Safe Surgeries opening the door to better refugee care

Being an asylum seeker or a refugee means starting over. It means leaving your family and everything you once knew in hope of sanctuary. Asylum seekers have to navigate an entirely unfamiliar healthcare system which naturally comes with its challenges, such as learning how and where to appropriately access healthcare, and overcoming financial, cultural and language barriers.

This is compounded by an already strained NHS with long wait times for mental health services and for GP appointments due to the ongoing pressures in general practice. Doing this alongside concerns about your asylum claim, poor housing conditions, isolation and separation from your loved ones or not being allowed to work is far from a simple feat.

How to improve refugee care in your GP surgery

Safe Surgeries is an initiative set up by Doctors of the World (DOTW) which aims to tackle some of these barriers through establishing a simple Safe Surgeries framework that GP surgeries can follow in line with NHS policy. One key aspect is to encourage the use of interpreters, where possible, to break down the language barrier, allowing for better communication. Patients with insecure immigration status, such as asylum seekers and undocumented migrants, understandably may have fears around information being shared with the Home Office. Therefore, as a Safe Surgery you are advised not to ask for proof of immigration status, to ensure patient information remains protected, and that frontline staff are able to create a welcoming and reassuring environment.

Having had a four-month GP rotation in a Safe Surgery, I saw first-hand the pressures of primary care and how Safe Surgery practices allow for more effective interactions. I witnessed a GP partner look after a young Venezuelan refugee who was suffering from high blood pressure and stress. The GP partner immediately accessed the interpretation services and was able to swiftly and compassionately proceed with the consultation, amend his blood pressure medications, explain his prescription entitlements and then walked him to our adjacent pharmacy as this was his first encounter in UK primary care. Small changes like this have a significant impact on patient experience and, as a result, health seeking behaviours.

All frontline staff were Language Line trained and were able to successfully register all the newly arrived asylum seekers to the area, improving patient access. 

Working with GPs under pressure in primary care

Of course, we understand the unprecedented pressures GPs and their teams are working under so DOTW can support surgeries to become Safe Surgeries through training, offering resources and posters in different languages and a template registration policy. Many GPs are already following the good practice and the Safe Surgeries guidelines can help provide a level of confidence that the steps they have taken are endorsed by medical leaders in the area of refugee health care.

It is important to remember Safe Surgeries is a framework that supports all marginalised patients, including undocumented migrants, victims of sex trafficking, unhoused patients or sex workers. Additional funding can be provided to support patients of these underserved groups.

Expanding Safe Surgeries in Wales is an aspect of our advocacy work with the Cardiff Refugee Health Project. We aim to empower refugees and asylum seekers to get the care that they deserve and to create a welcoming environment for all patients accessing healthcare. We hope we have inspired you to become a ‘Safe Surgery’ too.

About the writers

A bright portrait of Dr Makeda Kingue Sousseing smiling wearing an orange shirt over a black top.

Dr Makeda Kingue Sousseing

Cardiff Refugee Health Project founder

Dr Makeda Kingue Sousseing is a Foundation Year 2 Doctor based in Bedfordshire Hospital Trust. She is a Cardiff University graduate and intercalated in Population Medicine which sparked her interest in health inequalities. She has worked with charities such as Student Action for Refugees and Make a Smile UK, holding local and national leadership roles. Her experience in the charity sector has made her a passionate advocate for creating a more equitable NHS service. During her final year she started the Cardiff Refugee Health Project that aims to tackle refugee health inequalities in Wales.