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«Policy HR / Workforce Performance Management IM & T Planning Finance Clinical Partnership Working Document Purpose For Information ROCR Ref: Gateway ...»

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Caring for Dispersed Asylum Seekers Evaluation Monthly quantitative data is collected on referral and patient numbers, client ethnicity, unmet requests, complaints, etc. and these are presented as part of a quarterly service performance report. Qualitative feedback on service delivery is also obtained through annual surveys or focus groups with both users and staff.

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Refugee Health Team (RHT) – Community Health South London Trust Carmen Rojas, Team Leader, The Refugee Health Team, Masters House (First Floor), Dugard Way (off Renfrew Road), Kennington, London SE11 4TH. Tel: 020 7414 1507, Fax: 020 7414 1513 E-mail : carmen.rojas-jaimes@lambethpct.nhs.uk Aims Improve knowledge and understanding of the NHS by refugees and asylum seekers by working directly with

refugee community organisations, local hostels, colleges and individuals. The RHT achieves this by:

• Empowering refugees and asylum seekers with information on primary health services, availability of local health centres and rights of refugees to use these services.

• Providing individual support to patients, facilitating access to services, sign posting and making appropriate referrals. The team has a limited caseload of complex cases.

• Planning, organising and delivering information sessions, seminars/workshops and training for refugees and asylum seekers attached to refugee community organisations (RCOs), day centres, residents of local hostels, ESOL classes, etc. Sessions are delivered in relevant language or using an interpreter. The team works with other NHS services to deliver sessions when appropriate, such as HIV, TB, chiropodists teams, etc. Offers telephone/group, advice and support.

• Developing/increasing RCOs health capacity by:

– training community workers, volunteers and be-frienders on health issues, health access and refugee’s issues.

– establishing partnerships with RCOs in the delivery of health advice and in appropriate community setting.

– producing health information tools, Health information folder for communities, that helps community groups to have relevant information available for their day to day work.

• Production and distribution of appropriate and culturally sensitive information leaflets on a variety of health issues on primary health care services and refugees and asylum seekers rights to use them.

Using English as Second Language (ESOL) classes as an opportunity to cascade information about the project and health issues for Asylum Seekers/Refugees. Partnership with ESOL staff has led to inclusion of health access and topics in their programmes.

A comprehensive Welcome Pack is available in a variety of languages containing the following:

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Caring for Dispersed Asylum Seekers Advice Services; Day Centres; Education Departments; Social Services and Refugee and Voluntary Organisations outside London.

Provides advocacy and interpreting service to users of primary and community services in the City and Hackney area, and Homerton University Hospital. Service operates 9.30 – 17.15 Monday to Friday. An out of hours telephone interpreting service is provided to GPs by Newham Language Shop funded by the PCT.

The team is reviewing this information to produce a second edition.

Improve knowledge and understanding of refugees and asylum seekers by the NHS service providers :

• Working with GPs, health visitors, hospitals and NHS agencies to improve understanding of the reasons why refugees and asylum seekers have difficulty accessing health services and what are their major health issues. This is done through support to health providers in the delivery of services, especially in primary care.

• Organising seminars/workshops and training for health workers on Refugee Awareness, NASS support, cultural issues and health needs.

• Offer telephone/group, advice and support.

• Working with the Local Authority Asylum Teams to improve the ability of asylum seekers without access to welfare benefits to access health services.

• Co-ordinating and networking with other organisations, key people and agencies across Lambeth, Southwark and Lewisham who work with refugees and asylum seekers, to improve co-operation and collaborative working. One example of these, is the ‘NASS liaison meeting’ where local NHS agencies, key local agencies and NASS representative meet to identify solutions to local concerns. Partnership working is a key theme to this project.

• Influencing national agenda by participating in national forums such as NRIF sub committee of Health and Social Care.

The RHT jointly with St Thomas, Guys and King’s Medical school runs a special study module “Who cares about refugees: the community response.” This was done by third year medical students through a one-day involvement with a Refugee Community Organisation. A member of the team was involved during their assessments. The course was run for 3 or 4 years, and it may inspire the development of similar courses in other medical schools.

Funding This project is funded through Lambeth PCT. The Refugee Health Team is a multicultural team, which is part of the Three Boroughs Primary Health Care Team.

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Consultation with asylum seekers

4.41 Involving local refugees and asylum seekers, and refugee community organisations (RCOs) can help agencies deliver services more effectively. However consultation with asylum seekers and RCOs is currently limited. Organisations should ensure that the mechanisms already in place to consult service users can be adapted and used to consult asylum seekers as appropriate.

