1. Health Needs of Unaccompanied Asylum Seeking Children(UASC)
CLA Health Team Calderdale
December 2016

2. Introduction
Unaccompanied children seeking asylum are children and young people under 18 years who are applying for asylum in their own right due to fear and persecution in their home country and have become separated from their parent and where there is no adult to care for them in law. (Care of Unaccompanied and trafficked children 2014)
UASC are defined as both unaccompanied asylum seeking children and unaccompanied refugee children who are Looked after Children and Young People.

3. National Dispersal Programme
The National Unaccompanied Asylum Seeking Transfer Scheme has been created to enable the safe transfer of children from the receiving Local Authority into another allocated Local Authority from the 1st July This decision has been made by agreement of all Local Authorities to ensure a fairer distribution of children across all regions.

4. Dispersal Calculation
A calculation has been made by the Home Office that when a child first enters the country and the place of entry has over 0.07% of UASC to child population the child will be eligible for the child transfer scheme. This will be managed by a central team who will decide the region and a regional team will then decide which Local Authority the child will be placed in.
If the receiving Local Authority exceeds 0.07% of UASC that Local Authority will not receive any further children and will be able to access the transfer scheme.

5. Overriding Principle
In all decisions the welfare and best interest of the child is paramount and will be the primary consideration in line with section 1(3) of the Children Act 1989.

6. Recognised health needs both from research and Public Health in Kent.
UASC have significant physical, psychological and mental health needs.
These are influenced by basic healthcare in their home country, experience of hardship, witnessing traumatic events
and the duration and difficulty of their journey to the UK.
Health Need
Kent’s Experience
Screening for Tuberculosis
70% screened
Screening for Hepatitis B
100% screened
Poor dental health
43%
Visual disturbance/problem
35%
Immunisations
100% needed full vaccination
Psychological/mental health concerns
41%

7. Other Physical Health Needs
Include;
Poor nutrition and anaemia.
Sexual health concerns, pregnancy, STI’s and need for contraception.
Rashes, scars and fungal infections.
Parasitic infection, lice and scabies.
Musculoskeletal complaints.
Smoking, drugs and alcohol dependency.
Most of the physical conditions that children present are non- urgent, emergency care was needed for respiratory illness in a number of cases.

8. Psychological and mental health issues.
Most common concern;
Post Traumatic Stress Disorder (PTSD)
Anxiety
Depression
Sleep disturbance
Nightmares and flashbacks
The experience from Kent referenced that most of the concerns around trauma and mental health difficulties had a delayed presentation. This needs to be taken account of when assessing children’s needs and the provision of services.

9. Calderdale :Local Picture
Currently we have provided Initial health intervention to 11 UASC
HEALTH NEED
CALDERDALE
Screening for Tuberculosis
11=100%
Screening for Hepatitis B
Poor dental health
3=27%
Visual disturbance/problem
Immunisations
Psychological/mental health problems
1=9%

10. Additional Health Needs
Kidney problems
G.P registration
Dental registration
Interestingly there was no identified substance misuse, smoking or sexual activity….

11. Issues that need to be considered to meet health needs of UASC
Quick response in relation to first assessment (IHA)
Blood born virus screening.
TB screening.
Immunisations.
Physical health intervention (impetigo / scabies etc)
Mental health assessment and intervention (maybe immediate intervention or delayed)
Follow up of interventions from IHA and completion of RHA
Development of a health passport (as per statutory guidance
Named health professional to ensure continuity and communication with relevant stakeholders / professionals.
Quality Assurance of health assessments.

12. Don’t Forget Safeguarding Issues Communication
Safeguarding Issues
Unaccompanied Asylum Seeking Children are at higher risk being trafficked for CSE or modern slavery. These children are at a high risk of going missing. Girls may have been the victim of FGM and rape.
All of these safeguarding issues need to be considered at the time of the Initial Health Assessment or at any other health contact.
Communication
It is likely that UASC will have none or very poor command of English. This will be taken into account for their placement and interpreters will be needed for every health contact.

13. References:- Care of unaccompanied and trafficked children (DfE 2014)
Promoting the health and well-being of looked after children (DoH 2015)
Unaccompanied Asylum Seeking and Refugee Children Briefing Note (HO 2016)
Interim national UASC transfer protocol (HO DfE )
Health Needs Assessment – Unaccompanied children seeking asylum. (Kent Public Health Observatory 2016)
The Health Needs of Unaccompanied Asylum Seeking Children and Young People (Simmonds and Merredew)

14. Children Looked After Health Team
Designated Nurse
Named Nurse
Designated doctor
Administrator
Contact the team