General Health
Definitions
What is the NHS?
To understand the healthcare system in the UK you first need to know about the NHS. The NHS stands for the National Health Service, this is a publicly funded service that offers free care.
In all four nations of the UK, refugees and asylum seekers with an active application or appeal are fully entitled to free NHS care, in the same way as any other patient. People whose application for asylum has been rejected may still have access to free NHS services. You can check if you are entitled to free care by clicking the button below:
What is a General Practitioner (GP)?
The general practitioner (GP) is the “family doctor”. The GP is the first point of contact for all non-emergency healthcare needs and to access the NHS. The GP treats all common medical conditions and can refer patients to hospitals and other medical services for urgent or specialist treatment. Your GP will have an important role in looking after you in your home and within the community where you live.
It may be scary going to the doctors but this is nothing to be frightened of, it is very normal to visit your GP surgery in the UK. If you have concerns about your appointment you should be able to discuss this with them.
To see a GP in the UK, you will usually go to a doctor’s office, often called a GP surgery. Everyone has a right to register with a GP. You do not need proof of address, immigration status, ID or an NHS number, although you may be asked for them to track your medical records. GP services are never chargeable.
You can find lots of different videos and materials, translated into many different languages here on how to access your GP surgery and what to expect from appointments.
Doctors of the World Access Card
You may find it helpful to have an ‘access card’ explaining your right to access a GP and that you may need help filling in forms, reading and understanding English. Doctors of the World have created this to help people be aware of their rights and ensure they are able to communicate them and get the assistance they need. You can click the button below to download your own access card.
Doctors of the World also have a number of resources translated into many languages and feature advice on oral health, on keeping young people healthy, on wellbeing guidance and on navigating the NHS and the right to healthcare. You can find all the translated guides by clicking here.
Arrival medical practice
Arrival medical practice in Stockton also provide tailored services for asylum seekers and refugees, which includes mental health and wellbeing support. The Red Cross also offer appointments at Arrival every Wednesday and offer various services such as emotional support. If you would like more information you can visit their website using the button below.
What is Primary Care?
Primary care means healthcare in the community, it is usually the first point of contact in the healthcare system. Primary health includes: access to a GP, dental treatment, eyesight tests, family planning services, prescriptions and some mental health services.
There are also a number of resources to improve access to primary care for refugees and asylum seekers that have been translated by refugee council into a number of languages, to enable fair access to health treatment. You can access them here
What is A&E?
Accident and emergency (A&E) departments offer access 24 hours a day, 365 days a year.
Medical staff are highly trained in all aspects of emergency medicine and they deal with genuine, life threatening emergencies.
You can call 999 for emergency services in the event of a serious medical emergency. You can call 111 if you want non-urgent medical advice. Both lines are free to use no matter who you are, or where you are.
What is Secondary Care?
Secondary care tends to be hospital care and describes the sort of services you might be referred to if you need to be seen by someone with more specialist knowledge. Secondary health care includes: services mainly based in a hospital or clinic, specialist doctor, physiotherapist or dieticians.
For secondary health services you may need a HC2 certificate, as discussed above, more detail can be found below in our ‘Looking after your Health’ guide here.
Can I Access Secondary Care?
If you have (Pre-)Settled Status, you will be entitled to secondary care but you may be asked to provide proof of (Pre-)Settled Status and that you are settled in the UK (you can show rental agreement/bills/letters from school). If you do not have a status, or a HC2 certificate, you will be charged 150% of the tariff for any secondary care service received.
Professional interpreting in your preferred language should always be offered if you are struggling with language barriers for any NHS appointments.
Advice on healthcare entitlements
Free advice is available to the public/professionals from Doctors of the World’s national helpline: 020 75157534 (10am to 12pm, Mon to Fri). Outside of these times you can e-mail: clinic@doctorsoftheworld.org.uk
Screening Programmes
Screening programmes are very important to get a picture of your overall health. There are several tests you might be asked to undertake to make sure you are fit and well. These include screening programmes for infectious diseases like Tuberculosis (often referred to as TB), malaria and typhoid. Screening programmes are not only important for your overall health but also for the health of others and preventing the spread of diseases in the UK, particularly when people have come from countries where these are more common.
