A service evaluation of clinicians’ Signposting of asylum seekers and refugees (ASRs) attending an emergency department in South-West England

Recent changes to health entitlements for asylum seekers and refugees (ASRs) in the UK may exacerbate existing barriers of access to healthcare for ASR patients and lead to greater numbers seeking emergency care. In the city in South-West England where this Formative Service Evaluation took place, there has been an increase in the population of ASR patients living in temporary accommodation and their usage of local health services is expected to increase. This Formative Service Evaluation evaluated clinicians' assessment and signposting of ASRs attending an Emergency Department in South-west England, by assessing three identified components of the service. It informed interventions that were then developed to improve the service. A mixed-methods survey was used to evaluate the service, whereby clinicians manage and signpost care for ASRs attending the Emergency Department. Purposive sampling was used to recruit 50 participants, including 30 medical and 20 nursing staff. Quantitative survey data was analysed using descriptive statistical analysis and qualitative data was analysed using conventional content analysis. This evaluation points at some inconsistencies of knowledge of ASRs health entitlements within the service; suboptimal practice of understanding and acting on barriers to ASRs' access to emergency service, and limited knowledge of local services available for ASR patients. Understanding the factors and circumstances affecting challenges to service provision to ASRs is important in developing strategies to improve this service.