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Kiran Kenth and Elizabeth Lawson-Bennett NHS Birmingham

Kiran Kenth and Elizabeth Lawson-Bennett NHS Birmingham. Sensitising Professionals and Volunteers Working in Health Services to the Needs of Immigrants & Migrants. Migrants – A Local Picture for Birmingham. Migrants are a heterogeneous group: Asylum Seekers Refugees Refused Asylum Seekers

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Kiran Kenth and Elizabeth Lawson-Bennett NHS Birmingham

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  1. Kiran Kenth and Elizabeth Lawson-BennettNHS Birmingham Sensitising Professionals and Volunteers Working in Health Services to the Needs of Immigrants & Migrants

  2. Migrants – A Local Picture for Birmingham • Migrants are a heterogeneous group: • Asylum Seekers • Refugees • Refused Asylum Seekers • Illegal Immigrants • Entry Without Visa Clearance/Undocumented • UK Boarder Agency (2009) - 3,453 supported Asylum seekers from 58 countries placed in Birmingham. • Iraq (468) • Zimbabwe (439) • Iran (356) • China (280) • Eritrea (229) • Pakistani (209) • Democratic Republic of Congo (204) • 170 different languages are spoken • 80,000 migrant workers based in Birmingham were issued with National Insurance Numbers (NINO’s) – fall in the number of NINO registrations for the 8 EU accession states (38 – 24%)

  3. Asylum Seekers supported by UKBA • Top 5 Nationalities Being Supported Under Section 95: • Zimbabwe (741) • Pakistan (302) • Afghanistan (250) • China (241) • Iran (217) • Top 5 Nationalities Being Supported Under Section 4: • Iran (501) • Zimbabwe (410) • China (440) • Iraq (646) • Somalia (239)

  4. Asylum Seekers by Gender and Age of Main Applicant

  5. Health Policy Context • Tacking Health Inequalities, Investing in Health 2 • DRE programme and National Indicators • World Class Commissioning • NHS Rights and Entitlements • Access to NHS care for foreign nationals

  6. Asylum Seeker Health Model • Specialist primary care service - Asylum Seeker Health Team (950 registered patients) • Asylum Seeker Health Screen – UK Border Agency Hostel for Newly Arrived • Partial integration with mainstream primary health care • £500,000 per annum investment by one PCT (but accessed on a pan-Birmingham basis) Main Areas of Consultation : • Acute episodes of poor physical health and/or mental health • Sexual health issues • Maternity care • Chronic dependence on drugs, alcohol or other substances • Chronic disease management/Need for medication for long term conditions • Follow up immunisations • Letters related to health for other agencies A Significant number of consultations require an interpreter

  7. Key Issues • Access to Services • Difficulties in accessing and registration with GP services, interpretation & language services and maternity services • Understanding of UK health system • Professionals unequipped to signpost individuals correctly • Health • Communicable Disease – TB and Immunisations • Sexual Health – FGM, HIV and other STI’s • Women's Health – late stages of pregnancy and maternity care • Long Term Conditions – Diabetes, Hypertension • Health promotion for new migrant communities – Drugs and Alcohol • Mental Health • Wider Impact • Language • Destitution and impact on health • Dispersal of asylum seekers • Lack of awareness on entitlements to health care • Irregular or undocumented migrants

  8. The Proposed Solution • Integrated Primary Care Services for newly arrived asylum seekers, refugees and economic migrants • Integrated Primary Care Services for those who have ‘No Recourse to Public Funds’ • Enhanced patient experience • Galvanisation of support available through all key stakeholders • Best possible start for newly arrived asylum seekers • Continued access to healthcare in the community on confirmation of asylum status • Utilising the skills and experience of existing staff and transferring this in to specialist coordinated care in the community

  9. Lessons Learnt • Performance Management – robust framework needed to demonstrate impact over time • Need – a successful service will have the ability to change and adapt according to identified need • Shared Ownership – generated from shared investment of resources • Communications – a successful service will be supported by an effective communications plan which targets patients, professionals and the general public

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