Caring for Dispersed Asylum Seekers

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More information can be found in ‘Strengthening Accountability – Involving Patients and the Public, Policy and Practice Guidance’. In this practice guidance there is a section on how to reach your target audience i.e. issues and strategies to start thinking about the diverse ways, needs and issues engaging people. More information is available at www.doh.gov.uk/involvingpatients/strengthaccountpolicy.pdf 4.43 A local Compact should be an integral part of the on-going consultation and involvement process of monitoring, reviewing and implementing service changes. It is a mutually agreed framework that sets out the principles and undertakings that should underpin the relationship between the local voluntary, community and statutory sectors and is a useful framework for local stakeholders to agree local solutions to local issues. Local compacts will be one mechanism that NHS organisations will be able to demonstrate their compliance to the new duty see paragraph 4.42. NHS organisations signed up to a Local Strategic Partnership (LSP) will already be working within, or towards establishing, a local compact. For more information contact your Strategic Health Authority, Patient & Public Involvement lead or you can visit www.doh.gov.uk/compact and www.thecompact.org.uk

Caring for Dispersed Asylum Seekers

Refugee Health Professional Adaptation and Employment Project 4.44 There are clear economic and social benefits in supporting refugee health professionals back into employment in their professions. Vacancies in the NHS can be filled from a pool of local, skilled and experienced staff with a significant economic advantage. The estimated cost to train a refugee doctor to re-qualify in the UK is £3,000, compared to £200,000 to train a medical student. The Department of Health has recognised this by investing £1million over the past two years and a further £500,000 in 2003/4 in local projects designed to help refugee health professionals meet the necessary criteria for employment in the NHS. The Department is now developing a system of support for refugee health professionals, built into mainstream workforce development systems, and drawing on the lessons learned from the projects. The aim is to ensure that refugees have access to the same support as any other NHS employee or potential employee, while ensuring that their special needs are met.

4.45 Employing health professionals from local communities also facilitates access to providing comprehensive healthcare to these communities, where language and cultural difficulties may otherwise be barriers. Local people may also remain in posts for longer. Refugee health professionals may also contribute to the NHS workforce by raising awareness of refugee issues amongst other members of staff.

4.46 The case studies on the following pages outline examples of projects aimed at refugees and asylum seekers who are qualified health professionals.

Redbridge and Waltham Forest, Refugee Health Professional Initiative Rada Daniel Redbridge PCT, Beckett House, 2–14 Ilford Hill, Ilford, Essex, IG1 2QX Tel: 020 8926 5241 The projects is aimed at refugees and asylum seekers who are qualified health professionals (e.g. doctors, nurses, dentists etc) overseas and want to work in their profession in the UK. The Refugee Health Professionals Project supports refugee and overseas qualified health professionals through the re-qualification process so they can work in the NHS.

The Refugee Health Professionals Project provides:

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Refugee Doctors Database Project Deng Yai, Employment and Training Policy Adviser, The Refugee Council, 3 Bondway, London SW8 1SJ Tel 020 7820 3138 The refugee doctors’ database is a project organised by the Refugee Council and the British Medical Association. This is a voluntary database. Any details they send are confidential and are only shared with named organisations.

Aims of the project The main aim of the project is to set up a voluntary database for medically qualified refugees in the UK. It will identify the professional development, training and retraining needs of medically qualified refugees and facilitate the process of referral to service providers and in so doing accelerate their return to the profession.

The database is used to send refugee doctors information, which will help them as they prepare to continue their medical careers in the UK.

The database will collect information on:

• How many refugee doctors are in the UK?

• In which cities are the refugee doctors living?

• At what stage of their career are they?

• What help do they need?

The organisations working with this group will be able to target the right information and assistance, in the right areas. The database will also be used to send refugee doctors information which will help them to continue their career in the UK, such as meetings for refugee doctors, study groups and new projects for refugee doctors in their area.

5. Overview of Social Care Legislation

5.1 The role of the local councils with social services responsibilities in relation to asylum seekers has changed rapidly since 1996. Prior to then asylum seekers accessed services in the same way as the rest of the population.

5.2 Between 1996 and 2000, with the help of a grant from central government, councils provided accommodation and food to destitute in-country asylum seekers. The duty towards those already supported at 3 April 2000 continued under the interim arrangements. However when a person is eligible for support from NASS, councils are no longer permitted to house him or her. Specifically, the Immigration and Asylum Act 1999 excludes asylum seekers from services where the need arises ‘solely out of destitution or the effects of destitution’. In 2002 the Law Lords; in the case of Westminster City Council vs NASS, confirmed that where destitute asylum seekers have care needs, councils should both accommodate and provide services for them.

5.3 Where adult asylum seekers are destitute they should generally be accommodated by NASS.

Many forms of social care support, including accommodation under section 21 of the National Assistance Act 1948, are cut off from persons subject to immigration control (including asylum seekers) by sections 116 and 117 of the Immigration and Asylum Act 1999. However, where destitute asylum seekers have assessed care needs for which councils may provide community care services, no matter whether these care needs in themselves fall within or outside councils’ eligibility criteria, councils should accommodate such asylum seekers under section 21 of the 1948 Act. The services provided must be sufficient to address their needs including their accommodation needs, as they are cut off from all other means of support. The Department of Health and the Home Office are considering the implications of the Law Lords judgement in the Westminster City Council v NASS case in this respect.

5.4 The Immigration and Asylum Act 1999 introduced new arrangements, administered by the Home Office, for the reception and dispersal of all new asylum seekers from 3 April 2000.

Under these arrangements NASS has provided support and accommodation while asylum applications are considered.

5.5 On January 8 2003, the Nationality, Immigration and Asylum Act 2002 (the NIA Act) came into force. Section 54 of, and Schedule 3 to, the Act cut off a range of social care services, including residential accommodation under section 21 of the National Assistance Act 1948,

from:

• individuals with refugee status in other EEA countries,

• citizens of other EEA countries (except for workers, former workers and their dependants, and students in certain circumstances),

• failed asylum seekers who have not co-operated with removal directions, and

• individuals who are unlawfully in the UK.

Caring for Dispersed Asylum Seekers

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