The study in Tameside is the first of its kind into travellers who are moved on every two to three weeks.

Other projects working on the health needs of travellers have concentrated on communities who are more or less settled in one place.

The Tameside project started 18 months ago.

It found that travellers had problems accessing primary health services and tended to rely on accident and emergency units and dental hospital for basic care.

Jane Hutcheson, the lead health worker on the project, said: "Primary health care is now very much appointment-based.

"Many travellers cannot read or write and they often do not know what time or day it is.

"An appointment card is meaningless. Times and dates are not part of the way they live."

No incentive

She added that, since the travellers were only temporarily in one place, there was no real incentive for primary care services to be more flexible.

The recommendations which came out of the project will be presented to Tameside and Glossop Community and Priority Services NHS Trust next week.

The project workers got in touch with travellers through the education service and tried to identify any health needs.

Their main recommendations include the need for an identified health visitor who can respond when the family arrives in the area and assess their health needs.

The ideal would be to identify a traveller-friendly GP practice.

Jane Hutcheson said that this might be more possible under the new primary care groups being set up across England and Wales next year.

"There may be more scope for commissioning special services under primary care groups," she said.

But a spokeswoman for the British Medical Association said she thought this might be over-optimistic.

"If there were more money for primary care groups there may be more scope, but as far as we know there is no largesse involved in setting them up.

"It will just mean redeploying staff who are already working for the health authority."

Vaccinations

Another recommendation from the report concerns vaccinations for children.

By the time clinics have arranged an appointment for children, they have often moved on.

"GPs tend to have an immunisation clinic once a month and this does not fit in with travellers who have to move on," said Ms Hutcheson.