ࡱ> ;=:G bjbjَ ] ` 2>>>>>>>>1Gpp' $!#\K >>>>>K >>>>:>>>@ Z>2 ExF LMC Position Paper on Primary Care Medical Services for Asylum Seekers Rough Draft for substantial revision Introduction Asylum Seekers have significant medical needs that the NHS should meet. This requires planned and resourced special provision. Background Experience elsewhere in the UK is informative. This has shown: Asylum seekers have high levels of psychological morbidity They often do not understand how to use the NHS They may be very high demand patients for a short period of time Their health tends to actually deteriorate over their first months in the UK Placement Given that the placement of asylum seekers in Somerset is a planned transfer, we might hope that this will be reasonably well organised, with some advance notice to services of the arrangements. Sadly, precedent in England is not encouraging We understand that it is hoped to have 300 places in Taunton Deane and 150+ in Bridgwater. However, the shortage of accommodation in Somerset and the reluctance of landlords to let to organisations providing for asylum seekers means that this number will not be reached. Political Considerations Apart from general hostility generated by some media, and understandable concern about housing (given the rising numbers of people already waiting on housing lists) there must also be sensitivity about the way in which health services are arranged. It is important that whilst asylum seekers may have a slightly differently configured services, it should not be seen to be better that that available to the general population, particularly in access to specialist services. Anticipation of Requirements Given a modest amount of notice, the LMC would ask the PCTs to arrange the following: Access to translation services, preferably both by telephone and using language speakers available locally A dual language health record card for the patients to hold which also explains in the appropriate language how to access health care Advice from Health Protection about any special health needs of the population involved (according to their country of origin), and guidance on what screening, investigation, or immunisation would be appropriate Organisation of Services The LMC preference would be for the PCTs to agree a local Development Scheme, PMS plus, or Enhanced Service (if the new GMS contract is agreed), so that one or two practices in each locality would undertake to provide for people placed in that town. This would make it easier to arrange services like translation, would give clinicians some experiences of the health needs and culture of the group concerned, and would allow costs to be identified. Allocation of a few patients to each practice list would be an unsatisfactory solution that the LMC will resist. We must also recognise that as the plan is for 300 places and not people there may be a rapid turnover as individuals drift back to large urban centres. Large numbers of patients may be enrolled but not followed up. There will likely be a change in the ethnic and geographical background of placed people over time. Identification of Health Professionals amongst asylum seeker population Doctors, nurses, and other health professionals are a valuable resource amongst asylum seekers and need to be identified and approached for help at an early stage. Some groups contain significant numbers of such professionals. Dr John Crosby has undertaken on behalf of the BMA and LMC to try and co-ordinate arrangements for any doctors who may be placed in Somerset and we would endeavour to use their skills to support and advise clinicians caring for their ethnic group. 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