1. How an innovative statutory and voluntary sector partnership
met the need for refugee health assessments in the
context of the Irish Refugee Protection Programme
Dr. Bridget Kiely & Diane Nurse

2. Health Service Executive (HSE) overview
Safetynet & HSE | Statutory and voluntary sector partnership
Health Service Executive (HSE) overview
Responsible for the provision of health and personal social services for everyone
living in Ireland, with public funds.
Approximately 100,000 employees
Divisions include Acute Hospitals, Health and Wellbeing, Mental Health, Social Care, Primary Care, Mental Health, Community, Strategy and Planning, Clinical Programmes, Quality Improvement etc.
Provides services either directly or through funded agencies via service level agreements

3. Social Inclusion… Primary Care €133.3mil - 0.96% of health budget
Safetynet & HSE | Statutory and voluntary sector partnership
Social Inclusion…
Addiction, Homelessness Intercultural Health Traveller/Roma LGBT/DSGBV
Primary Care
Equality of access, participation & outcomes
Hep C, Prison health, HIV/AIDS, Survivors of abuse, Trafficking, etc
650 employees % of HSE
Service delivered via SLA under Section 39
Enhance access of vulnerable groups to
health services
€133.3mil % of health budget
The Health Service Executive employs 100,000 people making it Ireland's biggest employer. The HSE employs more than 65,000 staff in direct employment and a further 35,000 are employed by voluntary hospitals and bodies funded by the HSE. The budget of almost €12 billion is the largest of any public sector organisation. The majority of employees are frontline staff providing patient care.

4. Irish Refugee Protection Programme
Safetynet & HSE | Statutory and voluntary sector partnership
Irish Refugee Protection Programme
Established by Government Decision on 10 September 2015
as a direct response to the humanitarian crisis
Pledged to accept a total of 4,000 persons
EU relocation – 2,622 asylum seekers via the
EU Relocation Programme
Refugee Resettlement – 1,040 programme refugees
under the resettlement programme currently focused
on resettling UNHCR refugees from Lebanon
Other Mechanisms – The balance through a variety of
different mechanisms including the acceptance of
unaccompanied minors and family reunification
65%
EU Relocation 9%
Balance
26%
Programme
Significant influx

5. Health Assessments for newly arrived migrants in Ireland pre IRPP
Safetynet & HSE | Statutory and voluntary sector partnership
Health Assessments for newly arrived migrants in Ireland pre IRPP
Mechanism in place to offer all new arrivals a health assessment and screening for infectious diseases in accordance with national guidance
Depended on a single centrally located service with limited capacity
Local resources had been cut during downturn
Became clear there was not capacity to manage the large numbers arriving under IRPP to remote locations

6. Safetynet Overview Annual Report 2017
Safetynet & HSE | Statutory and voluntary sector partnership
Safetynet Overview
Annual Report 2017
Safetynet Primary Care is a medical charity that delivers quality care to those marginalised in society without access to healthcare, including homeless people, drug users and migrants.
Vision Everyone has access to healthcare regardless of means, circumstances, race or creed.
Mission To enable access to appropriate acceptable quality healthcare to those marginalised in society.
Approach Think outside the box to implement services that adapt to the patient rather than expecting the patient to fit with the system.
4 arms- homeless- inreach and outreach homeless services- clinics in homeless hostels and a bus at night for rough sleepers, open access clinics for Roma, Limerick, Cathedral, network of services dealing with homeless and vulnerable groups- shared IT system, networking events and the Mobile Health and Screening Unit

7. The Mobile Health & Screening Unit
Safetynet & HSE | Statutory and voluntary sector partnership
The Mobile Health & Screening Unit
Safetynet’s Mobile Health and Screening Unit (MHSU) is a new service provided by Safetynet Primary Care in partnership with HSE Social Inclusion. The MHSU provides the following services when there is an identified need among a vulnerable group not accessing health care services:
Health screening and medical assessments for relocated refugees.
Communicable disease screening including TB, Blood Borne Viruses, STIs for groups at risk.
Clinical assessments and prioritisation as part of healthcare needs analyses for response and service planning
The Mobile Health and Screen Unit (MHSU) is a health team (GP, Nurses, Project Manager and Driver) working from a mobile clinic equipped with an X-ray and consultation room.
Started in March 2017, responded to a call from Social Inclusion
Our approach is to work with local services and service managers to meet gaps, and facilitate integration into routine primary care services

8. Work of the Mobile Health & Screening Unit
Safetynet & HSE | Statutory and voluntary sector partnership
Work of the Mobile Health & Screening Unit
Conducted comprehensive health assessments for all arrivals under the IRPP since March 17
The first Irish mobile X Ray Unit operationalised
One stop Infectious Disease Screening for homeless and vulnerable groups in Galway and Limerick
Offered screening to new arrivals under family reunification
Supported the integration of internally relocated asylum seekers into local health services and provided the HSE with data to inform additional health care services required

9. Work of the Mobile & Screening Health Unit
Safetynet & HSE | Statutory and voluntary sector partnership
Work of the Mobile & Screening Health Unit
Data/Numbers
Health assessments for 647 Syrian arriving under IRPP completed
Of the Syrian refugees assessed
All had comprehensive health assessments within 10 days of arrival and were integrated into the local health system with local GP providing ongoing healthcare.
34% had a medical condition
10% had mental health issues
2.4% had chronic HBV
Current medical Conditions
Any immediate health needs met- rest prioritised for local GP review. Standardised assessment across centres, gather data to support additional services where indicated. Dental needs was something not well prepared for- since first involved secured funding to support access to dental care
Catch up immunisations were minimal due to work done in Greece, but all children reviewed and recommendations made

10. Mobile Health & Screening Unit – Key Learning
Safetynet & HSE | Statutory and voluntary sector partnership
Mobile Health & Screening Unit – Key Learning
Developing relationships with local healthcare providers to facilitate integration
Preparedness allowing ability to respond quickly (within 10 days) 1 4
Communication of emerging issues
Flexibility of approach 2 5
Capacity of leverage of different expertise, skills etc of partners in Statutory & Voluntary sector
Focus on integration into existing systems and not creating parallels 3 6

11. & Dr. Bridget Kiely, GP, Safetynet MHSU Tel: 0871523589
&
Diane Nurse, National Lead Social Inclusion, HSE
Phone: