Derby - Supporting children from asylum seeker families

A dedicated team has been set up in Derby to support children from asylum-seeking families. It is part of the 0-19 Derby Integrated Family Health Service and involves two public health nurses dually qualified as health visitors and school nurses, a family health practitioner and child practitioner. This case study showcases the important role of school nurses in the education system.


“We go knocking on doors”

Derby is one of the Home Office’s dispersal locations for the East Midlands. It means when asylum-seeking families arrive, they are housed in the city while applications are processed, and more permanent homes can be found.

There are nearly 100 properties that are used to house the asylum seekers along with a 140-bed bridging hotel that has been used for Afghan refugees over the past year where they are triaged until they are offered permanent housing in locations across the country. On top of that the city is seeing increasing number of Ukrainian refugees arriving as local residents offer up their homes under the government’s Homes for Ukraine scheme.

To help support children from asylum-seeking families, the council and NHS have funded a specialist team to provide both support for health and wellbeing and wider social support. It was established in the summer of 2021 and has been formed from staff from the council and Derbyshire Healthcare NHS Foundation Trust, which is commissioned to provide the 0-19 service.

It means when new children arrive with their families, the public health nurses, family health practitioner and child practitioner will carry out a health assessment. “We literally going knocking on doors,” said Virginia Hickman, the Specialist Community Public Health Nurse for Asylum Seeking Families. “That is often all we have – an address. Our immediate priority is to assess the health needs and check the children are up to date with their vaccinations. We then liaise with the local GP surgeries that update their routine childhood vaccinations and COVID record as needed.

“We have an additional qualification in prescribing so if they need medications for things like skin infections or other conditions, we can do that. Often these families have been living in pretty awful conditions before arriving in Derby so we find problems such as scabies can be common. We have also identified cases of TB that need treating.

“If the child has a specific long-term condition, like diabetes or asthma, we put them in touch with a specialist nurse. We help explain to them how the health system works.”

Supporting wider social needs

The wider social and wellbeing support is coordinated by the child practitioner, Sian Hallam. She is part of the council’s social care team so can arrange for early help or deal with safeguarding issues.

Ms Hallam said: “These families obviously have a variety of needs. Mental and emotional health support is often needed – although we find that it can take a few weeks for that to hit them. When they first arrive, there is a flight or fight tendency. We can also arrange things like Sure Start grants and really just answer any questions they have. One of the aims is to reduce reliance on services such as A&E.

“The idea is we provide support for the first six weeks and then we hand them over to the universal services. Many will move out of the area. But the ones that do stay we can provide ongoing support if they are really vulnerable or complex.

“For example, we have had cases where children have been bullied or been really unhappy and distressed when they have started in a local school. Because we are trusted by the families, we will continue working with them.”

Why building trust is key

Building trust with these families is a big part of the team’s work. Ms Hickman said: “We do find that some families do not want to immediately engage with us. They have been through so much and understandably are suspicious.

“There are also cultural sensitivities to navigate. You need to be aware of that to be able to support the family considerately.”

Another challenge is the language barriers. The team use the telephone translation services that are available via the NHS and council, but there are other methods too. “Sometimes it is a matter of making use of online services, even Google Translate sometimes. We also find family and community members may have good English language skills that can be utilised,” added Ms Hickman.

“You have to take it step by step. If they are not happy to talk to us during the first visit, we come back. Sometimes it can take a few weeks before they are willing to accept our help. We just make sure we are as visible as possible, and we even do a drop-in once a month at a women’s refugee group. It really helps us access those struggling to access our services. You have to be patient.”

Contact

Virginia Hickman

Specialist Community Public Health Nurse for Asylum Seeking Families, Derby Integrated Family Health Service

Email: virginiahickman@nhs.ne