(9):e1168–9. Available from: http://www.thelancet.com/article/S2214109X19303341/fulltext
  7. World Health Organization. Primary care [Internet]. Primary Care. 2020 [cited 2023 Mar 13]. Available from: https://www.who.int/teams/integrated-health-services/clinical-services-and-systems/primary-care
  8. UN Sustainable Development Group. UNSDG | Leave No One Behind [Internet]. 2023 [cited 2023 Mar 13]. Available from: https://unsdg.un.org/2030-agenda/universal-values/leave-no-one-behind
  9. Alencar A, Kondova K, Ribbens W. The smartphone as a lifeline: an exploration of refugees’ use of mobile communication technologies during their flight. https://doi org.nottingham.idm.oclc.org/101177/0163443718813486 [Internet]. 2018 Nov 30 [cited 2023 Feb 26];41(6):828–44.
  10. Chiesa V, Chiarenza A, Mosca D, Rechel B. Health records for migrants and refugees: A systematic review. Health Policy (New York). 2019 Sep 1;123(9):888–900. Available from: https://www.sciencedirect.com/science/article/pii/S0168851018306821
  11. Stowell E, Lyson MC, Saksono H, Wurth RC, Jimison H, Pavel M, et al. Designing and evaluating mHealth interventions for vulnerable populations: A systematic review. In: Conference on Human Factors in Computing Systems - Proceedings. Association for Computing Machinery; 2018. Available from: https://dl.acm.org/doi/10.1145/3173574.3173589 

This author is supported by the Horizon Centre for Doctoral Training at the University of Nottingham (UKRI Grant No. EP/S023305/1).