A guide to help refugees access different healthcare services in the UK
Helping newly arrived refugees to access the healthcare they need will be essential once they arrive in the UK. As part of your Sponsor Agreement with the Home Office you will be agreeing that you will help refugees to register with a GP within one week of arrival, and you will have researched the registration process as you completed your application to the Home Office.
This resource provides guidance on supporting refugees to access the healthcare they need and guide you to further useful links and resources.
All refugees arriving through Community Sponsorship will have had a Migrant Health Assessment (MHA), carried out in the host country by the International Organisation for Migration (IOM). Some members of your Group and the family members you support will have seen these details. You can see a blank version of this form on the Reset website (account log in required) which will provide you with details of any health conditions and previous medical records. Keep in mind that this is personal data, so not all Group members will see this form. The family members will have a copy of their MHA in a sealed envelope on arrival. They will have been briefed, and you should remind them that this document should be given to their GP when they register.
Everyone eligible for free healthcare in the UK will have an NHS number; this will be generated once a family member is registered with a GP.
You will have already located a GP surgery close to where the family you are supporting will be living, as well as found out the registration process and booked their registration appointment, if this is the process the surgery follows.
All GP surgeries have access to interpreters, usually via a phone line, for all patients. We do not recommend that Groups provide volunteer or paid interpreters for these appointments. As with anyone’s appointment, medical information is confidential and it is up to individuals to share their medical needs with others. For the first appointment, it may be useful to have an interpreter on hand to take family members as far as the GP/nurses door for their appointment. If you are in an area of the country that has not yet participated in refugee resettlement, GP surgeries may not be aware of the interpreting services available to them, so do make them aware of the NHS Guidance on this.
What to explain to family members
The General Practitioner model might be something new to the family members you are supporting, as well as the referral process in the UK. We recommend discussing:
Appointments – explain that having a 9.30am appointment does not mean leaving your house at 9.30! Explain the importance of allowing time to arrive a little early and expecting that the doctor may not see you at the time of your appointment. Make sure you explain the impact of a missed or late appointment; that you may not be seen and must rebook for another day. Also, explain the urgent appointment booking procedure at the surgery.
The role of the GP – explain that a GP or family doctor is the key representative of the NHS in a community, they will help to manage and treat illness in all family members and are highly skilled doctors. Remind the family that treatment via a GP is free and all conversations with a doctor or anyone within the practice is highly confidential, and medical records of adults will not be shared with other family members. The GP will make referrals to other specialist services, some of which are within their surgery (e.g. blood tests, health workers, birth control) or to hospitals for more specialised services. You can explain that most practices will have male and female doctors, and it’s usually possible to request to see either. You may find it useful to refer to the Patient Guide to GPs.
Talking about birth control – You may think this is a sensitive subject for the refugees you support but remember, it’s important to bring it up as soon as the family arrives. Many Groups find it easy to work the topic of accessing contraceptives into a conversation about the GP, when explaining the GP’s role in prescribing medicine. You can do this when the whole family is present to show that this is not a taboo subject or when speaking only with females in the family. If you feel unable to bring up the subject of birth control or contraception, find someone else in your Group who can. You can also inform female family members that they can request to see a female GP and use a female phone interpreter for their GP appointment.
Prescriptions – explain that the doctor will prescribe medications, if they feel these are needed. These will be dispensed via a pharmacy and sometimes there may be a charge for this service. You could also explain that some medications can be dispensed directly from a pharmacist in a chemist. You can find a pharmacy here.
If the family you are supporting are Muslim and choose to only use medicine that does not contain animal products, then do let them know that many capsule tablets are traditionally made from gelatin. The family’s GP or pharmacist can advise them of suitable alternatives.
Changing your GP – every patient in the UK has the right to change their GP for any reason; you do not have to tell a new surgery why you wish to change. If the family you support wishes to change doctors, help them to find the information they need to do this.
Things to be aware of – Groups who are supporting families have shared with us that family members tell them how antibiotics are more readily available in Middle Eastern countries, and painkillers are weaker in the UK than what they are used to. It’s worth being ready to answer these kinds of questions and remember that you can simply refer the family back to the GP.
