Our latest report using MYCaW® evaluated the service provided by a Personalised Care Team (PCT) dedicated to refugee and asylum seekers in Sussex. It was embedded within a wider Refugee and Asylum Seeker Service hosted by a GP federation, Alliance for Better Care CIC, providing an acute primary care response 7 days a week to refugees and asylum seekers living in hotels across Sussex. NHS Sussex received funding from NHS South East in July 2022 with further funding from West Sussex County Council to support the personal health budgets and from NHS Sussex Health Inequalities allocation.

The aim of the evaluation was to understand the needs and concerns of refugees and asylum seekers on referral to the Personalised Care Team for the Refugees and Asylum Seekers Service and to understand the impact that the project has supporting these needs.

Refugee and asylum seekers could self-refer to the personalised care team or be referred by other agencies, organisations or healthcare professionals. People who met the referral criteria were offered care coordination or social prescribing depending on their needs. The personalised care team could also offer small one-off personalised healthcare budgets (a maximum of £100) to enable service users to access the social prescription prescribed for them.

Analysis of Concerns

Using our personalised care framework we analysed the MYCaW® concerns reported (136 concerns from 73 people). The top three categories were:

• Concerns about wellbeing - which includes issues such as wanting to be involved with activities, being more physically active, having opportunities to socialise
• Practical concerns - issues such as housing, immigration, finance, and work
• Mental and emotional concerns - which heavily featured stress, depression, and loneliness

The percentage frequency of concerns that fall under each main theme.

 The top 5 concerns most frequently reported in the MYCaW® dataset (n=166).

The most concerns were about activities (26%). Here people wanted to join local clubs, volunteer in general, or use their specific skill set and activities for children.

"Support in attending Cafe Art training courses."

"I would like to do some volunteering as an electrician."

10% of all concerns related to parents with children who needed items such as clothing and toys or wanted to find activities for their children so they could socialise and play. Some concerns related to parents needing access to healthcare for their children.

"Social activity for myself and baby"

"Clothes/toys for my children"

Support and information concerns were identified at 10% where people expressed wanting to connect with different healthcare providers or healthcare services.

"GP registration to access healthcare and medication"

8% of concerns related to needing support to increase physical activity or exercise. Some people had specific medical issues that needed support with exercise, or they had been advised to increase physical activity by their GP.

"Improving mental health, joining sport, gym membership."

"I had a leg operation and back ache, need the gym to do exercise and swim."

8% of concerns were about general mental health issues or where several types of mental health issues have been listed by one person.

"mental health support",

"stress, low mood, anxiety, and self-esteem"

Measure Yourself Concerns and Wellbeing® Score changes

Out of the total number of baseline MYCaW® evaluations completed (n=73), 56/73 (77%), people also completed a follow-up MYCaW® form. Therefore, the 'paired' MYCaW® scores from the 56 social prescribing service users were analysed to get a sense of the impact of the refugee and asylum seeker social prescribing service. With this number, it would be appropriate to describe the following data as a 'proof of concept' that the refugee and asylum seekers social prescribing service can deliver its intended aims. 

 These are extremely high percentage improvements compared to other MYCaW® datasets. Overall, the average scores indicate that for the people who were supported by the refugee and asylum seeker social prescribing service, their concerns and wellbeing improved as a result.

What was important about the support received?

The final follow-up question on the MYCaW® form asks a person what they found most important about the service or support they received. 36/73 (49%) people responded to this question which resulted in seven categories being identified.

The most frequent response (33%) related to the positive impact on refugee and asylum seeker's health and wellbeing.

"Being helped with depression and anxiety sessions (Time to Talk)"

"mental health improvement."

The second most frequent response (19%) related to accessing activities and services. Nearly three-quarters of these specifically mentioned being able to do activities with or for their children. These are also related to being physically active and attending English classes.

"Accessing support and connections with different services to help my son, I am so thankful and feel very happy"

"Having some time with my son outside of the hotel, in the hotel is not good"

Another important aspect of the service with 17% of responses related to the need for ongoing support with accommodation and work and answers in this category are posed more as concerns than what was appreciated about the service. This aspect of the service to provide support in these areas appears to be key.

"a private room, or having a roommate that sleeps during the day."

"Having my own place to cook for my self permanent accommodation."

"Finding a job opportunity"

An appreciation of staff was also identified with 8% of people specifically mentioning how the staff supported them and gave them the sense of being listened to.

"Most importantly for me was that I met great, like [name] and [name] who are trying their level best to assist me in things that are a concern to me and worry, in the time spent with them they managed to get onto a Mental Health First aid course and now I call myself a Mental Health first aider"

The MYCaW® data analysis provides a very real insight into the concerns and issues faced by refugees and asylum seekers arriving in the country. It highlights the skills they bring with them, their eagerness to work, volunteer, and be involved in the community as well as the suffering and mental health issues they experience due to their circumstances. Above all, this evaluation shows how important the Personalised Care Team for the Refugees and Asylum Seekers Service is in effectively supporting a vulnerable group of people.

Demand for support from the Personalised Care Team for the Refugees and Asylum Seekers Service shows no signs of reducing and homelessness is forecast to increase in the coming months hence there will be a continued need for a dedicated provision for refugees and asylum seekers both in the hotels and the community.

Read the full report below.