In some countries, screening programmes for infectious diseases, such as hepatitis B and C, and HIV, may not be easily accessible, or people may not seek testing due to fear of stigma or lack of treatment options. In the UK, medical records are confidential, and any positive result regarding your health will not negatively affect your asylum application. This information is not shared with the Home Office unless you give permission to do so.
You may be asked to provide samples to check for communicable diseases, like TB, or parasitic infections, like Strongyloidiasis. These samples will often be a blood test, but various other swabs, samples and tests may be needed to check your health. You may also be offered a sexual health screening, this is nothing to worry about but it is important if you are or have ever been sexually intimate with anyone else. It will involve some samples and swabs, some of which you may be able to complete yourself. If you need to provide any swabs or samples for a screening your doctor will explain why it is important.
Vaccinations
Vaccines are important because they protect against serious disease and help your body’s immune system create antibodies to fight the diseases. Vaccines protect the community and help stop the spread of diseases, making it less likely to experience an outbreak in the community and to reduce the risk of death by eliminating and reducing the spread.
You might have had limited access to health care in your home country, you might have missed important vaccinations or may not have had any vaccinations ever. This is nothing to worry about and your doctor will know which vaccines you need if you have missed any. This is the same for your children and depending on their age they may be offered different vaccines.
Chronic Conditions
Chronic conditions mean a long-term health issue that can’t be cured but can be managed through either one or a mix of medication, lifestyle changes and stress management. Chronic conditions can include things like Asthma, Arthritis, Diabetes, High Blood Pressure. Chronic conditions can also include badly healed injuries that not cause disruption or pain.
For people migrating to the UK these conditions may be poorly controlled, this could be for a number of reasons but may include things such as poor access to medical treatment and check-ups in the first place, or not being able to keep up medication on the journey to the UK, due to cost or access.
Stress through the journey of coming to the UK and the ability to live a healthy, balanced life at this time could also be contributing factor’s for worsening chronic conditions. You should notify your GP of any changes that you have noticed in your body and they will generally check things like your blood pressure, your heart or your breathing at appointments to ensure any chronic conditions are picked up and advice can be given to manage them.
Opticians
An optician is a professional that looks at your eyes and eyesight, they are an important part of healthcare as monitoring eye conditions can help prevent vision loss, it can help improve your quality of life by improving your sight and it can also help detect other health conditions like diabetes or high cholesterol.
The length of an eye exam can vary depending on your needs, but it usually takes between 30 minutes and an hour. During an eye exam at an optician, you can expect the following to happen:
- The optician will ask you questions about your general health, lifestyle, vision, and any glasses you wear. They may also ask about any recent medical events or life changes.
- The optician will test your eyesight at near and far distances, and how your eyes focus between the two. They may use lights and lenses to estimate your prescription and check for near-sightedness, farsightedness, or astigmatism. They may also use an auto-refractor machine to measure your eyes’ ability to focus.
- The optician may also use a scan to examine the layers of your retina.
To prepare for your appointment, you can: bring any glasses you’re currently wearing, write down any questions you have and make a list of any medications, treatments, or tablets you’re taking.
Dental care
Another important aspect of healthcare is the care and health of your teeth. You might not have previously received any dental care in your home country, or it may have been a long time since you have had a dental appointment. In both cases you may need advice on oral hygiene and prevention, so it is really important to sign up to a dentist.
You do not need to wait for pain or problems to appear before seeing a dentist. Ideally you should see a dentist within your first month of arriving in the UK. Regular dental visits can help to prevent problems and healthcare professionals should provide new migrant patients with information about NHS dental care, entitlements to dental care, and how to find an NHS dentist.
In order to receive dental care, you will need to register with a dentist. This process will likely be similar to registering with a GP. There are currently national shortages of NHS dentists in the UK, so you may find that there is a waiting list for you to register. A list of NHS dentists to sign up to can be found here.
Professional interpreting in your preferred language should always be offered if you are struggling with language barriers.
