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Description and evaluation of a pathway for unaccompanied asylum-seeking children
  1. Alice Jane Armitage1,2,
  2. Jonathan Cohen3,
  3. Michelle Heys1,
  4. Pia Hardelid1,
  5. Allison Ward4,
  6. Sarah Eisen2
  1. 1Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
  2. 2Paediatric Department, University College London Hospitals NHS Foundation Trust, London, UK
  3. 3Paediatric Infectious Diseases & Immunology, Evelina London Children's Hospital, London, UK
  4. 4Community Paediatrics, Central and North West London NHS Foundation Trust, London, UK
  1. Correspondence to Dr Alice Jane Armitage, UCL Great Ormond Street Institute of Child Health, UCL, London NW1 2BU, UK; alicejanearmitage{at}nhs.net

Abstract

Objective (1) To describe a novel integrated pathway for unaccompanied asylum-seeking children (UASC).

(2) To evaluate a population engaged with this service.

Design Description of the integrated pathway (objective 1) and retrospective evaluation, using data from community paediatrics, infectious diseases (IDs) screening and a sexual health (SH) service (objective 2).

Setting Unlinked data were collected from three services across three National Health Service (NHS) trusts in London.

Patients All Camden UASC engaged with the service from 01 January 2016 to 30 March 2019.

Interventions A multidisciplinary approach prioritising the health needs of UASC including a childre and adolescent mental health service (CAMHS) clinican and a health improvement practitioner. There are low thresholds for onward referral and universal asymptomatic screening of UASC for ID.

Main outcome measures Data on demographics, unmet health needs and known outcomes.

Results Data were available for 101 UASC, 16% female, median age 16 years (range 14–17). Physical assault/abuse was reported in 67% and 13% disclosed sexual assault/abuse, including 38% of female UASC. Mental health symptoms were documented in 77%. IDs warranting treatment were identified in 41% including latent tuberculosis (25%) and schistosomiasis (13%). Interpreters were required for 97% and initial non-attendance rates at follow-up were 40% (ID) and 49% (SH).

Conclusions These data demonstrate high rates of historical physical and sexual assault/abuse, unmet physical, mental and emotional health needs among UASC and significant barriers to engaging with services. An integrated pathway has been successfully implemented and shown to deliver appropriate, joined-up care for UASC, consistent with current recommendations, with the potential to improve outcomes.

  • adolescent health
  • child abuse
  • health services research

Data availability statement

No data are available. Data were collected by staff members with honorary contracts at the respective trusts. The small numbers and unique characteristics of patients involved mean there is a risk of being able to identify the patients from the raw data. We are therefore unable to share the collected data due to risk of identification.

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Data availability statement

No data are available. Data were collected by staff members with honorary contracts at the respective trusts. The small numbers and unique characteristics of patients involved mean there is a risk of being able to identify the patients from the raw data. We are therefore unable to share the collected data due to risk of identification.

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Footnotes

  • Twitter @m_heys

  • Presented at Material from this article has been presented at the RCPCH online conference 2020 in two oral presentations, as well as several local presentations. Two abstracts have been published in Archives of Disease in Childhood.

  • Contributors All authors contributed to the article design. AJA carried out the data collection and analyses, with input from JC, MH, PH, AW and SE. All authors contributed to the interpretation of the results. AJA wrote the article. All authors commented on drafts of the article and have approved the final version.

  • Funding AJA is employed by UCL. Research at the UCL Great Ormond Street Institute of Child Health benefits from funding from the Great Ormond Street Hospital Biomedical Research Centre.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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