Swan Practice: proactive interventions for asylum seekers

Overview

The Swan Practice in Buckingham worked to address the new challenges to capacity brought about by the arrival of 146 asylum seekers in a nearby hotel, who needed support to register at the practice and to ensure that their vaccination records were up to date.

Key benefits and outcomes

• Reduced pressure on practice receptionists and on clinical appointments.
• No disease outbreaks occurred at the hotel in the 12 months that asylum seekers were in residence.

What the organisation faced

In October 2023, the Swan Practice, a member of the Swan Primary Care Network in Buckingham, responded to the arrival of 146 asylum seekers in a hotel near one of its member practices. The new residents of the hotel needed support to register at the practice and to ensure that their vaccination records were up to date. Both processes challenged the practice’s capacity and placed additional pressure on staff to support patients new to the country. To meet this emerging need and reduce pressure within the practice, the clinical services manager worked with a small team of administrative and clinical staff to put together a plan to address the new challenges to capacity.

What the organisation did

To meet this emerging need and reduce pressure within the practice, the clinical services manager worked with a small team of administrative and clinical staff to put together a plan to address the new challenges to capacity. The practice established a team which would visit the hotel weekly to register patients and provide interventions from health checks to vaccinations. Within 72 hours, the team was ready to begin a minor illness and injury clinic within the hotel every Monday afternoon. Alongside the clinical services manager, who was also the nursing lead for the team, an administrator, health coach, healthcare assistant, and translator attended the clinics to provide wraparound care.

With the support of the translator, they assessed patients’ vaccination history and established whether they needed catch up immunisations to bring them in line with the UK vaccination schedule. Those patients who needed to be caught up were then booked in for follow ups in the practice. They also offered opportunistic flu and COVID-19 vaccinations to reduce the risk of seasonal outbreaks within the asylum seeker community. Throughout the asylum seekers’ residency in the hotel, the practice team worked with Public Health England to prepare for, and limit the impact of, potential disease outbreaks.

Wider support for the hotel residents was coordinated by a taskforce within the ICB, which connected primary care, the Home Office, ICB and VCSE organisations.

Key benefits and outcomes

The weekly clinics eased pressure at reception, and the combined appointments meant that multiple issues could be addressed in one intervention, saving additional appointments. Moreover, the team worked with local partners, as part of a task group including social care, Home Office, ICB, and primary care PC, voluntary organisations to develop a wider support offer that would help keep patients well and engaged.

Thanks to the efficiency of the practice’s response, no disease outbreaks occurred at the hotel in the 12 months that asylum seekers were in residence.

Overcoming obstacles

• Language barriers: Without the support of translators, the clinical team would have been unable to register or receive consent from patients. Translators from local services were employed to attend the weekly clinics and any follow ups within the practice.
• Cultural differences: The staff had to adapt to the expectations of patients from countries that did not have a national health service and were not used to dealing with a range of practitioners. The weekly clinics helped the team to build trust with their patients and support them to understand how the NHS works.
• Negative public perception: Practice leadership provided support to staff affected by the negative public perception of a dedicated clinic for asylum seekers at a time when many permanent residents were facing waits for services.
• Transient population: The hotel community had a high level of turnover, making it challenging to determine who would be present during clinic times and when patients would be moving on. This improved once the team established a data-sharing arrangement and were granted access to a database that recorded the hotel residents.

Takeaway tip

Positive leadership: The clinical leadership team at Swan Practice embrace positivity and opportunity. Through this example, they were able to generate buy-in from their team and convey the benefits of introducing the new clinics to free up reception capacity and GP appointments. They also encourage their staff, in practice and across the PCN, to be ambassadors for the benefits of vaccination, which has had some influence in positive uptake levels in their local population.