Provision of an Asylum Seekers Health Access Service to support Cardiff and Vale Health Inclusion Service

Description

The Cardiff and Vale Health Inclusion Service (CAVHIS) is a University Health Board (UHB) commissioned service for inclusion health groups that face significant challenges when attempting to access health and social care services. It is situated in the Cardiff Royal Infirmary and is managed by the Primary, Community, and Intermediate Care Clinical Board. The service currently provides: - Public Health screening for people seeking asylum and refugees (via Welsh Government resettlement schemes). - GP registration and access to medical, health visiting and midwifery for asylum seekers arriving via irregular routes under section 98 of the Home Office 1996 Immigration Act. This care is provided for up to 3-4 months whilst individuals are supported to transition into traditional primary care services. Permanent registration may be required for those who are not stable enough, or are too vulnerable, to navigate traditional GMS care (this may include destitute asylum seekers, individuals with No Recourse to Public Funds (NRPF) and vulnerable refugees). - Level of specialist nursing to work with people experiencing homelessness in and around Cardiff Council’s high need hostels. - GP outreach clinics into agreed Cardiff Council’s high needs homeless hostels. - Health inclusion nurses based in the Emergency Unit to support the management and timely turnaround of health inclusion groups who do not require admission. - An Alternative Treatment Service for individuals who have been de-registered from GP Practices due to risk of verbal/physical abuse. To widen the remit of the current CAVHIS service to serve all inclusion health groups the service is under development. In 24/25 the service aims to: - Introduce drop in health clinics run by GP/nurse at probation sites. - Provision of street based medicine to those unable to attend drop in clinics (e.g., mobile Gypsy Roma Travellers who have stopped for short periods). - Expand current resource in the Emergency Unit to provide 7 day coverage and a specialist multi-agency team to attend the wards 3 days a week to support with discharge of complex patients. Lot 1: Although CAVHIS provides care to a range of inclusion health groups, this project focuses specifically on asylum seekers, destitute asylum seekers, individuals with No Recourse to Public Funds (NRPF) and vulnerable refugees. People seeking asylum often arrive in Cardiff having experienced traumatic events in their home countries and on their journey to the United Kingdom. However, despite often having complex, unmet health needs access to and use of healthcare services is a significant challenge for this client group. Key barriers to healthcare include: - Lack of understanding of how the UK healthcare system operates - Language barriers - Cultural factors - Insufficient information in appropriate languages - Associated costs (i.e., mobile phone credit to make appointments or public transport to attend appointments). - Lack of tailored services - Negative experiences when attempting to access health and care services These barriers, accompanied with risk factors for poor health, result in significantly poorer health outcomes, putting those affected beyond the extreme end of the gradient of health inequalities. Therefore, the successful contract holder for commissioned service must be very experienced in meeting the needs of asylum seekers and refugees from both a legislative requirement perspective and possessing the ability to work proactively with individuals whose first language is not English and whose staff are trained/experienced in working with individuals who have experienced trauma, who have access to linked services that are relevant to Health Inclusion Groups. Given the issues outlined above, a level of core UHB funding has been secured to deliver a specialist asylum seeker health access project to support CAVHIS. The project will also be required to provide a level of support to identified GP Practices in the Vale of Glamorgan who are providing care to a growing number of asylum seekers/refugees. This aspect of the service is under development and will need to be agreed between CAVHIS, Vale GP Practices and the provider. Due to this the need for an existing strong working at the interface across CAVHIS, GP practice and clusters is essential