Diet and exercise
Diet and exercise are both really important in maintaining your overall health, making sure you are a healthy weight will reduce the likelihood of developing heart disease, type 2 diabetes and even some cancers. You may be less active in the UK than when you were back home, and if you eat the same you will put weight on so this is really important to monitor.
Eating too much sugar, salt and fat is bad for our health. It is difficult when you are on a low income as the cheapest foods are often convenience or ‘fast’ foods. These tend to be low in nutritional quality and may contain too much sugar, fat and salt, so you should try to avoid eating them regularly if possible.
Balanced meals with lots of fruit and vegetables ensure your body is getting the right nutrients. Everybody needs different foods in the right amounts, such as starchy food, fruit and vegetables, protein, dairy and fats. What you need depends on how much exercise you do, or if you are ill, or for women, if you are pregnant. Having a balance diet means you have enough fibre, iron and vitamins to help your body function and keep you feeling your best. Drinking enough water is also very important too and should be prioritised over drinks that may contain a lot of sugar or caffeine.
For more information on eating a balanced diet, click the button below for NHS advice. Or for advice on a balanced diet for children and babies through the NENC Healthier Together programme, click here.
Exercising is also very important, it helps you to become stronger physically and mentally and can be really helpful for improving your mental health and wellbeing. Being active is important as physical activity can reduce risk of major illnesses such as cancer, type 2 diabetes and heart disease. Adults should aim for at least 30 minutes of physical activity per day, and children should aim for at least 1 hour per day. You don’t have to take part in a sport or join a club in order to do this, exercise can be any activity that raises your heart rate, makes you breathe faster and feel warmer. This could be dancing, walking, running, swimming or any other sport you enjoy.
Click the button below to read the NHS guidance on exercise
Stopping Smoking
Our lifestyle choices can have a big impact on our health. Smoking is one of those choices, that can contribute to harmful diseases like Lung diseases such as chronic obstructive pulmonary disease (COPD), Heart disease, Cancer, Type 2 Diabetes, harmful reproductive health effects and many other health impacts.
Smoking is extremely damaging to not only the smoker’s health but it can also impact the health of those around them, via second hand smoke. Children are extremely vulnerable to it’s effects and smoking in pregnancy increases risk of miscarriage, premature birth and stillbirth.
To find stop smoking services near you, click here.
Alcohol intake
It’s also very important to watch your alcohol intake if you do drink. Alcohol can have many dangers including: liver disease, heart disease, digestive problems, a weakened immune system, increased risk of Cancer, bone issues and even brain damage.
Alcohol is an addictive substance and it can worsen your mental health so it is important to monitor your use if you find yourself drinking alcohol to ease how you feel emotionally.
For NHS advice on drinking too much alcohol, click here.
Sexual Health
Sexual intercourse is the physical activity of sex between two people, sexuality and sexual experiences are a part of everyone’s life. In the UK it is okay to have a different sexuality and the Solace project can offer guidance and support with LGBTQIA+ asylum seekers and refugees.
It helps to talk about sex with your partner to make sure you are both on the same page. You and your sexual partner should both want and agree to have sex, this is called consent. You should never be forced to have sex or pressure anyone to have sex with you. Anyone can change their mind at any time, that’s okay.
Sexual health clinics can offer you advice to keep you healthy and can offer contraception to avoid pregnancy as well as testing to ensure you have not contracted any sexually transmitted infections. You should consider using a condom during sex to protect yourself from sexually transmitted infections.
There are a number of resources below including sexual services for those under 16, sexual services for young people and NHS advice.
Maternity care and care for women
Care during pregnancy is very important, particularly as research has shown worse outcomes for asylum seeking or refugee women in pregnancy, with common difficulties including malnutrition, poverty, late presentation to healthcare providers and FGM complications.
If you are pregnant it’s important to tell your doctor as soon as you know so they can discuss your options and start maternity care to keep you and your unborn child healthy. It is also important that you attend all healthcare appointments to monitor your health and your baby’s health as much as possible.
Refugees and asylum seekers with an active application or appeal are entitled to free NHS maternity care. If your asylum claim has been refused, you are entitled to free care if you are supported by the Home Office.
