Tailored information for primary care staff

Here you will find clinical guidance for primary care and GPs on the health needs of UASC, guidance and translated materials on blood borne infection testing and consent and a range of other materials of interest.

Key documents

Blood borne infections (BBI)

Blood-Bourne-Infection-testing-GUIDELINES.pdf [pdf] 221KB

Consent forms:

Country guidelines

Country profiles:

Initial health assessment

Resources

Legal Framework for Looked after children

Legal-Framework-for-Looked-after-Children.docx [docx] 49KB

This guidance sets out the functions and responsibilities of local authorities and partner agencies under Part 3 of the Children Act 1989 ('the 1989 Act'), which concerns the provision of local authority support for children and families. In particular it describes how local authorities should carry out their responsibilities in relation to care planning, placement and case review for looked after children.

Quick reference for medical registration

Quick reference for medical registration [docx] 40KB

This is a quick reference guide to show the important steps needed when registering a new person for Medical Care. A simple breakdown to ensure all steps are taken.

Registering a Young Person for Medical Care

Registering a Young Person for Medical Care [docx] 42KB

The process required with guidance for registering a new person for Medical care.

UASC Weekly Protocols to be followed

Actions for working with UASC that must be followed each week. Tips and guidance

Links to info about common illnesses

Links to info about common illnesses [docx] 41KB

This has links from the Patient.co.uk site to common conditions, those that we may suffer from but also common in UASC's too due to their difficult journey and the places they have passed through.

Doctors Clinics

Doctors-Clinics.docx [docx] 48KB

This provides information about Doctors Clinics for UASCs and important points to note and adhere to. It points to remember for the services and treatments that will be provided.

Immunisation Consent Form

Immunisation consent form [docx] 40KB

It is important that UASCs consent and fully understand what they are consenting to with regards to immunisations. This is a form to note if they have agreed to be immunised or not to be kept with their file and referred to each time they receive an immunisation.

Immunisation Log

Immunisation log [docx] 38KB

This is for logging and documenting when Young people receive immunisations. This can be completed and signed each time to ensure nothing is missed. It can travel with them so everyone can be aware which immunisations they have received.

The National Health Service

How-the-NHS-works-infographic.pdf [pdf] 582KB

This contains guidance on providing NHS treatment for asylum seekers and refugees. It explains how the NHS works in the UK. It also explains how to get help with health and what to do in an emergency. This document is in English

Use of A&E

Use of A&E [docx] 89KB

It is often confusing for young people to know how to react in different emergencies so it is important for them to be fully aware of when they should visit A & E and when they shouldn't. Attached is a list of examples to explain exactly that.

Health passport

The UASC Health Passport is designed to offer guidance and advice for care leavers, including:

  • Statutory health assessments
  • Next steps
  • Health services
  • Registering with a GP and Dentist
  • Child Sexual Exploitation (CSE)

Find public health information and resources: Public health | ICS

Toolkit for primary care commissioners and providers

This toolkit summarises good practice for Integrated Care Boards (ICBs), primary care commissioners and providers in the provision of primary care services for people seeking asylum supported by the Home Office in initial and contingency accommodation.

Questions to consider

Who are my designated doctor and nurse for looked after children?

The Designated Doctor and Designated Nurse for Looked after Children within your Integrated Care Board (ICB) area will have a role in ensuring that there is enough provision within the local area to meet the needs of any UASC placed within the ICB.

They will also work closely with the Named doctor and nurse within your provider organisation to deliver the service.

Who are they key people within my local authority?

There will be a Director of Children's Social Services who will have the overall responsibility for the care of UASC. There is likely to be Assistant Directors with specific areas of responsibility. There is likely to be a LAC/UASC Service Manager and the young person's social worker.

Do I need a translator?

This will depend on what type of appointment you have with the child/young person.

For example it is important to have a translator at the initial health assessment, but it may not be possible when a young person is accessing emergency care. If you do not have a translator available, you can use language lines or the hospital communication book.

You will need to liaise with your contact within the Local Authority, to confirm whether they have a duty to provide an interpreter. In Kent, interpreters were provided for all Fitness to travel, Initial and Review Health Assessments. There is a section on working with interpreters in the  Clinical guidance document [pdf] 736KB.

Does the statutory framework apply?

A UASC is a Looked after Child and is afforded the rights as any LAC.

This means that all aspects of promoting the health and wellbeing of LAC (statutory guidance) applies.

Who will provide medical consent?

