应根据个人的临床需求提供医疗保健并确定优先级，对吗？好吧，实际上取决于有关个人。至少，在许多最边缘化和服务不足的人的情况下，这种普遍的医疗保健政策通常不适用，他们的感染风险更高，非传染性疾病和暴力，但仍然面临严重的不平等，但仍面临严重的不平等现象访问护理。

一种workshop2017年10月4日在奥地利加斯坦（Gastein），带来了许多服务不足的团体的代表 - 即与男人发生性关系的男人（MSM），注射毒品（PWID），移民，性工作者，性工作者，囚犯和无家可归者的人 - 政策专家以及政策专家以及其他会议参与者确定护理障碍和政策解决方案的共同点。

Underserved, marginalised people are often referred to as ‘hard to reach’, whereas from the perspective of these individuals it is the services that are hard to reach

Underserved, marginalised people are often referred to as ‘hard to reach’, whereas from the perspective of these individuals it is the services that are hard to reach. Service design (or re-orientation) is crucial to take services out of hospitals and into community locations routinely used and trusted by service users – such as harm reduction centres, drop-in centres and homeless shelters. Services must be provided on a person-centred, flexible and non-judgemental basis, preferably with the involvement of peers to foster engagement and confidence among users.

理想情况下，此类服务应提供基于证据的健康促进，预防/减少损害，筛查，治疗和康复的整体连续性，这也解决了非传染性疾病，虐待和心理健康问题以及传染病。甚至更好的是，这些社区卫生服务应与社会支持服务进行集成或联系（带有明确的路标），以便在必要时可以解决住房问题和其他健康状况不佳的驱动因素。必须进行教育计划，以确保其他医疗保健专业人员更好地了解服务不足的团体面临的挑战，并改善对话和转介这些社区服务。

Examples of good practice already exist, such as the Shared Addiction Care Copenhagen (SACC）project in Denmark and the检查点希腊的中心和这些中心在EFHG研讨会上介绍。

鉴于健康和社会状况不佳的相互依存关系，健康和社会政策至少对健康和社会政策至关重要

国家或区域级的理由手艺人ng for such services follows both from a public health basis and from the human right to health. Integration, or at least alignment, of health and social policy is vital, given the interdependence of poor health and social conditions. Policymakers must also identify and address legal or bureaucratic barriers that dis-incentivise marginalised people from accessing care, such as requirements for fixed residency status, out-of-pocket payments and systems whereby healthcare access triggers criminal and immigration law enforcement. Crucially, affected communities must be engaged in policy and service redesign and delivery to ensure the services meet their needs.

欧盟可以通过战略和行动计划，基于证据的政策（例如，最佳实践的共享），结构改进（例如欧洲结构基金）和协调的疾病监视，通过其专业机构来支持这种范式的转变。

这些问题进一步探讨了article在特别的加斯坦版Eurohealthand will no doubt be a recurring them at future editions of the forum.