In a move to address healthcare inequalities faced by people seeking asylum and refugees in Nottingham, the City Council has approved a £684,087 contract to fund a specialised healthcare access service over the next five years.
The programme, set to begin on April 1, 2025, will be funded through the ring-fenced public health grant, at an annual expenditure of £136,817.
New delegated decision documents state that the new service will replace the existing “Into the Mainstream” initiative, which has been operating under Nottingham and Nottinghamshire Refugee Forum (NNRF) for over 12 years. The contract, structured for a 3+2 year period, seeks to offer stability to providers and ensure continued healthcare support to some of the city’s most vulnerable populations.
Healthcare barriers for refugees and asylum seekers
Individuals seeking asylum and those granted refugee status face significant challenges in accessing healthcare services in the UK. These barriers include difficulties in registering with General Practitioners (GPs), language and literacy limitations, financial struggles, and unfamiliarity with the NHS system. Refugees and asylum seekers are known to experience higher rates of communicable diseases and mental health issues, while women often face delayed access to antenatal care, resulting in poorer health outcomes.
The number of asylum seekers in Nottingham has increased in recent years, with the Home Office reporting around 1,500 asylum seekers in the city by December 2023. This figure excludes several thousand recognised refugees and an unknown number of people who have been refused asylum but still require healthcare support. These numbers have been boosted by recent arrivals from Afghanistan and Ukraine, further increasing the pressure on local services.
New approach
The decision to launch a new tendered service comes after a comprehensive review in 2023. The review assessed the support needed for asylum seekers, refugees, and those refused asylum. It included consultations with service users, stakeholders such as the Nottingham Resettlement Team, and other local partners. Surveys conducted in 2020 and August 2023, along with feedback from stakeholder events, provided a deep understanding of the needs and challenges facing this population.
Despite exploring the potential for joint commissioning with neighbouring authorities, changes in local demographics made a collaborative approach unviable. The City Council is now focused on independently procuring a service tailored to Nottingham’s unique needs.
The tender process will be competitive, aiming to secure a high-quality service provider while ensuring value for money. Key Performance Indicators (KPIs) will be developed to monitor the service’s impact, including the number of individuals supported to register with GPs, access to dental services, and the use of translation services. Regular performance reviews will ensure the service can adapt to changing needs and maintain effectiveness.
Rising costs
The increasing cost of delivering services has been a concern, and Nottingham City Council aims to address this by reflecting true service costs in the new contract. While the total approved contract value is £684,087, the council is also exploring potential additional funding from the Home Office’s dispersal scheme grants. Should additional funds become available, they may be incorporated into the existing contract to enhance health outcomes for asylum seekers and refugees.
However, if any new activities diverge significantly from the current service, they may require separate procurement processes.
The newly commissioned service aims to ensure asylum seekers and refugees can navigate the healthcare system, register with local GPs and dentists, make appointments, and access translation services when necessary. The service will also provide support with acquiring HC2 certificates, which entitle people to free prescriptions, dental treatment, and other NHS services.
Beyond immediate healthcare access, the programme is designed to foster resilience and community development. Volunteering opportunities within the service will allow individuals to upskill and improve employability. Additionally, by promoting peer support and health literacy, the service is expected to contribute to broader community well-being. The service will also link refugees and asylum seekers with other agencies for housing assistance and English language learning opportunities, further aiding their integration into society.