Consent needs to be sought for UASC in the same way as for any Looked after Child, but ensuring that information has been given to them in an accessible format. 

If they are Gillick Competent, they can provide their own consent, as long as this has been informed. Otherwise the Local Authority responsible for the child would give consent.

Information about Blood Borne Infection consent and immunisation consent is also on the paediatrics resource page.

What should I do if I have a safeguarding concern?

This should be discussed/referred via your local safeguarding team in just the same way for any other child/young person. You need to pay particular attention to child sexual exploitation, trafficking and human slavery, missing, female genital mutilation and PREVENT policies for your area.

Kent Safeguarding Children Board website.

Are UASC entitled to free medical treatment?

As any Looked after Child, an unaccompanied child is eligible for free treatment.

For further information please see the  clinical guidance for clinicians undertaking IHAs [pdf] 689KB.

How do UASC get a NHS number?

This is allocated through GP registration and all UASC are eligible to register with a GP Practice using the Family Doctor Service registration Form (GMS1). We recommend that this is undertaken as soon as they arrive in the UK and prior to any move under the National Transfer Scheme.

Who completes HC1 forms?

The child's social worker should complete the HC1 form which will enable the young person to have support to pay for dental treatment, glasses or contact lenses or travel to receive NHS treatment.

What immunisations are appropriate for UASC?

In our experience, UASC have missed immunisations and therefore should be immunised according to the  UK Vaccination of Individuals with Uncertain or Incomplete Immunisation Status Schedule [pdf] 184KB.

What screening is appropriate for UASC?

Up to date guidance should be sought from Public Health England, but in Kent we recommended universal screening for TB and blood borne infections in light of the needs assessment. There is information available for young people in relation to screening requirements on the Public Health page.

The Clinical guidance document [pdf] 736KB also found a high prevalence of vision and dental needs within the population. We would recommend developing pathways to screening services with local providers and commissioners within NHS England.

Which mental health tools are appropriate?

There are no validated screening tools for UASC. We have devised the distress screening tool [pdf] 533KB which is part of our fitness to travel work. In our Initial health assessment we have been using the moods and feelings questionnaire [pdf] 179KB and the SDQ as these are generic tools used by CAMHS.

External links

Public Heath Kent County Council

The health needs assessment was undertaken by Rachel Coyle, Public Health Registrar and Samantha Bennett, Public Health Consultant in Kent County Council. The health needs assessment was supported by the Kent UASC Project Team. The assessment is the most detailed and in-depth research into the health needs of the current population of UASC in Kent. The findings have helped to inform and focus current and future resourcing and commissioning.

Unaccompanied-children-Health-Needs-Assessment.pdf [pdf] 1MB

NHS Kent and Medway and partners

The Kent Transformation Plan for Children, Young People and Young Adults  outlines how all partners in Kent will transform emotional wellbeing and mental health services between 2015 and 2019. The transformation programme across Kent has funded the  Emotional Health and Wellbeing Action Research Project - so that we can better understand the emotional health and wellbeing needs of our UASC population.

Kent-Transformation-Plan-for-Children.pdf [pdf] 1MB

Freedom from torture

Freedom from Torture, formerly the Medical Foundation for the Care of Victims of Torture, has been working for more than 30 years to provide direct clinical services to survivors of torture who arrive in the UK, as well as striving to protect and promote their rights.

Since its inception, over 50,000 individuals have been referred for help. Thanks to the dedication of staff and volunteers - as well as scores of passionate supporters and funders - thousands of torture survivors have been able to rebuild their lives in incredibly difficult circumstances.

Find out more.

Make a referral.

Public Health England / NHS England

Latent TB Testing and Treatment for Migrants

The Collaborative TB Strategy for England 2015−2020(2) recommends LTBI testing and treatment for 16 to 35 year olds who recently arrived in England from high incidence countries, where TB incidence is 150/100,000 population or over. This guide aims to support the implementation of local LTBI testing and treatment, and provide practical advice as part of a robust local and regional TB control programme.

Vaccination of individuals with uncertain or incomplete immunisation status

This single page reminder based on Immunisation against infectious disease: the Green Book helps health professionals vaccinate people correctly to protect them and their families from disease.

An equivalent screening algorithm is available.

Kent Safeguarding Children Board

Advice and information for professionals working with children in Kent.

National transfer scheme protocol for UASC

This is the latest Government guidance for the National Transfer Scheme.

Videos

UASC practice nurse.

Other useful resources are available on our Youtube.