Healthcare for Asylum Seekers and Refugees; A Scoping Review

The number of asylum seekers and refugees entering the UK is increasing. There is a strong body of evidence considering the health needs and barriers that this group experience. There is far less evidence on the best models for the organisation, delivery and provision of health services for these populations. This scoping review synthesised the published evidence and evaluations on how health care services for asylum seekers and refugees are organised and delivered across the UK. Electronic databases were searched in June 2022 to identify relevant peer reviewed literature from 2002 onwards. Mental and physical health services for adults and children were included. To source grey literature, requests for relevant service evaluations were made through the UK Health Security Agency, the Office for Health Improvement and Disparities Migrant Health Network and the websites of relevant organisations were searched. Six semi structured interviews were carried out with public health practitioners and clinicians working with asylum seekers and refugees. Twenty-one articles were included in the scoping review. Nine (42.8%) were focused on services in London. Seven (33.3%) articles were service evaluations. The majority were descriptive analyses, surveys or reports. Only seven (33.3%) of articles included service users’ views. A thematic analysis grouped the articles and interviews into six themes; accessibility, link worker, training, integrated pathways, GP registration and time. There is a paucity of evidence relating to the delivery and effectiveness of services for asylum seekers and refugees in the UK. The key themes identified were consistent over the 20-year search period. Recommendations for services include routine evaluation of services with dissemination of findings and patient and public involvement. Given the increasing numbers and health needs of this group, the economic evaluation of health care services is essential. KEY MESSAGES: • There is a paucity of evidence on healthcare delivery for asylum seekers and refugees. • Key themes for services are accessibility, link worker, training, integrated pathways, GP registration and time.