DEVELOPING AN INTEGRATED HEALTH PATHWAY FOR ASYLUM SEEKING CHILDREN: A HOLISTIC MULTI-BOROUGH APPROACH TO CARING FOR VULNERABLE UNACCOMPANIED MINORS IN CARE

Najette Ayadi O'Donnell

Whittington Hospital NHS Trust, London

Najette graduated from Imperial College School of Medicine in 2010 but prior to medicine had completed a degree in Political Science. She is currently undertaking research with Dr Deborah Hodes, the British Paediatric surveillance Unit (BPSU) on the prevalence of FGM in under 16's in the UK and is completing a MSc at the Institute of Child Health (ICH) at University College London. She is the first to be awarded the Michelle Zalkin Scholarship for work in child protection at the ICH. Her interests lie in acute paediatrics, child safeguarding, the health needs of looked after children and unaccompanied minors. She has worked in a rural setting in South Africa, travels extensively and has taught Child Safeguarding/FGM to GP's, undergraduates and other NHS workers. She is a member of the Royal College of Paediatrics and Child Health and the London School of Paediatrics Trainee Committee.

Allison Ward

Central and Northwest London NHS Foundation Trust

Dr Allison Ward is a Consultant Paediatrician working in the inner-city London Borough of Camden, where she is named doctor for both safeguarding and looked after children. Her special interests include addressing the health needs of vulnerable children (including child refugees) and ensuring the voice of the child is paramount in all paediatric safeguarding work.

Abstract

Objectives:Unaccompanied asylum seeking children (UASC) are a vulnerable population with complex wide-ranging health needs that differ from those of UK-born children entering the care system. There is no standardisation of... [ view full abstract ]

Objectives:

Unaccompanied asylum seeking children (UASC) are a vulnerable population with complex wide-ranging health needs that differ from those of UK-born children entering the care system. There is no standardisation of care for vulnerable UASC in UK.

We developed an integrated health pathway for unaccompanied minors, initiated at their looked after child’s (LAC) Initial Health Assessment (IHA), across three neighbouring boroughs.

Method:

Discussions amongst health professionals working with UASC identified three key areas of health need: physical health (including infections), sexual health (including FGM and sexual violence) and emotional health. Corresponding specialist paediatric services were invited to participate in a tri-borough pathway. Data was routinely collected at IHAs (November 2015 – November 2016) and specialist service assessment.

Results:

Between November 2015 and November 2016, 72 UASC were seen for IHA s across the three boroughs, with average age 15 years. 88% were male (n=63). UASC originated from 18 different countries with 31% (n=23) from Albania, 15% Eritrea (n=11) and 13% Afghanistan (n=10).

76% (n=55) reported physical symptoms such as headache, body pain, abdominal pain. 4% (Female=3, male=1) reported a history of sexual violence. 40% (n=29) reported psychological symptoms such as poor sleep, low mood/anxiety and were referred to Child and Adolescent Health Mental Services (CAHMS). Of those referred to CAHMS, 60% (n=17) were diagnosed with Post-Traumatic Stress Disorder and 20% (n=6) with a co-morbid depressive disorder.

Of 33 UASC given appointments for infection screening to date, 18 attended. 8 (44%) were found to have either active or latent infection (schistosomiasis n=2, tapeworm n=2, latent TB infection n=4, Giardia n=2).

Conclusion:

Routine use of an integrated health pathway, initiated at the LAC IHA, helps to ensure early identification and treatment of complex health needs in UASC. A tri-borough approach provided opportunities for peer review, knowledge dissemination and standardisation of care.

Authors

Najette Ayadi O'Donnell (Whittington Hospital NHS Trust, London)
Adeeb Ahmed (University College London Hospital NHS Foundation Trust)
Mei-Ling Wong (Central and Northwest London NHS Foundation Trust)
Jonathan Cohen (University College London Hospital NHS Foundation Trust)
Sarah Eisen (University College London Hospital NHS Foundation Trust)
Rebecca Evanson (Whittington Hospital NHS Trust, London)
Susannah Fairweather (The Tavistock and Portman NHS Foundation Trust)
Deborah Hodes (University College London NHS Foundation Trust)
Allison Ward (Central and Northwest London NHS Foundation Trust)

Topic Area

Refugee Children

Session

Oral 25 » Session 3- Refugee Children (16:15 - Tuesday, 3rd October, King Willem Alexander Compact)

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