Written evidence submitted by Health and well-being themes for Initial Accommodation residents in Birmingham


Whilst many asylum seekers do arrive in the UK in relatively good physical health, health problems can rapidly develop whilst they are in the UK. Asylum seekers may face difficulty in accessing healthcare services for several reasons:

         Lack of awareness of entitlement and/or problems in registering and accessing primary and community healthcare services, particularly if their claim has been refused.

         language barriers

         a number may have faced imprisonment, torture or rape prior to migration, and will bear the physical and psychological consequences of this;

         many may have come from areas where healthcare provision is already poor or has collapsed.

         some may have come from refugee camps where nutrition and sanitation has been poor so placing them at risk of malnourishment and communicable diseases.

         the journey to the UK can have effects on individuals through the extremes of temperatures, length of the journey, overcrowded transport and stress of leaving their country of origin.

         health needs of asylum seekers can be significantly worsened (and even start to develop in the UK) because of the loss of family and friends' support, social isolation, loss of status, culture shock, uncertainty, racism, hostility (e.g. from the local population), housing difficulties, poverty and loss of choice and control.


Birmingham is a City of Sanctuary and immensely proud of the role it plays in supporting asylum seeker and refugees.

We have services in place to manage the assessment of asylum seekers’ immediate health and care needs during their residence in the Initial Accomodation Centre (IAC), including those with possible COVID-19 symptoms, and we have a facility for residents to appropriate care and delivering this by remote means wherever possible.

The health unit supports efficient and safe functioning of health services and access for people resident at the IAC by providing access to health checks and subsequent referral for health care interventions for new arrivals. This includes:

         immunisations and vaccinations history

         maternity history. Contraception and sexual health advice is offered to both men and women;

         Any sexual health problems discussed on assessment and appropriate action taken.

         Identification of special needs and liaison with the UKBA, or whichever agency is sub- contracted to oversee dispersal, to ensure the provision of appropriate accommodation and support where needed on dispersal.

         Substance misusing patients referred to drug treatment services.

         Symptom screening or Mantoux testing

         Full clerical and clinical administration of service.

         Direct referral to chest clinic/ chest x-ray.

         Access to a minor illness service

         Access to emergency/urgent GP services.

         Prescribing as appropriate and to follow and prescribe in accordance with CCG guidelines and formulary

         Minor ailments services

         Immunisation and vaccination - TB vaccinations are offered as appropriate.

         Access to a Clinical Psychiatric Nurse

         Primary care outreach

         A midwifery and birth partner service


Residents of IAC are presenting with more complex needs and long-term care needs.  Longer length of stays in IAC are causing significant detrimental Impact on resident’s mental health and well-being. There is insufficient resource from the Home Office to remedy this
We recognise that since the start of the COVID-19 pandemic, there has been an increase in the use of contingency accommodation (hotels) for asylum seekers.
We recognise that prior to COVID-19 there were already system pressures with an unprecedented spike in asylum seeker numbers over the winter. The lockdown of IAC capacity to prevent infection spread has meant that no new arrivals may be accommodated and there is limited onward dispersal of existing residents.

The CCG has gathered intelligence them from services Sandwell & West Birmingham commissions;

Themes included from these sources illustrate the range of health and well-being challenges faced:


October 2020