Associate Parliamentary Health Group
             16th June 2004

          Dr Astri Robinson
   Asylum Seeker Coordination Team
“...owing to a well founded fear of being persecuted
   for reasons of race, religion, nationality,
   membership of a particular social group or
   political opinion, is outside the country of his
   nationality and is unable, or owing to such fear, is
   unwilling to avail himself of the protection of that
United Nations 1951 Convention relating to the Status of
  Refugees (Geneva Convention)

 A person who has applied for refugee status (i.e. claimed asylum)
 under the Geneva Convention and is waiting for a decision from
 the Home Office


 A person accepted as a refugee under the Geneva Convention.
 This person will be granted indefinite leave to remain, permanent
 residency, and is eligible for family reunion - spouse and children
 under 18 also given indefinite leave to remain.


 A person granted the right to stay in the UK for 4 years as there
 are strong reasons against returning to the country of origin.

2003 49,370 applications (61,050 inc. dependants)
     Top 3 countries: Somalia, China, Iran

2002   84,130 applications (103, 080 inc. dependants)
       Top 3: Iraq, Zimbabwe, Afghanistan

2001   71,025 applications (91,600 inc. dependants)
       Top 3: Afghanistan, Iraq, Somalia

From April 2000 the National Asylum Support Service (NASS)
 has been responsible for the support of asylum seekers.
• Accommodation and subsistence
• Subsistence only (where choosing to stay with families)
• Specific grants e.g. maternity grants

Unaccompanied minors and those with special needs continue to be
  supported by local authorities.

Asylum seekers and refugees are entitled to full NHS provision.

Asylum seekers are a heterogeneous group,
Many are healthy but some have specific health needs
Many will have difficulty accessing NHS services appropriately due
  to lack of understanding or for cultural or linguistic reasons.

Historically there has been a considerable concentration of asylum
  seekers in London and the South East of England.
This puts a disproportionate pressure on services in these areas.

NASS disperses asylum seekers to areas where there is a ready
  supply of accommodation away from the South East.
                 INDUCTION CENTRES

A managed process giving intense support prior to dispersal.
In 7-10 days newly arrived asylum seekers receive:
• assistance completing the form to claim asylum (NASS1)
• briefing on the asylum process, rights + responsibilities in the UK

AIM: to reduce pressure on London and the South East by ensuring
  that people spend as short as time as possible in this area -

This prevents people from developing ties with local services and
  the local community and reduces the likelihood of return at a later
    INDUCTION CENTRES - health provision

All asylum seekers are offered an initial health assessment and
  screening for TB.
The assessment is recorded in a hand held record.

AIMS: Allow access to health care for immediate needs,
Reduce burden on dispersal areas by:
      carrying out an initial health assessment
      preventing exacerbation of health problems through delayed
                                                    access to care.
      flagging up chronic and non-urgent needs
Address individual and public health risks through screening for TB.
            INDUCTION CENTRES - rollout

East Kent

Pilot site opened June 2002. 3 sites 540 bedspaces. Dispersal across

Yorkshire and Humberside

Opened July 2003. 2 sites 105 bedspaces. Dispersal predominantly
  across Yorkshire and Humberside.

Greater Manchester

Due to Open July 2004. Distributed model. 250 bedspaces. Dispersal
  predominantly across Greater Manchester.
Asylum seekers are dispersed to „cluster‟ towns and cities across
  England and Wales.

NASS accommodation is given until final determination has been
  reached (Home Office decision made and, where appropriate, all
  rights of appeal exhausted).

Those given leave to remain are free to move around the UK, to find
  work and to access services on the same basis as other UK

Those whose application is rejected and who exhaust all subsequent
  rights of appeal are „failed asylum seekers‟. They are not able to
  reside in the UK legally and have limited access to services.
         DISPERSAL - spreading expertise
Refugee Health Conference
Hosted by Lambeth Southwark and Lewisham Refugee Health Team

Conference for GPs working with Asylum Seekers + Refugees.
Shepway PCT and DH.

Conference for nurses working with Asylum Seekers + Refugees.
Sheffield Health and DH

 “Caring for Dispersed Asylum Seekers: A resource Pack” DH
“Meeting the Health Needs of Refugess and Asylum Seekers in the
   UK.” Burnett and Fassil
              KEY ISSUES - Mental health

“Delivering Race Equality: A Framework for Action”

• Access to, and design of, health and social care services
• User and carer experiences within health and social care services
• Health outcomes

“Caring for Dispersed Asylum Seekers: mental health resource
           KEY ISSUES - Interpreting services
NHS Direct National Contract
• Telephone-based interpretation;
• Translation services;
• Remote based access to British Sign Language interpreters.

“Guidance on developing local communication support services and
• Analysis of existing provision
• Recommendations for commissioners/planners.

Multilingual phrasebook, over 60 of the most common medical
 questions for first contact staff. British Red Cross Society and DH., multilingual appointment card.

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