A lack of appropriate access to health care is one of the main barriers that refugees face

Young male leaning on fence looking out at river

‘I do not ask for services, I would like to, but I don’t know what to request or how to initiate a request. I do not know who the service providing agencies are. I’m disabled and sitting at home’ - Disabled asylum seeking adult

Health care barriers

  • Refugees and asylum seekers may not know what services are available to them, or they will not be familiar with services that are very different to those in their home country
  • Language and cultural barriers can cause great concern and misunderstanding for families, particularly if medical terms are misunderstood or do not exist in other languages. This is common with some learning disabilities and mental health problems
  • Be careful not to use too much terminology and jargon. Some terms are not recognised in other languages and can cause worry and confusion that can prevent families from accessing support, i.e. ‘GP’ may not be recognised, use ‘Doctor’ instead
  • There is stigma surrounding particular types of ill health and disability. Differing views and attitudes between the health worker and the patient could impact upon treatment and support provided.
  • Asylum seekers living with ill health and disability may not disclose health condition and any care needs, as they may fear that it could impact upon their asylum claim
  • Some asylum seekers live in extreme isolation which can have a significant impact on their physical and mental health.

Solutions to these barriers

Barriers to health care for a disabled or ill person could result in children and young people in the family taking on inappropriate caring roles and responsibilities in the absence of adequate statutory service support.

Effective support enables refugees and those seeking asylum to find the information they need, access services and become more confident in advocating for themselves and their families. This can be achieved by:

  1. Providing information and guidance on how the NHS works, such as appointment systems, waiting lists and prescriptions. This information needs to be made available on arrival.
  2. Providing health and disability information in other languages.
  3. Providing translated materials­, organise for interpreters to attend appointments or use Language Line­. Children should not be used as informal interpreters for other family and community members as this may be inappropriate and create safeguarding issues. Train staff in the effective use of interpreting services for multi-lingual services.
  4. Offering routes for obtaining interpreting services for medical appointments should be agreed and clarified for all medical practitioners. The interpreting service should be booked by the receptionist prior to the appointment.
  5. Being aware of your own cultural assumptions and how these may affect your responses to people from different ethnic groups.
  6. Health workers and social care workers should be trained, even to a basic level, about different cultural needs in their local area.
  7. Consulting with service users to ensure that the views and experiences of different groups within ethnic communities, including asylum seeking families, are taken in to account to support the planning and development of accessible services.
  8. Working in partnership with black and minority ethnic communities to provide and advocate for appropriate health services and facilities.
  9. If asylum seekers and refugees are having difficulties registering with a GP, the local Clinical Commissioning Group can provide a list of practices to which they can apply. They also have the power to allocate them to a GP Practice if they have had their application to join a practice refuse.
  10. Identifying resources available, locally and nationally, to support people from refugee and asylum seeking backgrounds.
  11. The specific needs of asylum seekers and refugees should be routinely considered as part of mental health strategies and also drug treatment agencies strategies.
  12. Identifying a named person to lead and act as coordinator in each area.