Edinburgh Napier University

  Commissioned by NHS Hull, this project has four aims: a. to gather the views of asylum seekers and refugees in Hull about their lives, and health; b. to consult with all relevant agencies in the city concerned with the health and social care of asylum seekers and refugees; c. to identify best practice in asylum seeker and refugee care in other parts of the country; d. to propose a strategy for the health and social care of asylum seekers and refugees in Hull. We carried out extensive interviews with asylum seekers and refugees, and with service providers, and present the findings in chapters 2-4. While much good work is being done in Hull, we found evidence of many shortcomings, with asylum seekers finding it difficult to access primary care, and widespread examples of poor housing affecting health. Professional interpreters are not used as much as they could be, and felt the need for more training and support. Other cities which we visited had elements of exemplary approaches to asylum seeker care, notably Sheffield but also Bradford, Leeds and Birmingham (chapter 5) and we recommend the adoption of many of these methods. We draw attention to several important and authoritative reports, especially the three reports of the Independent Asylum Commission (6.4), and the two on destitution from the Joseph Rowntree Charitable Trust (3.1). Our recommendations (chapter 7) fall into two groups: strategic and operational. Strategically we recommend: 1. that NHS Hull and the Local Strategic Partnership create a Sanctuary Board (SB) under the main LSP Board, to oversee the proposed strategy for the health and social care of asylum seekers and refugees, with a small staff to support the work for change. 2. the wider use of the term “Sanctuary” instead of “asylum” (because of the latter’s negative associations in the public mind) and the promotion of Hull as a “City of Sanctuary”. 3. a city-wide educational programme for all NHS personnel, which the SB and its staff would action, The health and social needs of asylum seekers and refugees in Hull. - 7 - 4. better communication between agencies, both statutory and voluntary, leading to more “joined up working” across the sectors. This again would be a function of the new board. Operationally we propose: 5. minor changes to enhance existing TB screening, 6. the adoption of a local patient-held Personal Health Record, 7. changes to clinical recording to facilitate audit in Primary Care, 8. training and support for interpreters, 9. commissioning of specific mental health treatment for posttraumatic stress disorder (PTSD), 10. a new multi-media multi-language DVD welcome programme for all new arrivals, 11. greater involvement by the PCT in ensuring adequate standards of housing, 12. a greater focus on the needs of destitute people, 13. a review of family and child counselling services, and specific support for the Haven Project, 14. training of health staff in awareness of trafficking of adults and children, 15. an enhanced capitation fee for general practice care of asylum seekers for the first 18 months. The cost of implementing these recommendations is about £140,000, of which £70,000 is for the Haven Project, £35,000 for the PTSD service, and £22,000 for staff to support the proposed new Sanctuary Board. Some of this, such as the commissioning of additional mental health care, and the support for the interpreter service, may be recouped from the new Transitional Impacts of Migration Fund from the Department of Communities and Local Government. The educational recommendations should be implemented through the existing training structures, such as the “protected time for learning” for all primary care staff, but also by encouraging practice-based learning. After Wilberforce, who spent his life working towards the abolition of slavery, the city has an opportunity to address another humane goal, to welcome those seeking sanctuary from persecution around the world. “Humane Hull” would be a welcome label for this city, after Wilberforce.