1. The Haven Healthcare for new asylum seekers & refugees in Bristol Ginny Burdis Specialist Health Visitor

2. An overview of the service NHS Bristol funded health service, established in 2004 Specialist service set up to address complex, initial needs of asylum seekers, and now includes ‘family re-union’ new arrivals Provided in a primary care setting, in a central city location Employs an ‘extended gateway’ service model Staffed by 3 practitioners – GP, nurse, health visitor Clinics held 3 mornings per week Outreach service by health visitor Liaison & partnership working with other agencies is key to the way we work.

3. Service delivery Aims To reduce health inequalities by facilitating access to health care To relieve pressure from other services e.g. A&E depts To identify and address areas of unmet need Clients In 2010/11 188 new patients; 31% 16yrs or under 44% female Top 6 countries of origin: Somalia (50%), Iran, Iraq, Sudan, Afghanistan, Gambia

4. What influences health and makes some women vulnerable? Pre flight experiences In flight experiences Living in exile including: the effect of the asylum seeking process re-uniting with family / partner social factors in host community

5. Health issues Sexual health - Pregnancy - Female Genital Mutilation (FGM) - Rape / sexual violence Depression - different connotations within some cultures. - often distressed about leaving family behind - stress of taking on new role and being sole provider for children PTSD - often witnessed or been involved in traumatic events

6. Health issues (cont) Communicable disease - uptake of all screening tends to be low. Injuries sustained through trauma /war Isolation, separated from support networks Need for dentistry, opticians, family planning Lack of understanding about UK health care systems

7. What does the Haven provide? Holistic health assessment Listen to experiences and prioritise actions according to individual’s needs Offer screening for communicable diseases, give immunisation update and general health advice Sexual health history, discuss FGM, contraception Mental health assessment Complex issues referred to Haven Dr for treatment

8. Enabling women to move on Registration with a GP local to her home address Health records and action plans sent to GP Information about eligibility and access to services such as dentist, optician, family planning Help with application for free prescriptions Linking into voluntary sector for befriending, ESOL, family tracing, way-finding, social activities Introduction to next practitioner – e.g midwife On going support provided via social centre, home visits and telephone calls.