'We don't know where we stand’

Key findings

The mental health impact of waiting was worsened by lack of information and deterioration in physical health.

• The mental health burden of being on a waiting list was compounded by people’s uncertainty about their asylum claim.
• People felt left in the dark without information about their wait and unsure who to contact if they had questions.
• Ongoing pain being untreated and poor accommodation conditions led to physical deterioration, which had a knock-on impact on people’s mental health. 

People told us that people seeking asylum may be more likely to miss elective care appointments due to a mixture of practical, financial and trust issues.

• Professionals we spoke to had seen many examples of logistical and administrative issues, including letters not reaching people who had been relocated by the Home Office, which impacted their ability to attend health appointments.
• People seeking asylum and professionals described practical barriers to accessing elective care, particularly the cost of travel and lack of support for childcare.
• Fears of being charged for accessing care or uncertainty about data sharing acted as a trust barrier. 

People seeking asylum are at risk of falling through the gaps between different parts of the system and being left reliant on variable ‘pockets of excellence’ or to advocate for themselves.

• Professionals we interviewed highlighted a lack of clear process or clarity over responsibility for ensuring continuity, or safe transfer of elective care provision when people are relocated at short notice by the Home Office.
• This can lead to interruptions in care, people waiting longer than they should or missing out on the care they need.

Recommendations

Based on our findings, we have developed a set of recommendations for the Department of Health and Social Care and NHS England, commissioners and healthcare providers and the Home Office. 

They centre around the following four themes:

1. Reducing the physical and mental health impacts of waiting.
2. Improving communication and information.
3. Supporting people to attend appointments.
4. Ensuring relocation does not impact on people’s care.

Full recommendations can be found in the report [PDF].

Acknowledgements

This research was conducted by the British Red Cross with support from the Health and Wellbeing Alliance.

We are grateful to the seven experts by experience and three professionals who generously made time to share their insights and experiences.

We would like to thank Doctors of the World and the VOICES Network for supporting with the recruitment of participants.