The pilot started in October 2021 to assess the needs of asylum seeker and refugee children and adults, and improve access to health and social care. The service has seen approximately 1,200 people a year, for a one-stop nurse-led appointment, care planning and onward referral. The service has been featured in the BMJ: 'Why asylum seekers deserve better healthcare, and how we can give it to them'. (BMJ 2022; 376:n3069).
We offer a one-hour, one-off appointment with a nurse specialist in the community (contingency hotel or primary care), to asylum-seeking adults and children living in temporary home office accommodation in Camden, Islington, Haringey and Barnet.
The health needs assessment includes:
- Review of physical, dental, sexual and women's health, mental health and social, educational and developmental needs (for children)
- Height, weight and blood pressure measurement
- Full blood count, renal and liver profile, bone profile, vitamin D level, cholesterol, HbA1C
- Panel infection screening, based on up-to-date guidance and evidence:
- blood: schistosoma, strongyloides, hepatitis B and C, HIV, syphilis, tuberculosis
- urine: chlamydia and gonorrhoea NAAT (when appropriate)
- stool: parasitic examination.
Common onward referrals include primary care, mental health, musculoskeletal, paediatric, infectious diseases, safeguarding and third sector services.
An integrated care plan will be provided to the service user, GP and other appropriate professionals summarising results and actions, to ensure that information is available if the person is relocated.
The pilot will close on 31 March 2023 as planned. All other RESPOND services will continue to be available for this complex patient cohort. We are currently exploring funding options to deliver our Outreach Health Assessment and Care Planning pilot service in the longer term.
These UCLH/HTD-based clinics offer infection screening and treatment for asymptomatic individuals to all people migrating to the UK and living in all types of accommodation in any borough.
- UCLH family clinic: Families are seen together in one appointment at UCLH supported by both adult and paediatric services
- RESPOND Unaccompanied Asylum-Seeking Children service (UASC) - open to all unaccompanied asylum-seeking children and young people, in partnership with local Children Looked After health services.
- Hospital for Tropical Diseases infection screening and treatment for asylum seeking adult individuals
Panel infection screening includes:
- Blood: Schistosoma, Strongyloides, Hepatitis B and C, HIV screen, Syphilis, Tuberculosis
- Urine: Chlamydia and Gonorrhoea NAAT (when appropriate)
- Stool: parasitic examination.
Any infections identified will be treated in specialist clinics at UCLH or HTD. All results and actions will be shared with the service user, the GP and other appropriate professionals.
To refer to this service email uclh.
If you need advice and guidance on the management of an asylum-seeking or refugee person or family with complex health and wellbeing needs, the RESPOND multidisciplinary team (MDT) can help. This is a virtual forum, providing advice and support to health and allied professionals working with asylum-seekers and refugees of all ages, including lone adults, families and unaccompanied asylum-seeking children, and in all boroughs.
The MDT is held monthly via MS Teams and is hosted by a core panel of professionals with expertise in migrant health, adult and child refugee mental health and safeguarding. Additional input is provided from key partners across the network including community health services, primary care, social care and third sector organisations.
To refer, please email uclh.
- confirmation that patient/guardian consent has been gained for MDT discussion
- patient details, including borough
- the specific question you would like to bring to the MDT
- for cases external to the North Central London sector, details of any additional external professionals to invite, such as representatives from social care, school nursing and health visiting.
- your name, organisation and role.
Asylum-seeking and refugee general paediatrics clinic
This service offers general paediatric clinic appointments at UCLH to asylum seeking and refugee children. Children are seen by a dedicated team of paediatricians with expertise in asylum seeker and refugee healthcare and trauma informed care. Children may be referred to the RESPOND MDT for discussion if appropriate.
Children’s infection and tropical clinics
This clinic is for children requiring treatment of infections identified at screening.
This clinic is for children in a family group.
There is a need for greater understanding of the specific health needs of asylum-seekers, and the barriers and facilitators to accessing healthcare. RESPOND has close links with both London School of Hygiene and Tropical Medicine (LSHTM) and University College London (UCL). It is currently leading several research projects with the aim of providing crucial data on the health needs of this population and use of health services.
We are co-producing qualitative work with both service users and providers, to give much-needed insights into the experience of asylum-seekers when accessing the health system, and the staff who work with them. The RESPOND team deliver education and training in a variety of settings. For more information, get in touch by email uclh.
We have strong links with Hospital for Tropical Diseases Fellowship Scheme, which offers research opportunities for doctors in training. Please email davidajmoore1
Sanchez Clemente N, Cinardo P, Ward A, Longley N, Harkensee C, Eisen S . A whole-child, whole-family approach to health assessments for asylum-seeking children. BMJ Paediatrics Open 2022, 6 (1) e001575
The Forgotten People: Hepatitis B Virus (HBV) infection as a priority for the inclusion health agenda. In press
Farrant O, Eisen S, van Tulleken C, Ward A, Longley N. Why asylum seekers deserve better healthcare, and how we can give it to them. BMJ 2022; 376:n3069
Cinardo P, Farrant O, Gunn K, Ward A, Eisen S, Longley N. Screening for Neglected Tropical Diseases and other infections in refugees and asylum seeker populations in the UK: a review article. Therapeutic Advances in Infectious Disease 2022, Vol 9, 1-12
Sanchez-Clemente N, Eisen S, Harkensee C, Longley N, O’Grady R, Ward A. Beyond Arrival: Safeguarding Unaccompanied Asylum-Seeking Children in the UK. Archives of Disease in Childhood 2022; Jun 21:archdischild-2021-323648. doi: 10.1136/archdischild-2021-323648. Epub ahead of print. PMID: 35728940.
Armitage AJ, Cohen J, Heys M, Hardelid P, Ward A, Eisen S. Description and evaluation of a pathway for unaccompanied asylum-seeking children. Arch Dis Child 2022;107(5):456-460.
Williams B, Boullier M, Williams A, Ward A, Cricks Z, Naidoo R, Robinson K, Eisen S, Cohen J. Screening for infection in unaccompanied asylum-seeking children and young people. Archives of Disease in Childhood 2020; 105:530–532
Portnoy S and Ward A. Unaccompanied asylum-seeking children and young people – Understanding their journeys towards improved physical and emotional health. Clinical Child Psychology and Psychiatry 2020 Jul;25(3):636-647.https://pubmed.ncbi.nlm.nih.gov/32538134/
Greenwall L, Hurry K, Ward A, Eisen S, Longley N. Rapid response to Children’s oral health is “national disgrace,” says head of royal college. BMJ 2023;380:p5 (letter)
Why do some people receive holistic screens and others only infection screening?
This is related to current commissioning arrangements. We hope in the future to offer full holistic screening to all asylum seekers.
Can Ukrainian and Afghan refugees access RESPOND?
Those in the UK under a Government resettlement scheme cannot currently access the Outreach Health Assessment pilot; however, they remain eligible for all other RESPOND services.
I am interested in participating in the RESPOND Research Programme – how can I find out more?
RESPOND has wide ranging academic collaborations across multiple sectors and fields. To find out more, join one of our monthly Q&A sessions; email uclh.
I am a medical student – how can I get involved?
RESPOND is currently running several collaborations with medical students at UCL – email uclh.
Does RESPOND accept volunteers?
Unfortunately, at the moment RESPOND is not able to accept volunteers.