Abstract

Objectives
This review explored the perceived barriers and facilitators to accessing statutory and non-statutory health and social care services among disadvantaged populations in England. Community-based services delivered by statutory bodies and the voluntary, community, faith, and social enterprise (VCSFE) sector are critical for addressing social determinants of health, fostering resilience, and promoting equity. However, in disadvantaged areas, complex needs and structural exclusion frequently limit their effectiveness.

Methods
Co-produced with academics, VCFSE sector, and public contributors, this review synthesised qualitative research published since 2003, drawing on first-hand accounts of service users to explore how intersecting forms of disadvantage affect service access.

Results
The review identified four themes influencing access to community-based services among disadvantaged groups: structural and informational barriers, the impact of cultural, social, and economic contexts, institutional trust and continuity, and emotional motivators and barriers.

Conclusion
Improving access to community-based services requires structural and cultural alignment with users’ lives. Services ought to prioritise flexibility, trust, and navigational support while addressing emotional and institutional barriers.