All hospitals are able to access interpreters, usually via a phone line, for all patients. We do not recommend that Groups provide volunteer or paid-for interpreters for appointments. As mentioned in the previous section, medical information is confidential and it’s up to individuals to share their medical needs with others. You may wish to ask the family if they would like to be accompanied to hospital appointments initially, if this is something that you are happy to do. The wide variety of departments in a hospital may mean that the team providing healthcare to the family you support might not be aware of their requirement to provide interpreters, so do make them aware of the NHS Guidance.
What to explain to family members
Accident and Emergency – explain to the family the purpose of A&E departments, including the triage system (most urgent first) and likely waiting times. Explain where the nearest A&E is, and how to get there. Should family members need to use A&E, it may not always be possible or appropriate for a Group member to wait with the family. Explain that the use of A&E is not charged.
Emergency Services – explaining how to use the ‘999’ service should be part of your welcome pack, and the key information that you provide to the family on arrival day. Explain how this should be used in an emergency explaining that in the event of an accident or health emergency, the first call should be to the emergency services. For those who do not speak English, they should be instructed to say the name of the language that they do speak e.g. “Arabic”, and an interpreter will be sourced.
You can also explain the ‘111’ NHS 24 hour advice line that anyone can call – you will need to ask for an interpreter at the start of the call. It’s important to enable the family to talk through their own medical conditions, so do avoid doing all the talking for the family members using this service.
Hospital Appointments – you can explain that a GP may refer a person to a hospital for further tests or to see a specialist. There are various ways these appointments will be booked – either directly, or a date can be chosen. You should make it clear that the referral process and the time it takes to book an appointment requires a waiting time for everyone.
It is highly likely that the family you support will not have had access to dental care in some time, if at all. Whilst the application form you complete for the Home Office will not ask you about registering with a dentist, it is an important thing to consider. You can find dentists who accept NHS patients in your area here. Community Sponsorship Groups have told us that finding a dentist with a specialisation in treating nervous patients has been advantageous for family members.
Dentists in the UK do not have access to or funding for interpreters like doctors or the hospital as standard, so do ensure that when you help a family register this is something that you discuss at this stage. It will be really important for dentists to have the informed consent of parents or the patient to perform procedures, so communication is key. Some Groups have provided interpreters initially, but you should speak to the dental surgery regarding what is needed.
What to explain to family members
Appointments and waiting times – explain the appointment system to the family as you did when explaining the GP, making sure it’s clear that waiting for an appointment is usual for everyone.
Dentists in the UK – explain that as they have refugee status, all family members will be entitled to free dental care on the NHS, however, waiting times to see a dentist can be long. It is possible to pay for private dental care in the UK, but this can be expensive.
Again, you won’t have been asked about helping the family to register with an optician as part of your application process, but this is likely a service that you will need to help family members access.
Opticians in the UK do not have access to or funding for interpreters like doctors or the hospital as standard, so do ensure that when you help a family register this is something that you discuss at this stage. Some Groups have provided interpreters initially, but you should speak to the opticians regarding what is needed.
What to explain to family members
Cost of optical services – Access to opticians and eye tests are free for some in the UK: those under 16, those over 60, and those who receive benefits, although there are a number of criteria which would make accessing these services free. Find out more here.
Funding for optical aids – For those who do require glasses or contact lenses, they may be entitled to NHS optical vouchers to help toward the cost of purchasing these. Further details are available on the NHS website.
Costs of eyewear – Should glasses be needed by any family member, do explain the variable cost of glasses in the UK; from budget lines through to designer frames and how far any vouchers that family members are eligible for will go toward the cost of these.
Choice of opticians – explain that there is a huge number of opticians in the UK from high street chains to locally run opticians. Ask family members whether they would like to see a male or female optician and explain that they can change opticians very easily.
- Migrant Health Checklist for healthcare practitioners
- Migrant Health Guide on Interpreters
- British Medical Association Guidance for Healthcare Professionals
- Migrant Health Assessment
- Migrants’ Rights Network – Know Your Rights Guide on Mental Health
- Rethink Rebuild Society – Introduction to the health system in England (in Arabic)