If you are unsure whether you will need to pay, get advice straight away. You can find out more from Maternity Action. Maternity care will never be delayed or refused because you cannot pay or have not paid or because there are questions about whether or not you need to pay.
All prescriptions and NHS dental treatment are free while you are pregnant and for 12 months after your baby’s due date. However, you must have a valid maternity exemption certificate (MATEX) before you claim these. You can ask for this from your doctor or midwife. You may also be entitled to help with the costs of travel to your maternity appointments if you have a low income.
If you’re more than 10 weeks pregnant or have a child under four, you may be entitled to get help to buy healthy food and milk through the Healthy Start Scheme, that you can find out more about, here.
You can also find a video guide about giving birth in UK created for refugee’s by Maternity Stream of Sanctuary that includes a lot of important information as well as common worries and questions from people with lived experience. You can also find information from the Refugee Council on maternity care in the UK by clicking on the button below.
Maternity Action also provides free telephone advice to help women get the maternity care they need and on charging (0808 800 0041, Thurs. only 10am-12noon) & email advice at: maternitycareaccess@maternityaction.org.uk
There is lots of helpful advice out there about the Menopause released by Healthwatch Middlesbrough, which can be accessed here. It features lots of accessible guidance, videos, information and specific resources for women who are black, Muslim or for LGBTQIA+ individuals who are experiencing menopause.
Leo’s Amanah Project
Leo’s, the region’s neonatal and baby loss mental health charity, are launching a new space for the ethnic minority communities in Middlesbrough, called the Amanah Project. This is part of The Middlesbrough Family Hubs Initiative and sessions are aimed at mothers and babies within the community, you do not need to have had a loss or a neonatal stay to attend.
The Amanah Project’s ‘Stay & Play Group’ will take place every other Wednesday from February 26th at the Abingdon Family Hub. The group will meet from 10-11:30am, offering a relaxed stay and play environment for mothers to come along regardless of whether you are registered with Leo’s or not. Children are able to play whilst Mothers can enjoy conversations, refreshments, games and craft activities.
The Amanah Project offers culturally informed and sensitive care to help you confidently understand women’s health and the journey of motherhood. For any enquiries about the group, please contact the project lead, Ava by emailing ava@leosneonatal.org or calling 07561104092. Please click the button below to view the Amanah Project flyer.
FGM
FGM stands for female genital mutilation but it is sometimes often referred to as genital cutting. FGM has no health benefits, and it harms girls and women in many ways. It involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls’ and women’s bodies.
Immediate complications can include severe pain, shock, haemorrhage (bleeding), tetanus or sepsis (bacterial infection), urine retention, open sores in the genital region and injury to nearby genital tissue.
Long-term consequences can include:
- the need for later surgeries. For example, the FGM procedure that seals or narrows a vaginal opening (type 3 above) needs to be cut open later to allow for sexual intercourse and childbirth. Sometimes it is stitched again several times, including after childbirth, hence the woman goes through repeated opening and closing procedures, further increasing and repeated both immediate and long-term risks.
- recurrent bladder and urinary tract infections;
- cysts;
- infertility;
- an increased risk of childbirth complications and new-born deaths;
- sexual dysfunction and dyspareunia (painful sexual intercourse)
FGM is found in the UK amongst members of migrant communities, it is estimated that approximately 60,000 girls aged 0-14 were born in England and Wales to mothers who had undergone FGM. UK communities that are most at risk of FGM include Kenyan, Somali, Sudanese, Sierra Leonean, Egyptian, Nigerian and Eritrean. Non-African communities that practise FGM include Afghan, Yemeni, Kurdish, Indonesian and Pakistani.
There are also national specific FGM clinics through the NHS. This is a place for women with FGM to discuss their health needs in a sensitive and non-judgmental environment. The services are provided by an all-female team and can offer emotional support and counselling as well as physical assessment and treatment.
Unfortunately there is not an FGM clinic within the North East, as the nearest one is in Leeds. However, there are a number of support resources that can be accessed via the buttons below:
The NSPCC also have a specific FGM helpline offering advice, information and support to anyone concerned that a child’s welfare is at risk due to FGM. You can access their helpline by calling 0800 028 3550 or emailing help@NSPCC.org.uk
